REPRESENTATIVES Hagan, Miller, Allen, Barrett, Beatty, Calvert, Clancy, Core, C. Evans, Faber, Flowers, Hartnett, Hughes, Husted, Jerse, S. Patton, T. Patton, Peterson, Raga, Schlichter, Schmidt, Strahorn, Trakas, Ujvagi, Wilson

To amend sections 127.16 and 2921.13 and to enact

1

sections 5110.01, 5110.02, 5110.03, 5110.05,

2

5110.07 to 5110.19, 5110.21, 5110.22, 5110.23,

3

5110.25, 5110.26, 5110.27, 5110.28, 5110.29,

4

5110.32, 5110.33, 5110.35, 5110.351, 5110.352,

5

5110.353, 5110.354, 5110.36 to 5110.40, 5110.45 to

6

5110.51, 5110.55 to 5110.59, and 5110.99 of the

7

Revised Code to create the Ohio's Best Rx Program

8

and to make an appropriation.

9

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 127.16 and 2921.13 be amended and	10
sections 5110.01, 5110.02, 5110.03, 5110.05, 5110.07, 5110.08,	11
5110.09, 5110.10, 5110.11, 5110.12, 5110.13, 5110.14, 5110.15,	12
5110.16, 5110.17, 5110.18, 5110.19, 5110.21, 5110.22, 5110.23,	13
5110.25, 5110.26, 5110.27, 5110.28, 5110.29, 5110.32, 5110.33,	14
5110.35, 5110.351, 5110.352, 5110.353, 5110.354, 5110.36, 5110.37,	15
5110.38, 5110.39, 5110.40, 5110.45, 5110.46, 5110.47, 5110.48,	16
5110.49, 5110.50, 5110.51, 5110.55, 5110.56, 5110.57, 5110.58,	17
5110.59, and 5110.99 of the Revised Code be enacted to read as	18
follows:	19

Sec. 127.16.  (A) Upon the request of either a state agency	20
or the director of budget and management and after the controlling	21
board determines that an emergency or a sufficient economic reason	22
exists, the controlling board may approve the making of a purchase	23
without competitive selection as provided in division (B) of this	24
section.	25

(B) Except as otherwise provided in this section, no state	26
agency, using money that has been appropriated to it directly,	27
shall:	28

(1) Make any purchase from a particular supplier, that would	29
amount to fifty thousand dollars or more when combined with both	30
the amount of all disbursements to the supplier during the fiscal	31
year for purchases made by the agency and the amount of all	32
outstanding encumbrances for purchases made by the agency from the	33
supplier, unless the purchase is made by competitive selection or	34
with the approval of the controlling board;	35

(2) Lease real estate from a particular supplier, if the	36
lease would amount to seventy-five thousand dollars or more when	37
combined with both the amount of all disbursements to the supplier	38
during the fiscal year for real estate leases made by the agency	39
and the amount of all outstanding encumbrances for real estate	40
leases made by the agency from the supplier, unless the lease is	41
made by competitive selection or with the approval of the	42
controlling board.	43

(C) Any person who authorizes a purchase in violation of	44
division (B) of this section shall be liable to the state for any	45
state funds spent on the purchase, and the attorney general shall	46
collect the amount from the person.	47

(D) Nothing in division (B) of this section shall be	48
construed as:	49

(1) A limitation upon the authority of the director of	50
transportation as granted in sections 5501.17, 5517.02, and	51
5525.14 of the Revised Code;	52

(2) Applying to medicaid provider agreements under Chapter	53
5111. of the Revised Code or payments or provider agreements under	54
the disability medical assistance program established under	55
Chapter 5115. of the Revised Code;	56

(3) Applying to the purchase of examinations from a sole	57
supplier by a state licensing board under Title XLVII of the	58
Revised Code;	59

(4) Applying to entertainment contracts for the Ohio state	60
fair entered into by the Ohio expositions commission, provided	61
that the controlling board has given its approval to the	62
commission to enter into such contracts and has approved a total	63
budget amount for such contracts as agreed upon by commission	64
action, and that the commission causes to be kept itemized records	65
of the amounts of money spent under each contract and annually	66
files those records with the clerk of the house of representatives	67
and the clerk of the senate following the close of the fair;	68

(5) Limiting the authority of the chief of the division of	69
mineral resources management to contract for reclamation work with	70
an operator mining adjacent land as provided in section 1513.27 of	71
the Revised Code;	72

(6) Applying to investment transactions and procedures of any	73
state agency, except that the agency shall file with the board the	74
name of any person with whom the agency contracts to make, broker,	75
service, or otherwise manage its investments, as well as the	76
commission, rate, or schedule of charges of such person with	77
respect to any investment transactions to be undertaken on behalf	78
of the agency. The filing shall be in a form and at such times as	79
the board considers appropriate.	80

(7) Applying to purchases made with money for the per cent	81
for arts program established by section 3379.10 of the Revised	82
Code;	83

(8) Applying to purchases made by the rehabilitation services	84
commission of services, or supplies, that are provided to persons	85
with disabilities, or to purchases made by the commission in	86
connection with the eligibility determinations it makes for	87
applicants of programs administered by the social security	88
administration;	89

(9) Applying to payments by the department of job and family	90
services under section 5111.13 of the Revised Code for group	91
health plan premiums, deductibles, coinsurance, and other	92
cost-sharing expenses;	93

(10) Applying to any agency of the legislative branch of the	94
state government;	95

(11) Applying to agreements or contracts entered into under	96
section 5101.11, 5101.20, 5101.201, 5101.21, or 5101.214 of the	97
Revised Code;	98

(12) Applying to purchases of services by the adult parole	99
authority under section 2967.14 of the Revised Code or by the	100
department of youth services under section 5139.08 of the Revised	101
Code;	102

(13) Applying to dues or fees paid for membership in an	103
organization or association;	104

(14) Applying to purchases of utility services pursuant to	105
section 9.30 of the Revised Code;	106

(15) Applying to purchases made in accordance with rules	107
adopted by the department of administrative services of motor	108
vehicle, aviation, or watercraft fuel, or emergency repairs of	109
such vehicles;	110

(16) Applying to purchases of tickets for passenger air	111
transportation;	112

(17) Applying to purchases necessary to provide public	113
notifications required by law or to provide notifications of job	114
openings;	115

(18) Applying to the judicial branch of state government;

116

(19) Applying to purchases of liquor for resale by the	117
division of liquor control;	118

(20) Applying to purchases of motor courier and freight	119
services made in accordance with department of administrative	120
services rules;	121

(21) Applying to purchases from the United States postal	122
service and purchases of stamps and postal meter replenishment	123
from vendors at rates established by the United States postal	124
service;	125

(22) Applying to purchases of books, periodicals, pamphlets,	126
newspapers, maintenance subscriptions, and other published	127
materials;	128

(23) Applying to purchases from other state agencies,	129
including state-assisted institutions of higher education;	130

(24) Limiting the authority of the director of environmental	131
protection to enter into contracts under division (D) of section	132
3745.14 of the Revised Code to conduct compliance reviews, as	133
defined in division (A) of that section;	134

(25) Applying to purchases from a qualified nonprofit agency	135
pursuant to sections 4115.31 to 4115.35 of the Revised Code;	136

(26) Applying to payments by the department of job and family	137
services to the United States department of health and human	138
services for printing and mailing notices pertaining to the tax	139
refund offset program of the internal revenue service of the	140
United States department of the treasury;	141

(27) Applying to contracts entered into by the department of	142
mental retardation and developmental disabilities under sections	143
5123.18, 5123.182, and 5123.199 of the Revised Code;	144

