Title 48 — Foods and Drugs.

The Council finds that: (1) Affordability is critical in providing access to prescription drugs for District of Columbia residents. (2) AccessRx enables the District to take steps to make prescription drugs more affordable for qualified District residents, thereby increasing the …

For the purposes of this chapter, the term: (1) “AccessRx” means the District of Columbia AccessRx program established by § 48-831.03. (2) “Average wholesale price” means the wholesale price charged for a specific commodity that is assigned by the drug wholesaler and is listed in…

(a) AccessRx is hereby established. AccessRx shall be administered by the Department, which shall utilize, among other things, manufacturer rebates, pharmacy discounts, and aggregate purchasing to reduce prescription drug prices. In addition, the Department shall investigate the …

The Department shall make every effort to reduce and contain the cost of prescription drugs purchased for publicly funded pharmaceutical assistance programs, including D.C. Medicaid, the D.C. Health Care Alliance, and the Department of Mental Health. These efforts shall include m…

A drug manufacturer or labeler that sells prescription drugs in the District through any publicly funded pharmaceutical assistance program shall enter into a rebate agreement with the Department under AccessRx. The rebate agreement shall require the manufacturer or labeler to mak…

(a) The Director of the Department shall negotiate the amount of the rebate required from a manufacturer or labeler in accordance with this subchapter. (b) The Director shall take into consideration the rebate calculated under the Medicaid Rebate Program pursuant to section 1927 …

(a) Participating retail pharmacies shall submit claims to the Department to verify the amount charged to qualified residents and to receive reimbursement. (b) The Department shall not impose transaction charges on participating retail pharmacies that submit claims or receive pay…

(a)(1) Upon receipt of the data from the Department, the manufacturer or labeler shall calculate the quarterly payment. If a discrepancy is discovered, the Department may, at its expense, hire a mutually agreed-upon independent auditor to verify the manufacturer’s calculation. If…

(a) The names of manufacturers and labelers who do and do not enter into rebate agreements pursuant to this subchapter are public information. The Department shall release this information to health care providers and the public on a regular basis. The Department also shall publi…

(a) The AccessRx Fund is established as a nonlapsing, dedicated fund, into which shall be deposited revenue from manufacturers and labelers that pay rebates pursuant to this subchapter and any appropriations or allocations designated for the AccessRx Fund, along with accruing int…

The Department shall: (1) Establish simplified procedures for determining eligibility and issuing AccessRx enrollment cards to qualified residents; (2) Undertake outreach efforts to build public awareness of AccessRx and maximize enrollment of qualified residents; and (3) Adjust …

The method of prescribing or ordering drugs may include, but is not limited to, the use of standard or larger prescription refill sizes in order to minimize operational costs and maximize economy. Unless the prescribing physician indicates otherwise, the use of the lowest cost ge…

The Department may contract with one or more third parties to administer any or all components of AccessRx, including outreach, eligibility, claims, administration, and rebate recovery and redistribution.

The Department may seek any waivers of federal law, rule or regulation necessary to implement the provisions of this chapter.

The Department shall submit a written report on the enrollment and financial status of AccessRx to the Council by the 2nd week of January each year.

The District may negotiate and enter into purchasing alliances and regional strategies with the governments of other jurisdictions, and with other public and private entities, for the purpose of reducing prescription drug prices for residents of the District.

The Mayor is authorized to issue any rules necessary to implement the provisions of this subchapter.

(a) The Department shall conduct a program to provide low-cost prescription and nonprescription drugs, medications, and medical supplies to low-income elderly individuals (“AccessRx for low-income elderly”). (b) The Director shall provide sufficient personnel to ensure efficient …

To be eligible, an individual shall: (1) Be a resident of the District; (2) Be at least 62 years of age; and (3) Have a household income that is not more than 200% of the federal poverty level.

(a) The Director shall establish the amount of payment to be made by eligible low-income elderly individuals toward the cost of prescription or nonprescription drugs, medications, and medical supplies furnished under AccessRx for low-income elderly; provided, that: (1) The total …

The Department shall conduct a program to negotiate low-cost prescription and nonprescription drugs, medications, and medical supplies for uninsured District residents (“AccessRx for uninsured”). The Director shall provide sufficient personnel to ensure efficient administration o…

To be eligible, an individual shall: (1) Be a resident of the District; (2) Have a household income that is not more than 350% of the federal poverty level; and (3) Not be enrolled in any public or private medical insurance program.

(a) Any participating retail pharmacy that sells prescription drugs covered by a rebate agreement pursuant to § 48-831.05 shall discount the retail price of those drugs sold to uninsured qualified residents. (b) The Department shall establish discounted prices for drugs covered b…

The Department shall conduct a program to provide life saving prescription and nonprescription medications and medical supplies by enrolling eligible individuals into pharmaceutical assistance programs. Of the funds appropriated for the Department of Health for fiscal year 2006, …

(a) To be eligible, an individual shall: (1) Be a resident of the District; (2) Have a household income not exceeding 300% of the federal poverty level; and (3) Lack prescription coverage. (b) Eligibility shall be determined by the contract organization administering the program.…

(a) A pharmacy benefits manager owes a fiduciary duty to a covered entity and shall discharge that duty in accordance with all applicable laws. In performance of that duty, a pharmacy benefits manager shall adhere to the practices set forth in this section. (b)(1) A pharmacy bene…

Compliance with the requirements of this subchapter is required in all contracts between a pharmacy benefits manager and a covered entity entered into in the District of Columbia or by a covered entity in the District of Columbia executed after May 18, 2004.

A violation of this subchapter is a violation of Chapter 39 of Title 28, for which a fine of not more than $10,000 may be adjudged.

A manufacturer or labeler of prescription drugs dispensed in the District that employs, directs, or utilizes marketing representatives in the District shall report marketing costs for prescription drugs in the District. These marketing costs shall be reported to the Department fo…

By July 1st of each year, a manufacturer or labeler of prescription drugs that directly or indirectly distributes prescription drugs for dispensation to residents of the District shall file a report with the Department in the form and manner provided by the Department. The report…

(a) Except as provided in subsection (b) of this section, the annual report filed pursuant to § 48-833.02 shall include the following information as it pertains to marketing activities conducted within the District in a form that provides the value, nature, purpose, and recipient…

By November 30th of each year, the Department shall provide an annual report, providing information in aggregate form, on prescription drug marketing expenses to the Council and the Corporation Counsel. By January 1, 2005, and every 2 years thereafter, the Department shall provid…

Notwithstanding any provision of law to the contrary, information submitted to the Department pursuant to this subchapter is confidential and is not a public record. Data compiled in aggregate form by the Department for the purposes of reporting required by this subchapter is a p…

This subchapter may be enforced in a civil action brought by the Corporation Counsel. A manufacturer or labeler that fails to provide a report as required by this subchapter commits a civil violation for which a fine of $1,000 plus costs and attorney’s fees may be adjudged.

The Mayor is authorized to issue any rules necessary to implement the provisions of this subchapter.

The Department shall report to the committee of the Council having jurisdiction over health and human services matters on or before January 1, 2005 and on or before July 1, 2005 on the assessment of fees on manufacturers and labelers of prescription drugs.

This subchapter shall apply as of July 1, 2004.