SENATE BILL No. 69

 

 

January 28, 2003, Introduced by Senators BRATER, BERNERO, JACOBS and SCHAUER and

     referred to the Committee on Health Policy.

 

 

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill entering into the midwest pharmaceutical compact; and                      

                                                                                

    for related purposes.                                                       

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 1.  The midwest pharmaceutical compact is enacted into                 

                                                                                

2   law and entered into with all jurisdictions legally joining in              

                                                                                

3   the compact, in the form substantially as follows:                          

                                                                                

4                     MIDWEST PHARMACEUTICAL COMPACT                            

                                                                                

5                          ARTICLE I.  PURPOSE                                  

                                                                                

6       The purpose of the midwest pharmaceutical compact shall be                  

                                                                                

7   to provide an enlarged pool for the purchase of pharmaceutical              

                                                                                

8   products and services for all medicaid recipients, publicly                 

                                                                                

9   insured or uninsured health care recipients, and any other                  

                                                                                

10  persons who the commission deems eligible who reside in the                 

                                                                                

11  compacting states that are party to this compact.                           

                                                                                

12  Pharmaceuticals purchased through the compact shall be                      

                                                                                


                                                                                

1   distributed as determined by the commission to medicaid                     

                                                                                

2   recipients, publicly insured and uninsured citizens, and any                

                                                                                

3   other persons deemed eligible who are served by health care                 

                                                                                

4   professionals, public hospitals and clinics, nonprofit hospitals            

                                                                                

5   and clinics, organized emergency departments, or free clinics               

                                                                                

6   within each compacting state.                                               

                                                                                

7                        ARTICLE II.  DEFINITIONS                               

                                                                                

8                                                                                As used in this compact:                                                           

                                                                                

9       (a) "Commission" means the midwest pharmaceutical commission                

                                                                                

10  established by this compact.                                                

                                                                                

11      (b) "Compacting state" means any state or province that has                 

                                                                                

12  enacted the enabling legislation for this compact.                          

                                                                                

13      (c) "Compacting state's delegation" means the 5 resident                    

                                                                                

14  members of the commission from a compacting state.                          

                                                                                

15      (d) "Health care professional" means an individual licensed                 

                                                                                

16  or registered under article 15 of the public health code, 1978 PA           

                                                                                

17  368, MCL 333.16101 to 333.18838, and engaged in the practice of             

                                                                                

18  his or her health profession in a proprietorship, partnership,              

                                                                                

19  professional corporation, or other business entity.  However,               

                                                                                

20  health care professional does not include a sanitarian or a                 

                                                                                

21  veterinarian.                                                               

                                                                                

22      (e) "Pharmaceutical" means any medicinal substance,                         

                                                                                

23  preparation, device, or service recognized by the United States             

                                                                                

24  pharmacopoeia and national formulary, or any revision thereof,              

                                                                                

25  any substance and preparation dispensed pursuant to a                       

                                                                                

26  prescription issued by an authorized health care practitioner and           

                                                                                

27  intended for external and internal use in the cure, diagnosis,              

                                                                                


                                                                                

1   mitigation, treatment, or prevention of disease in humans, and              

                                                                                

2   any substance and preparation other than food intended to affect            

                                                                                

3   the structure or any function of the human body.  Pharmaceutical            

                                                                                

4   includes any drug delivery system, testing kit, or any other                

                                                                                

5   supplies dispensed pursuant to a prescription.                              

                                                                                

6       (f) "State" means any state of the United States, the                       

                                                                                

7   District of Columbia, and any other territory of the United                 

                                                                                

8   States.                                                                     

                                                                                

9                      ARTICLE III.  THE COMMISSION                             

                                                                                

10      (1) The compacting states hereby create the midwest                         

                                                                                

11  pharmaceutical commission.  The commission shall be a public body           

                                                                                

12  corporate of each compacting state.  The commission shall serve             

                                                                                

13  as the negotiating and purchasing entity for pharmaceutical                 

                                                                                

14  products for the compacting states.  The commission shall have              

                                                                                

15  all the responsibilities, powers, and duties set forth herein,              

                                                                                

16  including the power to sue and be sued, and any additional powers           

                                                                                

17  that may be conferred upon it by subsequent action of the                   

                                                                                