(28) Applying to payments made by the department of mental	145
health under a physician recruitment program authorized by section	146
5119.101 of the Revised Code;	147

(29) Applying to contracts entered into with persons by the	148
director of commerce for unclaimed funds collection and remittance	149
efforts as provided in division (F) of section 169.03 of the	150
Revised Code. The director shall keep an itemized accounting of	151
unclaimed funds collected by those persons and amounts paid to	152
them for their services.	153

(30) Applying to purchases made by a state institution of	154
higher education in accordance with the terms of a contract	155
between the vendor and an inter-university purchasing group	156
comprised of purchasing officers of state institutions of higher	157
education;	158

(31) Applying to the department of job and family services'	159
purchases of health assistance services under the children's	160
health insurance program part I provided for under section 5101.50	161
of the Revised Code or the children's health insurance program	162
part II provided for under section 5101.51 of the Revised Code;	163

(32) Applying to payments by the attorney general from the	164
reparations fund to hospitals and other emergency medical	165
facilities for performing medical examinations to collect physical	166
evidence pursuant to section 2907.28 of the Revised Code;	167

(33) Applying to contracts with a contracting authority or	168
administrative receiver under division (G)(2) of section 5126.055	169
of the Revised Code;	170

(34) Applying to reimbursements paid to the United States	171
department of veterans affairs for pharmaceutical and patient	172
supply purchases made on behalf of the Ohio veterans' home agency;	173

(35) Applying to agreements the department of job and family	174
services enters into with terminal distributors of dangerous drugs	175
under section 5110.12 of the Revised Code.	176

(E) Notwithstanding division (B)(1) of this section, the	177
cumulative purchase threshold shall be seventy-five thousand	178
dollars for the departments of mental retardation and	179
developmental disabilities, mental health, rehabilitation and	180
correction, and youth services.	181

(F) When determining whether a state agency has reached the	182
cumulative purchase thresholds established in divisions (B)(1),	183
(B)(2), and (E) of this section, all of the following purchases by	184
such agency shall not be considered:	185

(1) Purchases made through competitive selection or with	186
controlling board approval;	187

(2) Purchases listed in division (D) of this section;

188

(3) For the purposes of the thresholds of divisions (B)(1)	189
and (E) of this section only, leases of real estate.	190

(G) As used in this section, "competitive selection,"	191
"purchase," "supplies," and "services" have the same meanings as	192
in section 125.01 of the Revised Code.	193

Sec. 2921.13.  (A) No person shall knowingly make a false	194
statement, or knowingly swear or affirm the truth of a false	195
statement previously made, when any of the following applies:	196

(1) The statement is made in any official proceeding.

197

(2) The statement is made with purpose to incriminate	198
another.	199

(3) The statement is made with purpose to mislead a public	200
official in performing the public official's official function.	201

(4) The statement is made with purpose to secure the payment	202
of unemployment compensation; Ohio works first; prevention,	203
retention, and contingency benefits and services; disability	204
financial assistance; retirement benefits; economic development	205
assistance, as defined in section 9.66 of the Revised Code; or	206
other benefits administered by a governmental agency or paid out	207
of a public treasury.	208

(5) The statement is made with purpose to secure the issuance	209
by a governmental agency of a license, permit, authorization,	210
certificate, registration, release, or provider agreement.	211

(6) The statement is sworn or affirmed before a notary public	212
or another person empowered to administer oaths.	213

(7) The statement is in writing on or in connection with a	214
report or return that is required or authorized by law.	215

(8) The statement is in writing and is made with purpose to	216
induce another to extend credit to or employ the offender, to	217
confer any degree, diploma, certificate of attainment, award of	218
excellence, or honor on the offender, or to extend to or bestow	219
upon the offender any other valuable benefit or distinction, when	220
the person to whom the statement is directed relies upon it to	221
that person's detriment.	222

(9) The statement is made with purpose to commit or	223
facilitate the commission of a theft offense.	224

(10) The statement is knowingly made to a probate court in	225
connection with any action, proceeding, or other matter within its	226
jurisdiction, either orally or in a written document, including,	227
but not limited to, an application, petition, complaint, or other	228
pleading, or an inventory, account, or report.	229

(11) The statement is made on an account, form, record,	230
stamp, label, or other writing that is required by law.	231

(12) The statement is made in connection with the purchase of	232
a firearm, as defined in section 2923.11 of the Revised Code, and	233
in conjunction with the furnishing to the seller of the firearm of	234
a fictitious or altered driver's or commercial driver's license or	235
permit, a fictitious or altered identification card, or any other	236
document that contains false information about the purchaser's	237
identity.	238

(13) The statement is made in a document or instrument of	239
writing that purports to be a judgment, lien, or claim of	240
indebtedness and is filed or recorded with the secretary of state,	241
a county recorder, or the clerk of a court of record.	242

(14) The statement is made with purpose to obtain an Ohio's	243
best Rx program enrollment card under section 5110.09 of the	244
Revised Code or a payment from the department of job and family	245
services under section 5110.17 of the Revised Code.	246

(B) No person, in connection with the purchase of a firearm,	247
as defined in section 2923.11 of the Revised Code, shall knowingly	248
furnish to the seller of the firearm a fictitious or altered	249
driver's or commercial driver's license or permit, a fictitious or	250
altered identification card, or any other document that contains	251
false information about the purchaser's identity.	252

(C) It is no defense to a charge under division (A)(4) of	253
this section that the oath or affirmation was administered or	254
taken in an irregular manner.	255

(D) If contradictory statements relating to the same fact are	256
made by the offender within the period of the statute of	257
limitations for falsification, it is not necessary for the	258
prosecution to prove which statement was false but only that one	259
or the other was false.	260

(E)(1) Whoever violates division (A)(1), (2), (3), (4), (5),	261
(6), (7), (8), (10), (11), or (13), or (14) of this section is	262
guilty of falsification, a misdemeanor of the first degree.	263

(2) Whoever violates division (A)(9) of this section is	264
guilty of falsification in a theft offense. Except as otherwise	265
provided in this division, falsification in a theft offense is a	266
misdemeanor of the first degree. If the value of the property or	267
services stolen is five hundred dollars or more and is less than	268
five thousand dollars, falsification in a theft offense is a	269
felony of the fifth degree. If the value of the property or	270
services stolen is five thousand dollars or more and is less than	271
one hundred thousand dollars, falsification in a theft offense is	272
a felony of the fourth degree. If the value of the property or	273
services stolen is one hundred thousand dollars or more,	274
falsification in a theft offense is a felony of the third degree.	275

(3) Whoever violates division (A)(12) or (B) of this section	276
is guilty of falsification to purchase a firearm, a felony of the	277
fifth degree.	278

(F) A person who violates this section is liable in a civil	279
action to any person harmed by the violation for injury, death, or	280
loss to person or property incurred as a result of the commission	281
of the offense and for reasonable attorney's fees, court costs,	282
and other expenses incurred as a result of prosecuting the civil	283
action commenced under this division. A civil action under this	284
division is not the exclusive remedy of a person who incurs	285
injury, death, or loss to person or property as a result of a	286
violation of this section.	287

Sec. 5110.01.  As used in this chapter:

288

(A) "Administrative fee" means the amount specified in rules	289
adopted under division (G) of section 5110.35 of the Revised Code.	290

(B) "Children's health insurance program" means the	291
children's health insurance program part I and part II established	292
under sections 5101.50 to 5101.5110 of the Revised Code.	293

(C) "Disability medical assistance program" means the program	294
established under section 5115.10 of the Revised Code.	295

(D) "Medicaid" means the medical assistance program	296
established under Chapter 5111. of the Revised Code.	297

