Missouri § 208.227 - Multiple prescriptions, case management and surveillance programs to be established — rulemaking authority — state plan amendments and waivers.

§ 208.227. Multiple prescriptions, case management and surveillance programs to be established — rulemaking authority — state plan amendments and waivers.

1.  The division shall establish a pharmaceutical case management or polypharmacy program for high risk MO HealthNet participants with numerous or multiple prescribed drugs.  The division shall also establish a behavioral health pharmacy and opioid surveillance program to encourage the use of best medical evidence-supported prescription practices.  The division shall communicate with providers, as such term is defined in section 208.164, whose prescribing practices deviate from or do not otherwise utilize best medical evidence-supported prescription practices.  The communication may be telemetric, written, oral, or some combination thereof.  These programs shall be established and administered through processes established and supported under a memorandum of understanding between the department of mental health and the department of social services, or their successor entities.

2.  The provisions of this section shall not prohibit the division from utilizing clinical edits to ensure clinical best practices, including, but not limited to:

(1)  Drug safety and avoidance of harmful drug interactions;

(2)  Compliance with nationally recognized and juried clinical guidelines from national medical associations using medical evidence and emphasizing best practice principles;

(3)  Detection of patients receiving prescription drugs from multiple prescribers; and

(4)  Detection, prevention, and treatment of substance use disorders.

3.  The department of social services may promulgate rules and regulations to implement the provisions of this section.  Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.  This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2017, shall be invalid and void.

4.  The department shall submit such state plan amendments and waivers to the Centers for Medicare and Medicaid Services of the federal Department of Health and Human Services as the department determines are necessary to implement the provisions of this section.

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(L. 2007 S.B. 577 § 2, A.L. 2017 S.B. 139, A.L. 2021 H.B. 432)

---- end of effective  28 Aug 2021 ----

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