18  respective legislatures of the compacting states in accordance              

                                                                                

19  with the terms of this compact.                                             

                                                                                

20      (2) The commission shall consist of 5 resident members of                   

                                                                                

21  each compacting state as follows:                                           

                                                                                

22      (a) The governor or minister or his or her designee who                     

                                                                                

23  shall serve during the tenure of office of the governor or                  

                                                                                

24  minister.                                                                   

                                                                                

25      (b) One legislator from each chamber who shall serve 2-year                 

                                                                                

26  terms and be appointed by the appropriate appointing authority in           

                                                                                

27  each chamber of the legislature.                                            

                                                                                


                                                                                

1       (c) One member at large from the health care profession who                 

                                                                                

2   shall be appointed by the governor or minister.                             

                                                                                

3       (d) One member at large who shall be a layperson appointed                  

                                                                                

4   by the governor or minister.                                                

                                                                                

5       (3) One of the 2 at-large members initially appointed in                    

                                                                                

6   each state shall serve a 2-year term.  The other, and any                   

                                                                                

7   regularly appointed successor to either at-large member, shall              

                                                                                

8   serve a 4-year term unless otherwise established by law in a                

                                                                                

9   compacting state.  All vacancies shall be filled in the same                

                                                                                

10  manner as the original appointment and in accordance with the               

                                                                                

11  laws of the appointing state.  Any member appointed to fill the             

                                                                                

12  vacancy shall serve until the end of the incomplete term.                   

                                                                                

13      (4) The commission shall select annually, from among its                    

                                                                                

14  members, a chairperson, a vice-chairperson, and a treasurer.                

                                                                                

15      (5) The commission shall appoint an executive director who                  

                                                                                

16  shall serve at its pleasure and who shall act as secretary to the           

                                                                                

17  commission.  The treasurer, the executive director, and other               

                                                                                

18  personnel that the commission may determine shall be bonded in              

                                                                                

19  any amount required by the commission.                                      

                                                                                

20      (6) The commission shall meet at least once each calendar                   

                                                                                

21  year.  The chairperson may call additional meetings and, upon the           

                                                                                

22  request of a majority of the commission members of the compacting           

                                                                                

23  states, shall call additional meetings.  Public notice shall be             

                                                                                

24  given of all meetings and meetings shall be open to the public.             

                                                                                

25      (7) Each compacting state represented at any meeting of the                 

                                                                                

26  commission is entitled to 1 vote.  Each compacting state's                  

                                                                                

27  delegation shall appoint 1 member of the delegation as its voting           

                                                                                


                                                                                

1   member with the authority to vote on behalf of that compacting              

                                                                                

2   state and represent the position of that compacting state in all            

                                                                                

3   matters before the commission.  A majority of the voting members            

                                                                                

4   from the compacting states shall constitute a quorum for the                

                                                                                

5   transaction of business, unless a larger quorum is required by              

                                                                                

6   the bylaws of the commission.  Within each compacting state, a              

                                                                                

7   proxy may be assigned to another member of that compacting                  

                                                                                

8   state's delegation.                                                         

                                                                                

9            ARTICLE IV.  POWERS AND DUTIES OF THE COMMISSION                   

                                                                                

10      (1) The commission shall adopt a seal and suitable bylaws                   

                                                                                

11  governing its management and operations.                                    

                                                                                

12      (2) Irrespective of the civil service, personnel, or other                  

                                                                                

13  merit system laws of any of the compacting states, the commission           

                                                                                

14  in its bylaws shall provide for the personnel policies and                  

                                                                                

15  programs of the compact.                                                    

                                                                                

16      (3) The commission shall submit a budget to the governor and                

                                                                                

17  legislature of each compacting state as may be required by each             

                                                                                

18  compacting state.  The budget shall contain specific                        

                                                                                

19  recommendations of the amount or amounts to be appropriated by              

                                                                                

20  each of the compacting states.                                              

                                                                                

21      (4) The commission shall report annually to the governor and                

                                                                                

22  legislature of each compacting state concerning the activities of           

                                                                                

23  the commission during the preceding year.  The reports shall                

                                                                                

24  include any recommendations that may have been adopted by the               

                                                                                

25  commission.                                                                 

                                                                                

26      (5) The commission may borrow, accept, or contract for the                  

                                                                                