(E) "National drug code number" means the number registered	298
for a drug pursuant to the listing system established by the	299
United States food and drug administration under the "Drug Listing	300
Act of 1972," 86 Stat. 559, 21 U.S.C. 360, as amended.	301

(F) "Ohio's best Rx program administrator" means the entity,	302
if any, the department of job and family services contracts with	303
pursuant to section 5110.10 of the Revised Code to perform	304
administrative functions of the Ohio's best Rx program and to	305
offer the mail order system through which Ohio's best Rx program	306
participants may obtain drugs by mail.	307

(G) "Ohio's best Rx program applicant" or "applicant" means	308
an individual who signs an application for the Ohio's best Rx	309
program and submits it to the department of job and family	310
services, or the Ohio's best Rx program administrator, for a	311
determination of eligibility for the program.	312

(H) "Ohio's best Rx program participant" or "participant"	313
means an individual determined eligible for the Ohio's best Rx	314
program and included under a valid Ohio's best Rx program	315
enrollment card.	316

(I) "Ohio's best Rx program price" means the price a	317
participating terminal distributor is to charge an Ohio's best Rx	318
program participant for a drug included in the Ohio's best Rx	319
program as determined under section 5110.14 of the Revised Code.	320
"Ohio's best Rx program price" does not include either of the	321
following:	322

(1) The amount of the professional fee, if any, the	323
participating terminal distributor adds to the Ohio's best Rx	324
program price pursuant to an agreement under section 5110.12 of	325
the Revised Code;	326

(2) The amount of the administrative fee, if any, the	327
department of job and family services reports to the participating	328
terminal distributor under section 5110.29 of the Revised Code.	329

(J) "Participating manufacturer" means a drug manufacturer	330
participating in the Ohio's best Rx program pursuant to a rebate	331
agreement.	332

(K) "Participating terminal distributor" means a terminal	333
distributor of dangerous drugs participating in the Ohio's best Rx	334
program pursuant to an agreement entered into with the department	335
of job and family services under section 5110.12 of the Revised	336
Code.	337

(L) "Per unit price," with regard to a state health benefit	338
plan or state retirement system health benefit plan, means the	339
total amount paid to a terminal distributor of dangerous drugs	340
under a state health benefit plan or state retirement system	341
health benefit plan for one unit of a drug covered by the plan,	342
after the plan discounts or otherwise reduces the amount to be	343
paid to the terminal distributor. "Per unit price" includes both	344
of the following:	345

(1) The amount that the state health benefit plan or state	346
retirement system health benefit plan, or other government entity	347
or person authorized to make the payment on behalf of the plan,	348
pays to the terminal distributor of dangerous drugs;	349

(2) The amount that the beneficiary of the state health	350
benefit plan or state retirement system health benefit plan pays	351
to the terminal distributor of dangerous drugs in the form of a	352
copayment, coinsurance, or other cost-sharing charge.	353

(M) "Per unit rebate," with regard to a state health benefit	354
plan or state retirement system health benefit plan, means all	355
rebates, discounts, formulary fees, administrative fees, and other	356
allowances a drug manufacturer pays to the plan, or other	357
government entity or person authorized to receive all or part of	358
such payments, for a drug during a calendar year, divided by the	359
total number of units of that drug dispensed under the plan during	360
the same calendar year.	361

(N) "Rebate administration percentage" means the percentage	362
specified in rules adopted under division (K) of section 5110.35	363
of the Revised Code.	364

(O) "Rebate agreement" means an agreement under section	365
5110.21 of the Revised Code between the department of job and	366
family services and a drug manufacturer.	367

(P) "State health benefit plan" means a program of health	368
care benefits offered through the Ohio med preferred provider	369
organization, or a successor entity selected by the state, to	370
which either of the following apply:	371

(1) It is provided by a collective bargaining agreement	372
authorized by division (A)(4) of section 4117.03 of the Revised	373
Code.	374

(2) It is offered by the department of administrative	375
services to state employees in accordance with section 124.81 or	376
124.82 of the Revised Code.	377

(Q) "State retirement system" means all of the following: the	378
public employees retirement system, state teachers retirement	379
system, school employees retirement system, Ohio police and fire	380
pension fund, and state highway patrol retirement system.	381

(R) "State retirement system health benefit plan" means a	382
plan of health care benefits offered by a state retirement system	383
under section 145.58, 742.45, 3307.39, 3309.69, or 5505.28 of the	384
Revised Code.	385

(S) "Terminal distributor of dangerous drugs" has the same	386
meaning as in section 4729.01 of the Revised Code.	387

(T) "Third-party payer" has the same meaning as in section	388
3901.38 of the Revised Code.	389

(U) "Trade secret" has the same meaning as in section 1333.61	390
of the Revised Code.	391

(V) "Usual and customary charge" means the amount a	392
participating terminal distributor or the Ohio's best Rx program	393
administrator charges for a drug included in the program to an	394
individual who does not receive a discounted price for the drug	395
pursuant to any drug discount program, including the Ohio's best	396
Rx program, a prescription drug discount card program established	397
under section 173.061 of the Revised Code, or a pharmacy	398
assistance program established by any person or government entity,	399
and for whom no third-party payer or program funded in whole or	400
part with state or federal funds is responsible for all or part of	401
the cost of the drug the distributor dispenses to the individual.	402

Sec. 5110.02.  There is hereby established the Ohio's best Rx	403
program. Except as provided in section 5110.10 of the Revised	404
Code, the department of job and family services shall administer	405
the program.	406

Sec. 5110.03.  (A) Except as provided in division (B) of this	407
section, a drug shall be included in the Ohio's best Rx program if	408
the drug is covered by a state health benefit plan or state	409
retirement system health benefit plan or is covered by a rebate	410
agreement entered into under section 5110.21 of the Revised Code.	411

(B) The department of job and family services may exclude	412
from the program a drug covered by a state health benefit plan or	413
state retirement system health benefit plan if the plan receives a	414
rebate for the drug from the manufacturer but the drug is not	415
covered by a rebate agreement entered into under section 5110.21	416
of the Revised Code.	417

Sec. 5110.05. (A) To be eligible for the Ohio's best Rx	418
program, an individual must meet all of the following requirements	419
at the time of application or reapplication for the program:	420

(1) Be a resident of this state;

421

(2) Have family income, as determined under rules adopted	422
pursuant to section 5110.35 of the Revised Code, that does not	423
exceed two hundred fifty per cent of the federal poverty	424
guidelines, as revised annually by the United States department of	425
health and human services in accordance with section 673(2) of the	426
"Omnibus Budget Reconciliation Act of 1981," 95 Stat. 511, 42	427
U.S.C. 9902, as amended, or be sixty years of age or older;	428

(3) Not have outpatient prescription drug coverage paid for	429
in whole or in part by any of the following:	430

(a) A third-party payer;

431

(b) The medicaid program;

432

(c) The children's health insurance program;

433

(d) The disability medical assistance program;

434

(e) Another health plan or pharmacy assistance program that	435
uses state or federal funds to pay part or all of the cost of the	436
individual's outpatient prescription drugs, other than a	437
prescription drug discount card program established under section	438
173.061 of the Revised Code.	439

(4) Not have had outpatient prescription drug coverage	440
specified in division (A)(3) of this section during any of the	441
four months preceding the month in which the application or	442
reapplication for the Ohio's best Rx program is made, unless any	443
of the following applies:	444

(a) The individual is sixty years of age or older.

