KRS 205.564: Pharmacy and Therapeutics Advisory Committee -- Membership -- Duties

-- 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 M edicaid 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 physicia n 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 (1)

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 c ommittee 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 mak e 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 p erson 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 memb ers 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 th e 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 (14)

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 r equest 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 promulg ate an administrative

regulation in accordance with KRS Chapter 13A to implement the provisions of this

section.