27  services of personnel from any state, province, the United                  

                                                                                


                                                                                

1   States, Canada or any subdivision or agency thereof, any                    

                                                                                

2   interstate agency, or any institution, foundation, person, firm,            

                                                                                

3   or corporation.                                                             

                                                                                

4       (6) The commission may accept for any of its purposes and                   

                                                                                

5   functions under the compact any donations, grants, or both, of              

                                                                                

6   money, equipment, supplies, materials, and services from any                

                                                                                

7   state, province, the United States, Canada, or any subdivision or           

                                                                                

8   agency thereof, any interstate agency, or any institution,                  

                                                                                

9   foundation, person, firm, or corporation and may receive,                   

                                                                                

10  utilize, and dispose of the same.                                           

                                                                                

11      (7) The commission may establish and maintain offices that                  

                                                                                

12  are located within 1 or more of the compacting states.                      

                                                                                

13      (8) The commission may establish committees and hire staff                  

                                                                                

14  as necessary to carry out its functions.                                    

                                                                                

15      (9) The commission may provide for actual and necessary                     

                                                                                

16  expenses for attendance of its members at official meetings of              

                                                                                

17  the commission or its designated committees.                                

                                                                                

18               ARTICLE V.  ACTIVITIES OF THE COMMISSION                       

                                                                                

19      (1) The commission shall determine the pharmaceutical needs                 

                                                                                

20  of each compacting state.  The commission shall negotiate                   

                                                                                

21  pharmaceutical prices from each pharmaceutical company that seeks           

                                                                                

22  to provide pharmaceuticals for the formularies for all states and           

                                                                                

23  provinces in the compact.  The prices negotiated shall be at                

                                                                                

24  least as low to all compacting states as the lowest price to the            

                                                                                

25  individual state or province entering the compact.                          

                                                                                

26      (2) The commission shall be empowered to establish an open                  

                                                                                

27  formulary for all of the compacting states or to designate which,           

                                                                                


                                                                                

1   if any, pharmaceuticals shall be preauthorized for use within the           

                                                                                

2   compact.  The commission shall not exclude from its formulary any           

                                                                                

3   product of any pharmaceutical company that has entered into                 

                                                                                

4   agreement with the commission.                                              

                                                                                

5       (3) The commission may enter into agreements with any of the                

                                                                                

6   compacting states to provide pharmaceutical supplies and services           

                                                                                

7   to any of the other compacting states, provided that the price is           

                                                                                

8   less than that negotiated by the commission.                                

                                                                                

9       (4) The commission shall, after negotiations with interested                

                                                                                

10  parties and the compacting states, determine the costs of                   

                                                                                

11  providing pharmaceuticals for use in its agreements.  The                   

                                                                                

12  compacting states shall contribute appropriated funds not                   

                                                                                

13  otherwise provided, as determined by the commission, for carrying           

                                                                                

14  out the agreements.  The commission may also serve as the                   

                                                                                

15  administrative and fiscal agent in carrying out agreements for              

                                                                                

16  pharmaceutical services.                                                    

                                                                                

17                         ARTICLE VI.  FINANCE                                 

                                                                                

18      (1) Each compacting state shall be individually responsible                 

                                                                                

19  for the purchase of the pharmaceuticals necessary to meet the               

                                                                                

20  demand of its state.                                                        

                                                                                

21      (2) The monies necessary to finance the general operation of                

                                                                                

22  the commission not otherwise provided for in carrying forth its             

                                                                                

23  duties, responsibilities, and powers as stated herein shall be              

                                                                                

24  appropriated to the commission by the compacting states, when               

                                                                                

25  authorized by the respective legislatures, by equal apportionment           

                                                                                

26  among the compacting states.                                                

                                                                                

27      (3) The commission shall keep accurate accounts of all                      

                                                                                


                                                                                

1   receipts and disbursements.  The receipts and disbursements of              

                                                                                

2   the commission shall be subject to the audit and accounting                 

                                                                                

3   procedures established under its bylaws.  The receipts and                  

                                                                                

4   disbursements of the commission shall also be subject to audit by           

                                                                                

5   the official legislative auditor general or similar entity of any           

                                                                                

6   compacting state.  However, all receipts and disbursements of               

                                                                                