445

(b) The third-party payer that paid all or part of the	446
coverage filed for bankruptcy under federal bankruptcy laws.	447

(c) The individual is no longer eligible for coverage	448
provided through a retirement plan subject to protection under the	449
"Employee Retirement Income Security Act of 1974," 88 Stat. 832,	450
29 U.S.C. 1001, as amended.	451

(d) The individual is no longer eligible for the medicaid	452
program, children's health insurance program, or disability	453
medical assistance program.	454

(B) Application and annual reapplication for the Ohio's best	455
Rx program shall be made in accordance with rules adopted under	456
section 5110.35 of the Revised Code on a form prescribed in those	457
rules. An individual may apply or reapply on behalf of the	458
individual and the individual's spouse and children. The guardian	459
or custodian of an individual may apply or reapply on behalf of	460
the individual.	461

Sec. 5110.07.  The department of job and family services	462
shall provide each applicant for the Ohio's best Rx program	463
information about the medicaid program in accordance with rules	464
adopted under section 5110.35 of the Revised Code. The information	465
shall include general eligibility requirements, application	466
procedures, and benefits. The information shall also explain the	467
ways in which the medicaid program's drug benefits are better than	468
the Ohio's best Rx program.	469

Sec. 5110.08. On receipt of applications and annual	470
reapplications, the department of job and family services shall	471
make eligibility determinations for the Ohio's best Rx program in	472
accordance with procedures established in rules adopted under	473
section 5110.35 of the Revised Code. Each determination that an	474
individual is eligible is valid for one year beginning on a date	475
determined in accordance with the eligibility determination	476
procedures. The beginning date may not precede the date on which	477
the individual's eligibility is determined. Annual reapplication	478
may be made under division (B) of section 5110.05 of the Revised	479
Code if the individual seeks to continue to participate in the	480
program after the date eligibility would otherwise end.	481

An eligibility determination under this section may not be	482
appealed under Chapter 119., section 5101.35, or any other	483
provision of the Revised Code.	484

Sec. 5110.09.  The department of job and family services	485
shall issue Ohio's best Rx program enrollment cards to or on	486
behalf of individuals determined eligible to participate. One	487
enrollment card may cover each member of a family determined	488
eligible to participate. The card is valid only during the period	489
each individual covered by the card is eligible to participate.	490
The card shall be presented to a participating terminal	491
distributor each time a drug included in the program is purchased	492
under the program.	493

Sec. 5110.10. Subject to section 5110.11 of the Revised Code,	494
the department of job and family services may contract with a	495
person to be the Ohio's best Rx program administrator.	496

The Ohio's best Rx program administrator shall do all of the	497
following:	498

(A) Perform any duty this chapter gives the department that	499
the department specifies in the contract, other than adoption of	500
rules under sections 5110.35 and 5110.36 of the Revised Code and	501
employment of an ombudsperson under section 5110.40 of the Revised	502
Code;	503

(B) Subject to division (P) of section 5110.35 of the Revised	504
Code, offer the mail order system through which Ohio's best Rx	505
program participants may obtain drugs;	506

(C) Charge an Ohio's best Rx program participant for each	507
drug included in the program an amount not exceeding the Ohio's	508
best Rx program price as determined under section 5110.14 of the	509
Revised Code plus the administrative fee described in division (F)	510
of section 5110.12 of the Revised Code, if any.	511

Sec. 5110.11. Before entering into a contract under section	512
5110.10 of the Revised Code with a person to be the Ohio's best Rx	513
program administrator, the department of job and family services	514
shall issue a request for proposals from persons seeking to be	515
considered. The department shall develop a process which it shall	516
use in issuing the request for proposals, receiving responses to	517
the request, and evaluating the responses on a competitive basis.	518
In accordance with that process, the department shall select the	519
person to be awarded the contract.	520

Sec. 5110.12.  A terminal distributor of dangerous drugs may	521
enter into an agreement with the department of job and family	522
services to participate in the Ohio's best Rx program for purposes	523
of dispensing drugs. Before entering into an agreement with a	524
terminal distributor, the department shall provide the terminal	525
distributor with a formula that allows the terminal distributor to	526
calculate the price of each drug included in the program, a	527
statistically valid sampling of drug prices that includes the	528
prices of not less than two branded and two generic drugs from	529
each category of drugs included in the program, and the current	530
Ohio's best Rx program price for each drug included in the	531
program.	532

An agreement entered into under this section shall do all of	533
the following:	534

(A) Except as provided in division (C) of this section, be in	535
effect for not less than one year;	536

(B) Specify the dates that the agreement is to begin and end;

537

(C) Permit the participating terminal distributor to	538
terminate the agreement before the date the agreement would	539
otherwise end as specified pursuant to division (B) of this	540
section by providing the department notice of early termination at	541
least thirty days before the effective date of the early	542
termination;	543

(D) Require that the participating terminal distributor	544
charge an Ohio's best Rx program participant for each drug	545
included in the program the lesser of (1) the sum of the Ohio's	546
best Rx program price as determined under section 5110.14 of the	547
Revised Code, the professional fee under division (E) of this	548
section, if any, and the administrative fee under division (F) of	549
this section, if any, or (2) the terminal distributor's usual and	550
customary charge;	551

(E) Permit the participating terminal distributor to add to	552
the Ohio's best Rx program price a professional fee in an amount	553
not to exceed, except as provided in rules adopted under section	554
5110.35 of the Revised Code, three dollars;	555

(F) Require the participating terminal distributor to add to	556
the Ohio's best Rx program price an administrative fee, in an	557
amount determined in accordance with rules adopted under section	558
5110.35 of the Revised Code, for each transaction in which a	559
quantity of the drug is dispensed if an administrative fee is	560
required by those rules;	561

(G) Require the participating terminal distributor to	562
disclose to each participant the amount the participant saves	563
under the program as determined in accordance with section 5110.15	564
of the Revised Code;	565

(H) Require the participating terminal distributor to submit	566
a claim to the department under section 5110.16 of the Revised	567
Code for each sale of a drug to a participant;	568

(I) Permit the participating terminal distributor to deliver	569
drugs to Ohio's best Rx program participants by mail.	570

Sec. 5110.13. The department of job and family services may	571
not prohibit a terminal distributor of dangerous drugs from	572
participating in any other program the department administers on	573
the basis that the terminal distributor has not entered into an	574
agreement under section 5110.12 of the Revised Code.	575

No entity under contract with the department under section	576
5110.10 of the Revised Code may prohibit a terminal distributor of	577
dangerous drugs from participating in a program or network the	578
entity administers or operates on the basis that the terminal	579
distributor has not entered into an agreement under section	580
5110.12 of the Revised Code.	581

Sec. 5110.14.  The Ohio's best Rx program price for a drug	582
included in the program, as described in section 5110.03 of the	583
Revised Code, shall be determined by multiplying the number of	584
units of the drug a participating terminal distributor dispenses	585
to a participant by whichever of the following is applicable:	586

(A) If the drug is not subject to a rebate agreement entered	587
into under section 5110.21 of the Revised Code, the amount	588
computed under division (A)(1) or (2) of section 5110.27 of the	589
Revised Code, as applicable;	590

(B) If the drug is subject to a rebate agreement entered into	591
under section 5110.21 of the Revised Code, the amount computed	592
under division (C) of section 5110.27 of the Revised Code.	593

Sec. 5110.15. The amount that an Ohio's best Rx program	594
participant saves under the program on a transaction for a drug	595
included in the program shall be determined by subtracting the sum	596
of the following from the usual and customary charge for that	597
quantity of the drug the participating terminal distributor or	598
Ohio's best Rx program administrator dispenses to the participant:	599

(A) The Ohio's best Rx program price multiplied by the number	600
of units of the drug dispensed;	601

