Am J Hosp Pharm. 1991 Jan;48(1):114-7.
Provisions of the federal Omnibus Budget Reconciliation Act of 1990 that are designed to control federal and state outlays for prescription drugs by requiring rebates from drug manufacturers to state Medicaid programs are described, and their potential effects on pharmacy practice in organized health-care settings are discussed. As of January 1, 1991, for a manufacturer's drug product line to be eligible for any coverage under Medicaid, the manufacturer must provide rebates to all state Medicaid programs. Health maintenance organizations are exempt from the law. Hospitals that dispense outpatient drugs to Medicaid patients under a formulary system and that bill Medicaid not more than purchase costs are exempt. The law requires no immediate action by hospitals and other organized care settings; action may be required when provisions of the law concerning drug-use review programs and patient counseling become effective. If a state enters a rebate agreement, its Medicaid plan must permit coverage of all of a manufacturer's prescription drug products, but the law does not affect formulary systems of individual health-care institutions. Formulary issues, the scope of hospital exemption, and pharmacist participation in DUR activities and patient counseling need to be clarified as state Medicaid plans are amended to comply with the law; pharmacists in organized health-care settings can best influence these changes through action at the state level.
描述了1990年联邦综合预算协调法案中的条款，这些条款旨在通过要求药品制造商向州医疗补助计划提供回扣来控制联邦和州在处方药方面的支出，并讨论了它们对有组织的医疗保健机构中药房业务的潜在影响。截至1991年1月1日，制造商的药品产品线要获得医疗补助计划的任何承保资格，制造商必须向所有州医疗补助计划提供回扣。健康维护组织不受该法律约束。根据处方集系统向医疗补助患者配发门诊药品且向医疗补助收费不超过采购成本的医院可获豁免。该法律不要求医院和其他有组织的护理机构立即采取行动；当法律中有关药物使用审查计划和患者咨询的条款生效时，可能需要采取行动。如果一个州达成回扣协议，其医疗补助计划必须允许承保制造商的所有处方药产品，但该法律不影响个别医疗机构的处方集系统。随着州医疗补助计划为遵守该法律而进行修订，处方集问题、医院豁免范围以及药剂师参与药物使用审查活动和患者咨询等问题需要得到澄清；有组织的医疗保健机构中的药剂师可以通过在州一级采取行动来最好地影响这些变化。