7   funds handled by the commission shall be audited annually by a              

                                                                                

8   certified or licensed public accountant and the report of the               

                                                                                

9   audit shall be included in and become part of the annual report             

                                                                                

10  of the commission.                                                          

                                                                                

11      (4) The accounts of the commission shall be open at any                     

                                                                                

12  reasonable time for inspection by duly authorized representatives           

                                                                                

13  of the compacting states and persons authorized by the                      

                                                                                

14  commission.                                                                 

                                                                                

15        ARTICLE VII.  ELIGIBLE PARTIES AND ENTRY INTO COMPACT                 

                                                                                

16      (1) The states of Illinois, Indiana, Kansas, Minnesota,                     

                                                                                

17  Michigan, Missouri, Nebraska, North Dakota, Ohio, and Wisconsin             

                                                                                

18  and the Province of Ontario, Canada, shall be eligible to become            

                                                                                

19  party to this compact.  Additional states will be eligible if               

                                                                                

20  approved by a majority of the compacting states.                            

                                                                                

21      (2) As to any eligible state or province, this compact shall                

                                                                                

22  become effective when its legislature shall have enacted the same           

                                                                                

23  into law.  However, the compact shall not become effective unless           

                                                                                

24  enacted into law by 3 states prior to December 31, 2004.                    

                                                                                

25      (3) Amendments to the compact shall become effective upon                   

                                                                                

26  their enactment by the legislature of each compacting state.                

                                                                                

27         ARTICLE VIII.  WITHDRAWAL, DEFAULT, AND TERMINATION                  

                                                                                


                                                                                

1       (1) Any compacting state may withdraw from this compact by                  

                                                                                

2   enacting a statute repealing the compact.  A withdrawing state or           

                                                                                

3   province shall be liable for any obligations that it may have               

                                                                                

4   incurred on account of its party status up to the effective date            

                                                                                

5   of withdrawal, except that if the withdrawing state has                     

                                                                                

6   specifically undertaken or committed itself to any performance of           

                                                                                

7   an obligation extending beyond the effective date of withdrawal,            

                                                                                

8   it shall remain liable to the extent of the obligation.                     

                                                                                

9       (2) If any compacting state shall default in the performance                

                                                                                

10  of its obligations, assumed or imposed, in accordance with the              

                                                                                

11  provisions of this compact, all rights, privileges, and benefits            

                                                                                

12  conferred by this compact or agreements under this compact shall            

                                                                                

13  be suspended from the effective date of the default as fixed by             

                                                                                

14  the commission.  The commission shall stipulate the conditions              

                                                                                

15  and maximum time for compliance under which the defaulting state            

                                                                                

16  or province may resume its regular status.  Unless the default              

                                                                                

17  shall be remedied under the stipulations and within the time                

                                                                                

18  period set forth by the commission, this compact may be                     

                                                                                

19  terminated with respect to the defaulting state or province by              

                                                                                

20  affirmative vote of a majority of the other members to the                  

                                                                                

21  compact.  Any defaulting state may be reinstated by performing              

                                                                                

22  all acts and obligations as stipulated by the commission.                   

                                                                                

23              ARTICLE IX.  SEVERABILITY AND CONSTRUCTION                      

                                                                                

24      The provisions of the compact entered into under this act                   

                                                                                

25  shall be severable and if any phrase, clause, sentence, or                  

                                                                                

26  provision of the compact is declared to be contrary to the                  

                                                                                

27  constitution of any compacting state or province or of the United           

                                                                                


                                                                                

1   States or Canada or the applicability thereof to any government,            

                                                                                

2   agency, person, or circumstance is held invalid, the validity of            

                                                                                

3   the remainder of this compact and the applicability of the                  

                                                                                

4   compact to any government, agency, person, or circumstance shall            

                                                                                

5   not be affected thereby.  If this compact entered into under this           

                                                                                

6   act shall be held contrary to the constitution of any compacting            

                                                                                

7   state or province, the compact shall remain in full force and               

                                                                                

8   effect as to the remaining compacting states and in full force              

                                                                                

9   and effect as to the compacting state affected as to all                    

                                                                                

10  severable matters.  The provisions of this compact shall be                 

                                                                                

11  liberally construed to effectuate the purposes of this act.