(B) The professional fee, if any, the distributor or	602
administrator is permitted to charge pursuant to an agreement	603
under section 5110.12 of the Revised Code or a contract under	604
section 5110.10 of the Revised Code;	605

(C) The administrative fee, if any, the department of job and	606
family services reports to the distributor or administrator under	607
section 5110.29 of the Revised Code.	608

Sec. 5110.16. A participating terminal distributor or the	609
Ohio's best Rx program administrator shall submit a claim to the	610
department of job and family services for each drug dispensed to	611
an Ohio's best Rx program participant not later than thirty days	612
after the drug is dispensed. The claim shall be submitted in	613
accordance with the electronic method provided for in rules	614
adopted under section 5110.35 of the Revised Code.	615

The claim shall specify all of the following:

616

(A) The prescription number of the participant's prescription	617
under which the drug is dispensed to the participant;	618

(B) The name of, and national drug code number for, the drug	619
dispensed to the participant;	620

(C) The number of units of the drug dispensed to the	621
participant;	622

(D) The amount the distributor or administrator charged the	623
participant for the drug;	624

(E) The date that the distributor or administrator dispensed	625
the drug to the participant;	626

(F) Any additional information required by rules adopted	627
under section 5110.35 of the Revised Code.	628

Sec. 5110.17. (A) In accordance with rules adopted under	629
section 5110.35 of the Revised Code and subject to section 5110.19	630
of the Revised Code, the department of job and family services	631
shall pay a participating terminal distributor or the Ohio's best	632
Rx program administrator for complete and timely claims for drugs	633
included in the program that are covered by a rebate agreement	634
entered into under section 5110.21 of the Revised Code. The	635
payment for a complete and timely claim shall be made by a date	636
that is not later than two weeks after the claim is received by	637
the department.	638

(B) Subject to division (D) of this section, the amount to be	639
paid for a claim shall be determined as follows:	640

(1) Multiply the rebate amount for the national drug code	641
number for the drug for which the claim is made, as agreed to	642
under division (B)(4)(a) of section 5110.21 of the Revised Code or	643
computed under division (B) of section 5110.27 of the Revised	644
Code, as applicable, by the number of units of the drug dispensed	645
to the Ohio's best Rx program participant;	646

(2) If an administrative fee was charged, for each	647
transaction in which a quantity of the drug was dispensed,	648
subtract from the amount computed under division (B)(1) of this	649
section the administrative fee amount specified in rules adopted	650
under section 5110.35 of the Revised Code.	651

(C) The department may combine claims from a participating	652
terminal distributor or the administrator to make aggregate	653
payments under this section to the distributor or administrator.	654

(D) If the total of the amounts computed under division (B)	655
of this section for any period for which payments are due is a	656
negative number, the terminal distributor or administrator has	657
been overpaid for claims submitted under section 5110.16 of the	658
Revised Code. When there is an overpayment, the department shall	659
reduce future payments to the terminal distributor or	660
administrator under this section or collect an amount from the	661
terminal distributor or administrator sufficient to reimburse the	662
department for the overpayment.	663

Sec. 5110.18.  Neither the department of job and family	664
services nor the Ohio's best Rx program administrator may charge a	665
participating terminal distributor for the submission or	666
processing of a claim under sections 5110.16 and 5110.17 of the	667
Revised Code.	668

Sec. 5110.19. The department of job and family services may	669
not make a payment under section 5110.17 of the Revised Code for a	670
claim submitted under section 5110.16 of the Revised Code if any	671
of the following are the case:	672

(A) The claim is submitted by a terminal distributor of	673
dangerous drugs that is neither a participating terminal	674
distributor nor the Ohio's best Rx program administrator.	675

(B) The claim is for a drug that is not included in the	676
program.	677

(C) The claim is for a drug included in the program but the	678
drug is dispensed to an individual who is not covered by a valid	679
Ohio's best Rx program enrollment card.	680

(D) A person or government entity has paid the participating	681
terminal distributor or the administrator through any other	682
prescription drug coverage program or prescription drug discount	683
program for dispensing the drug, unless the payment is	684
reimbursement for redeeming a coupon or is an amount directly paid	685
by a drug manufacturer to the terminal distributor for dispensing	686
drugs to residents of a long-term care facility.	687

Sec. 5110.21.  (A) A drug manufacturer may enter into a	688
rebate agreement with the department of job and family services	689
regarding drugs it manufactures. The agreement shall specify the	690
time it is to be in effect, which shall be not less than one year	691
from the date the agreement is entered into.	692

(B) The agreement shall do all of the following:

693

(1) Specify which of the manufacturer's drugs are included in	694
the agreement;	695

(2) Permit the department to remove a drug from the agreement	696
in the event of a dispute over the drug's utilization;	697

(3) Require that the manufacturer make a rebate payment to	698
the department for each drug specified under division (B)(1) of	699
this section that is dispensed to an Ohio's best Rx program	700
participant;	701

(4)(a) Require that the per unit rebate be in an amount equal	702
to the greater of the following:	703

(i) The weighted average of the per unit rebates for the drug	704
as computed under division (C)(1) of this section;	705

(ii) A per unit amount specified by the manufacturer.

706

(b) Require that the rebate payment for a quantity of a drug	707
dispensed to an Ohio's best Rx participant be equal to the amount	708
determined by multiplying the applicable per unit rebate by the	709
number of units dispensed.	710

(5) Specify the intervals at which the manufacturer will	711
report to the department amounts specified pursuant to division	712
(B)(4)(a)(ii) of this section;	713

(6) Require that the manufacturer make the rebate payments to	714
the department on a quarterly basis or in accordance with a	715
schedule established by rules adopted under section 5110.35 of the	716
Revised Code.	717

(C)(1) For the purposes of division (B)(4)(a)(i) of this	718
section, once each year the department shall compute the weighted	719
average of the per unit rebates for each drug using the	720
information available to the department from submissions under	721
division (A)(4) of section 5110.25 of the Revised Code. The	722
computation shall be made in accordance with section 5110.28 of	723
the Revised Code and rules adopted under section 5110.35 of the	724
Revised Code.	725

(2) If no computation can be made under division (C)(1) of	726
this section, the rebate for the drug shall be the amount	727
specified under (B)(4)(a)(ii) of this section.	728

(D) On submission to the department by a manufacturer that	729
has entered into a rebate agreement under this section of a	730
request the department considers reasonable, the department shall	731
permit the manufacturer to audit claims submitted under section	732
5110.16 of the Revised Code.	733

Sec. 5110.22.  If a drug manufacturer has not entered into a	734
rebate agreement under section 5110.21 of the Revised Code with	735
respect to a drug it manufactures that is covered by a state	736
health benefit plan or state retirement system health benefit plan	737
that receives a rebate for the drug from the manufacturer, the	738
department of job and family services shall ask the department of	739
administrative services and each state retirement system to	740
determine whether the drug should be placed, for the following	741
plan year, on a prior authorization list of the state health	742
benefit plan or state retirement system health benefit plan.	743

Additions made under this section to prior authorization	744
lists shall be made in accordance with state law and applicable	745
collectively bargained agreements.	746

Sec. 5110.23. (A) The department of job and family services	747
shall compile both of the following:	748

(1) A list consisting of the name of each drug manufacturer	749
that enters into a rebate agreement under section 5110.21 of the	750
Revised Code and the names of the drugs included in each rebate	751
agreement;	752

(2) A list consisting of the name of each participating	753
terminal distributor.	754

(B) The lists compiled under this section are public records	755
for the purpose of section 149.43 of the Revised Code. The	756
department shall specifically make the lists available to	757
physicians, participating terminal distributors, and other health	758
professionals.	759

