205.564 Pharmacy and Therapeutics Advisory Committee -- Membership -- Duties
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/ky/205-564A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
-- Information posted on Web site -- Recommendations -- Presentations by
interested parties -- Appeals -- Administrative regulations.
(1)The Pharmacy and Therapeutics Advisory Committee is established and attached to
the Department for Medicaid Services for administrative purposes.
(2)The committee shall have fifteen
(15)members, as follows:
(a)Thirteen
(13)voting members who shall be physicians currently participating
in the Medicaid program who may legally prescribe a broad range of
scheduled and nonscheduled drugs, as categorized by the U.S. Drug
Enforcement Administration, or pharmacists who dispense prescriptions to
Medicaid recipients, as follows:
1. Three
(3)licensed, practicing family practice physicians;
2. Two
(2)licensed, practicing physicians who are pediatricians;
3. One
(1)licensed, practicing physician who is an
obstetrician/gynecologist or gynecologist;
4. One
(1)licensed, practicing internal medicine physician who is a
primary care provider;
5. One
(1)licensed, practicing physician from any medical specialty;
6. Two
(2)licensed, practicing physicians who are psychiatrists, one
who is a practicing psychiatrist in a community mental health center and
one
(1)from either the School of Medicine, University of Louisville, or
the College of Medicine, University of Kentucky; and
7. Three
(3)licensed, practicing pharmacists; and
(b)Two
(2)nonvoting members, as follows:
1. The medical director of the department; and
2. A representative of the department's pharmacy program, as designated
by the commissioner.
(3)One
(1)voting committee member shall be appointed, and may be reappointed, by
the Governor from a list of three
(3)nominees received from the President of the
Senate, and one
(1)voting committee member shall be appointed, and may be
reappointed, by the Governor from a list of three
(3)nominees received from the
Speaker of the House of Representatives. The remaining eleven
(11)voting
committee members shall be appointed, and may be reappointed, by the Governor
from a list of nominees submitted by the department. Terms of the voting
committee members shall be three
(3)years with no members serving more than
two
(2)consecutive terms, except that a member may continue to serve his or her
term until a successor is appointed.
(4)The Pharmacy and Therapeutics Advisory Committee shall:
(a)Act in an advisory capacity to the Governor, the secretary of the Cabinet for
Health and Family Services, and the Medicaid commissioner on the
development and administration of an outpatient drug formulary;
(b)Perform drug reviews and make recommendations to the commissioner
regarding specific drugs or drug classes to be placed on prior authorization or
otherwise restricted, as determined through a process established by the
cabinet;
(c)Provide for an appeals process to be utilized by a person or entity that
disagrees with recommendations of the committee;
(d)Establish bylaws or rules for the conduct of committee meetings; and
(e)Function in accordance with the Kentucky Open Meetings Law and the
Kentucky Open Records Law.
(5)Voting members of the committee shall elect a chair and vice chair by majority
vote. A quorum shall consist of eight
(8)voting members of the committee.
(6)The committee shall meet every other month for a total of at least six
(6)times per
calendar year or upon the call of the chair, the commissioner, the secretary of the
Cabinet for Health and Family Services, or the Governor. The Department for
Medicaid Services shall post the agenda on its Web site no later than fourteen
days prior to the date of a regularly scheduled meeting and no later than seventy-two
(72)hours prior to the date of a specially called meeting. Options, including any
recommendations, by the department for drug review or drug review placement
shall be posted on the department's Web site no later than seven
(7)days prior to the
date of the next regularly scheduled meeting and as soon as practicable prior to the
date of the next specially called meeting.
(7)Members of the committee shall receive no compensation for service, but shall
receive necessary and actual travel expenses associated with attending meetings.
(8)Any recommendation of the committee to the commissioner shall be posted to the
Web site of the Department for Medicaid Services within seven
(7)days of the date
of the meeting at which the recommendation was made.
(9)A recommendation of the committee shall be submitted to the commissioner for a
final determination. If the commissioner does not accept the recommendation of the
committee, the commissioner shall present the basis for the final determination at
the next scheduled meeting of the committee. The commissioner shall act on the
committee's recommendation within thirty
(30)days of the date that the
recommendation was posted on the Web site.
(10)Any interested party may request and may be permitted to make a presentation to
the board on any item under consideration by the board. The Cabinet for Health and
Family Services shall, by administrative regulation promulgated under KRS Chapter
13A, establish requirements for any presentation made to the board.
(11)The commissioner's final determination shall be posted on the Web site of the
Department for Medicaid Services.
(12)Any appeal from a decision of the commissioner shall be made in accordance with
KRS Chapter 13B, except that the time for filing an appeal shall be within thirty
(30)days of the date of the posting of the commissioner's final determination on the
Web site of the Department for Medicaid Services.
(13)The Cabinet for Health and Family Services shall promulgate an administrative regulation in accordance with KRS Chapter 13A to implement the provisions of this section.