Sec. 5110.25. (A) All of the following information shall be	760
submitted to the department of job and family services with	761
respect to a state health benefit plan and each state retirement	762
system health benefit plan:	763

(1) The name of the plan;

764

(2) The number of individuals eligible for benefits under the	765
plan;	766

(3) The formula used to determine the per unit price for each	767
drug covered by the plan and dispensed through means other than a	768
mail order system, the per unit price for those drugs, or, if the	769
formula and per unit price are available for submission under this	770
section, both the formula and per unit price.	771

(4) The per unit rebate for each drug covered by the plan and	772
dispensed through a mail order system or means other than a mail	773
order system.	774

(B) The information specified in division (A) of this section	775
shall be submitted in accordance with section 5110.26 of the	776
Revised Code and rules adopted under section 5110.35 of the	777
Revised Code. In the case of a state health benefit plan, the	778
information shall be submitted by the department of administrative	779
services. In the case of a state retirement system health benefit	780
plan, the information shall be submitted by the state retirement	781
system that offers the health benefit plan. The department of	782
administrative services and each state retirement system shall	783
ensure in all of their relationships with other persons that they	784
are able to submit the information to the department of job and	785
family services.	786

Sec. 5110.26.  In submitting information about a drug under	787
section 5110.25 of the Revised Code, the department of	788
administrative services and each state retirement system shall do	789
all of the following:	790

(A) Compute and submit information separately for each of the	791
drug's national drug code numbers;	792

(B) Submit the formula, per unit price, or formula and per	793
unit price information after each change to the formula or per	794
unit price, unless the formula or per unit price changes more than	795
once a week, in which case submit the formula or per unit price	796
information at least once each week;	797

(C) Provide for the formula or per unit price information to	798
reflect the formula or per unit price as most recently changed;	799

(D) Submit the information regarding the per unit rebate once	800
a year and provide for the information to reflect the per unit	801
rebate for the previous calendar year.	802

Sec. 5110.27.  In accordance with section 5110.28 of the	803
Revised Code and rules adopted under section 5110.35 of the	804
Revised Code, the department of job and family services shall do	805
all of the following for each drug included in the Ohio's best Rx	806
program:	807

(A) On receipt of each submission of formula or per unit	808
price information under division (A)(3) of section 5110.25 of the	809
Revised Code, or, at the department's discretion, more frequent	810
intervals, the department shall do the following using the	811
information available to the department from those submissions:	812

(1) If the drug is covered by one or more state health	813
benefit plans or state retirement system health benefit plans,	814
compute the weighted average of the per unit prices under those	815
plans;	816

(2) If the drug is not covered by any state health benefit	817
plan or state retirement system health benefit plan, compute a	818
weighted average per unit price using the formula information	819
received under division (A)(3) of section 5110.25 of the Revised	820
Code for comparable drugs covered by one or more state health	821
benefit plans or state retirement system health benefit plans.	822

(B) If the drug is covered by a rebate agreement entered into	823
under section 5110.21 of the Revised Code and the department has	824
established a rebate administration percentage by rule adopted	825
under section 5110.35 of the Revised Code, at intervals specified	826
by the department, the department shall do both of the following:	827

(1) Multiply the amount agreed to under division (B)(4)(a) of	828
section 5110.21 of the Revised Code by the rebate administration	829
percentage;	830

(2) Subtract the product determined under division (B)(1) of	831
this section from the amount agreed to under division (B)(4)(a) of	832
section 5110.21 of the Revised Code.	833

(C) If the drug is covered by a rebate agreement entered into	834
under section 5110.21 of the Revised Code, on receipt of each	835
submission of formula or per unit price information under division	836
(A)(3) of section 5110.25 of the Revised Code, or, at the	837
department's discretion, more frequent intervals, the department	838
shall subtract the amount agreed to under division (B)(4) of	839
section 5110.21 of the Revised Code or the amount computed under	840
division (B) of this section, as applicable, from the applicable	841
amount computed under division (A)(1) or (2) of this section.	842

Sec. 5110.28.  The department of job and family services	843
shall use the number of individuals eligible for benefits under a	844
state health benefit plan or state retirement system health	845
benefit plan to compute the weighted averages required by division	846
(C)(1) of section 5110.21 and division (A) of section 5110.27 of	847
the Revised Code.	848

Sec. 5110.29.  The department of job and family services	849
shall report all of the following to each participating terminal	850
distributor and the Ohio's best Rx program administrator in a	851
manner enabling the distributor and administrator to comply with	852
section 5110.14 of the Revised Code:	853

(A) For each drug included in the Ohio's best Rx program that	854
is not covered by a rebate agreement under section 5110.21 of the	855
Revised Code, the results of the department's computations under	856
division (A) of section 5110.27 of the Revised Code.	857

(B) For each drug included in the program that is covered by	858
a rebate agreement entered into under section 5110.21 of the	859
Revised Code, the results of the department's computations under	860
division (C) of section 5110.27 of the Revised Code.	861

(C) The administrative fee, if any, determined by the	862
department in accordance with rules adopted under section 5110.35	863
of the Revised Code.	864

Sec. 5110.32.  (A) The Ohio's best Rx program fund is hereby	865
created. The fund shall be in the custody of the treasurer of	866
state, but shall not be part of the state treasury. The fund shall	867
consist of the following:	868

(1) Rebate payments made by participating manufacturers made	869
pursuant to agreements under section 5110.21 of the Revised Code;	870

(2) Administrative fees;

871

(3) The fund's investment earnings.

872

(B) The department of job and family services shall use money	873
in the Ohio's best Rx program fund to make payments to	874
participating terminal distributors and the Ohio's best Rx program	875
administrator under section 5110.17 of the Revised Code.	876

Sec. 5110.33.  (A) The Ohio's best Rx administration fund is	877
hereby created in the state treasury. The treasurer of state shall	878
transfer from the Ohio's best Rx program fund to the Ohio's best	879
Rx administration fund amounts equal to the following:	880

(1) Amounts resulting from application of the rebate	881
administration percentage determined under section 5110.354 of the	882
Revised Code;	883

(2) The amount of administrative fees charged Ohio's best Rx	884
participants;	885

(3) The amount of investment earnings credited to the Ohio's	886
best Rx program fund.	887

The treasurer of state shall make the transfers in accordance	888
with a schedule developed by the treasurer of state and the	889
department of job and family services.	890

(B) The department of job and family services shall use money	891
in the Ohio's best Rx administration fund to pay the	892
administrative costs of the Ohio's best Rx program, including, but	893
not limited to, costs associated with contracted services, staff,	894
outreach activities, computers and network services, and the	895
Ohio's best Rx program council.	896

Sec. 5110.35.  The department of job and family services	897
shall adopt rules in accordance with Chapter 119. of the Revised	898
Code to implement the Ohio's best Rx program. The rules shall	899
provide for all of the following:	900

(A) Determination of family income for the purpose of	901
division (A)(2) of section 5110.05 of the Revised Code;	902

(B) For the purpose of section 5110.06 of the Revised Code,	903
the application and annual reapplication process for the program	904
and documentation to be submitted with applications and	905
reapplications for the purpose of verifying eligibility;	906

(C) For the purpose of section 5110.06 of the Revised Code	907
and subject to section 5110.351 of the Revised Code, the	908
application form for the program;	909

(D) The method of providing information about the medicaid	910
program to applicants under section 5110.07 of the Revised Code;	911

(E) For the purpose of section 5110.08 of the Revised Code,	912
eligibility determination procedures;	913

(F) Subject to section 5110.352 of the Revised Code,	914
periodically increasing the maximum professional fee that	915
participating terminal distributors may charge Ohio's best Rx	916
program participants under section 5110.12 of the Revised Code or	917
the Ohio's best Rx program administrator may charge under a	918
contract entered into under section 5110.10 of the Revised Code;	919

(G) Subject to section 5110.353 of the Revised Code, the	920
amount of the administrative fee, if any, participating terminal	921
distributors are to charge Ohio's best Rx program participants	922
under section 5110.12 of the Revised Code or the Ohio's best Rx	923
program administrator may charge under a contract entered into	924
under section 5110.10 of the Revised Code;	925

(H) The electronic method for participating terminal	926
distributors and the Ohio's best Rx program administrator to	927
submit claims to the department under section 5110.16 of the	928
Revised Code;	929

(I) Additional information participating terminal	930
distributors and the Ohio's best Rx program administrator shall	931
include on claims submitted under section 5110.16 of the Revised	932
Code that the department determines is necessary for the	933
department to be able to make payments under section 5110.17 of	934
the Revised Code;	935

(J) The method for making payments to participating terminal	936
distributors or the Ohio's best Rx program administrator under	937
section 5110.17 of the Revised Code;	938

(K) Subject to section 5110.354 of the Revised Code, the	939
percentage that is the rebate administration percentage;	940

(L) If the department determines it is best that	941
participating manufacturers make rebates under section 5110.21 of	942
the Revised Code on a basis other than quarterly, a schedule for	943
payment of the rebates;	944

(M) The process for the department of administrative services	945
and state retirement systems to calculate and submit the	946
information required by section 5110.25 of the Revised Code;	947

(N) Procedures for making computations under sections 5110.21	948
and 5110.27 of the Revised Code;	949

(O) Standards and procedures for the use and preservation of	950
records regarding the Ohio's best Rx program by the department and	951
the Ohio's best Rx program administrator pursuant to section	952
5110.59 of the Revised Code;	953

(P) For the purpose of section 5110.10 of the Revised Code,	954
the standards and procedures governing the operation of the mail	955
order system by the Ohio's best Rx program administrator;	956

(Q) The efficient administration of other provisions of this	957
chapter for which the department determines rules are necessary.	958

Sec. 5110.351.  In adopting a rule under division (C) of	959
section 5110.35 of the Revised Code to prescribe the application	960
form for the Ohio's best Rx program, the department of job and	961
family services shall do all of the following:	962

(A) Specify the information that an applicant must include in	963
the application about the applicant and the members of the	964
applicant's family included in the application;	965

(B) Require that the applicant attest that the information	966
the applicant provides in the application and the documentation	967
submitted with the application is accurate to the best knowledge	968
and belief of the applicant;	969

(C) Include a statement printed in bold letters informing the	970
applicant that knowingly making a false statement on the form is	971
falsification under section 2921.13 of the Revised Code, a	972
misdemeanor of the first degree.	973

Sec. 5110.352.  As used in this section, "medicaid dispensing	974
fee" means the dispensing fee established under section 5111.08 of	975
the Revised Code for the medicaid program.	976

In adopting a rule under division (F) of section 5110.35 of	977
the Revised Code increasing the maximum amount of the professional	978
fee participating terminal distributors may charge Ohio's best Rx	979
program participants under section 5110.12 of the Revised Code and	980
the Ohio's best Rx program administrator may charge under a	981
contract entered into under section 5110.10 of the Revised Code,	982
the department of job and family services shall review the amount	983
of the professional fee once a year or, at the department's	984
discretion, at more frequent intervals and shall not increase the	985
professional fee to an amount exceeding the medicaid dispensing	986
fee.	987

A participating terminal distributor and the Ohio's best Rx	988
program administrator may charge a maximum three dollar	989
professional fee regardless of whether the medicaid dispensing fee	990
for that drug is less than that amount. The department, however,	991
may not adopt a rule increasing the maximum professional fee for	992
that drug until the medicaid dispensing fee for that drug exceeds	993
that amount.	994

Sec. 5110.353. (A) Once a year or, at the discretion of the	995
department of job and family services, at more frequent intervals,	996
the department shall determine the amount, if any, to be specified	997
in a rule adopted under division (G) of section 5110.35 of the	998
Revised Code as the administrative fee. In determining the amount	999
of the administrative fee, the department shall determine an	1000
amount, not exceeding one dollar per transaction, that equals or	1001
is less than the amount needed to cover the administrative costs	1002
of the Ohio's best Rx program when added to the sum of the	1003
following:	1004

(1) The amount resulting from the application of the rebate	1005
administration percentage;	1006

(2) The investment earnings of the Ohio's best Rx program	1007
fund created by section 5110.32 of the Revised Code.	1008

(B) Once a year or, at the discretion of the department, at	1009
more frequent intervals, the department shall report the	1010
methodology underlying the determination of the administrative fee	1011
to the Ohio's best Rx program council.	1012

Sec. 5110.354. (A) At least once a year or, at the discretion	1013
of the department of job and family services, at more frequent	1014
intervals, the department shall determine the percentage, if any,	1015
to be specified in a rule adopted under division (K) of section	1016
5110.35 of the Revised Code as the rebate administration	1017
percentage. The percentage, which shall not exceed five per cent,	1018
shall result in an amount that equals or is less than the amount	1019
needed to cover the administrative costs of the Ohio's best Rx	1020
program when added to the sum of the following:	1021

(1) The administrative fee specified in section 5110.353 of	1022
the Revised Code;	1023

(2) The investment earnings of the Ohio's best Rx program	1024
fund created by section 5110.32 of the Revised Code.	1025

(B) Once a year or, at the discretion of the department, at	1026
more frequent intervals, the department shall report the	1027
methodology underlying the determination of the rebate	1028
administration percentage to the Ohio's best Rx program council.	1029

Sec. 5110.36.  Notwithstanding any provision of this chapter,	1030
the department of job and family services may adopt rules in	1031
accordance with Chapter 119. of the Revised Code to make	1032
adjustments to the Ohio's best Rx program that the department	1033
considers appropriate to conform the program to, or coordinate it	1034
with, any federally funded prescription drug program created after	1035
October 1, 2003.	1036

Sec. 5110.37.  The department of job and family services	1037
shall undertake outreach efforts to publicize the Ohio's best Rx	1038
program and maximize participation in the program.	1039

Sec. 5110.38.  The department of job and family services may	1040
coordinate the Ohio's best Rx program with a state health benefit	1041
plan to enhance efficiency, reduce the cost of drugs, and maximize	1042
the benefits of the Ohio's best Rx program and state health	1043
benefit plans.	1044

Sec. 5110.39.  Not later than April 1, 2005, the department	1045
of job and family services shall do all of the following:	1046

(A) Create a list of the twenty-five drugs most often	1047
dispensed to Ohio's best Rx program participants under the	1048
program, using data from the most recent six-month period for	1049
which the data is available;	1050

(B) Determine the average amount that participating terminal	1051
distributors charge, on a date selected by the department,	1052
participants for each drug included on the list created under	1053
division (A) of this section;	1054

(C) Determine, for the date selected for division (B) of this	1055
section, the average usual and customary charge of participating	1056
terminal distributors for each drug included on the list created	1057
under division (A) of this section;	1058

(D) By comparing the average charges determined under	1059
divisions (B) and (C) of this section, determine the average	1060
percentage savings in the amount participating terminal	1061
distributors charge Ohio's best Rx program participants for each	1062
drug included on the list created under division (A) of this	1063
section.	1064

Sec. 5110.40. The department of job and family services shall	1065
employ an ombudsperson to assist terminal distributors of	1066
dangerous drugs with grievances regarding the Ohio's best Rx	1067
program.	1068

Sec. 5110.45.  There is hereby created the Ohio's best Rx	1069
program council. The council shall advise the department of job	1070
and family services on the Ohio's best Rx program. With the	1071
approval of a majority of the council's appointed members, the	1072
council may initiate studies to determine whether there are more	1073
effective ways to administer the program and provide the	1074
department with suggestions for improvements.	1075

Sec. 5110.46.  The Ohio's best Rx program council shall	1076
consist of the following members:	1077

(A) The president of the senate;

1078

(B) The speaker of the house of representatives;

1079

(C) The minority leader of the senate;

1080

(D) The minority leader of the house of representatives;

1081

(E) A representative of the Ohio chapter of the American	1082
federation of labor-congress of industrial organizations,	1083
appointed by the governor from a list of names submitted to the	1084
governor by that organization;	1085

(F) A representative of the Ohio chapter of the American	1086
association of retired persons, appointed by the governor from a	1087
list of names submitted to the governor by that organization;	1088

(G) A representative of a disability advocacy organization	1089
located in the state of Ohio, appointed by the governor from a	1090
list of names submitted to the governor by disability advocacy	1091
organizations located in the state of Ohio;	1092

(H) A representative of the Ohio chapter of the united way,	1093
appointed by the governor from a list of names submitted to the	1094
governor by that organization;	1095

(I) A representative of the Ohio alliance of retired	1096
Americans, appointed by the governor from a list of names	1097
submitted to the governor by that organization;	1098

(J) Three representatives of research-based drug	1099
manufacturers, appointed by the governor from a list of names	1100
submitted to the governor by the pharmaceutical research and	1101
manufacturers of America;	1102

(K) A pharmacist licensed under Chapter 4729. of the Revised	1103
Code, appointed by the governor from a list of names submitted to	1104
the governor by the Ohio pharmacists association.	1105

Sec. 5110.47.  The governor shall make initial appointments	1106
to the Ohio's best Rx program council not later than thirty days	1107
after the effective date of this section. The members appointed by	1108
the governor shall serve at the pleasure of the governor. If an	1109
appointed member's seat becomes vacant, the governor shall fill	1110
the vacancy not later than thirty days after the vacancy occurs	1111
and in the manner provided for the initial appointment.	1112

Sec. 5110.48.  The president of the senate and speaker of the	1113
house of representatives shall serve as co-chairs of the Ohio's	1114
best Rx program council.	1115

The president of the senate, the minority leader of the	1116
senate, the speaker of the house of representatives, and the	1117
minority leader of the house of representatives may each appoint a	1118
member of the general assembly to attend any meeting of the Ohio's	1119
best Rx program council on behalf of the president of the senate,	1120
the minority leader of the senate, the speaker of the house of	1121
representatives, or the minority leader of the house of	1122
representatives, respectively.	1123

Sec. 5110.49.  Members of the Ohio's best Rx program council	1124
shall serve without compensation and shall not be reimbursed for	1125
any expenses associated with their duties on the council.	1126

Sec. 5110.50. Except for any part of records that contain a	1127
trade secret, the Ohio's best Rx program council's records are a	1128
public record for the purpose of section 149.43 of the Revised	1129
Code.	1130

Sec. 5110.51. Sections 101.82 to 101.87 of the Revised Code	1131
do not apply to the Ohio's best Rx program council.	1132

Sec. 5110.55.  Information transmitted by or to any of the	1133
following for any purpose related to the Ohio's best Rx program is	1134
confidential to the extent required by federal and state law:	1135

(A) Drug manufacturers;

1136

(B) Terminal distributors of dangerous drugs;

1137

(C) The Ohio's best Rx program administrator;

1138

(D) The department of job and family services;

1139

(E) The department of administrative services;

1140

(F) The state retirement systems;

1141

(G) A state health benefit plan or state retirement system	1142
health benefit plan;	1143

(H) Ohio's best Rx program participants;

1144

(I) Any other government entity or person.

1145

Sec. 5110.56.  (A) Except as provided by section 5110.57 of	1146
the Revised Code, all of the following are trade secrets, are not	1147
public records for the purposes of section 149.43 of the Revised	1148
Code, and shall not be used, released, published, or disclosed in	1149
a form that reveals a specific drug or the identity of a drug	1150
manufacturer:	1151

(1) The amounts determined under section 5110.17 of the	1152
Revised Code;	1153

(2) Information disclosed in a rebate agreement or in	1154
communications related to a rebate agreement;	1155

(3) Information that the department of administrative	1156
services and state retirement systems submit to the department of	1157
job and family services under divisions (A)(3) and (4) of section	1158
5110.25 of the Revised Code;	1159

(4) The elements of the computations under division (C) of	1160
section 5110.21 of the Revised Code and under section 5110.27 of	1161
the Revised Code and any results of those computations that reveal	1162
or could be used to reveal the drug pricing or rebate information	1163
and amounts used to make the computations.	1164

(B) No person or government entity shall use or reveal any	1165
information specified in division (A) of this section except as	1166
required for the implementation of this chapter.	1167

Sec. 5110.57.  Sections 5110.55 and 5110.56 of the Revised	1168
Code shall not preclude the department of job and family services	1169
from disclosing information necessary for the implementation of	1170
this chapter, including the Ohio's best Rx program price to	1171
participating terminal distributors or the Ohio's best Rx program	1172
administrator under section 5110.29 of the Revised Code.	1173

Sec. 5110.58. (A) As used in this section, "identifying	1174
information" means information that identifies or could be used to	1175
identify an Ohio's best Rx program applicant or participant.	1176
"Identifying information" does not include aggregate information	1177
about applicants and participants that does not identify and could	1178
not be used to identify an individual applicant or participant.	1179

(B) Except as provided in divisions (C), (D), and (E) of this	1180
section, no person or government entity shall sell, solicit,	1181
disclose, receive, or use identifying information or knowingly	1182
permit the use of identifying information.	1183

(C)(1) The department of job and family services and the	1184
Ohio's best Rx program administrator may solicit, disclose,	1185
receive, or use identifying information or knowingly permit the	1186
use of identifying information for a purpose directly connected to	1187
the administration of the Ohio's best Rx program, including	1188
disclosing and knowingly permitting the use of identifying	1189
information included in a claim that a participating manufacturer	1190
audits pursuant to division (D) of section 5110.21 of the Revised	1191
Code, contacting Ohio's best Rx program applicants or participants	1192
regarding participation in the program, and notifying applicants	1193
and participants regarding participating terminal distributors.	1194

(2) The department and administrator may solicit, disclose,	1195
receive, or use identifying information or knowingly permit the	1196
use of identifying information to the extent required by federal	1197
law.	1198

(3) The department and administrator may disclose identifying	1199
information to the Ohio's best Rx program applicant or participant	1200
who is the subject of that information or to the parent, spouse,	1201
guardian, or custodian of that applicant or participant.	1202

(D) A participating terminal distributor or the Ohio's best	1203
Rx program administrator may solicit, disclose, receive, or use	1204
identifying information or knowingly permit the use of identifying	1205
information to the extent required or permitted by an agreement	1206
the distributor enters into under section 5110.12 of the Revised	1207
Code or a contract the administrator enters into under section	1208
5110.10 of the Revised Code.	1209

(E) A participating manufacturer may, for the purpose of	1210
auditing a claim pursuant to division (D) of section 5110.21 of	1211
the Revised Code, solicit, receive, and use identifying	1212
information included in the claim.	1213

Sec. 5110.59. The department of job and family services and	1214
the Ohio's best Rx program administrator shall use and preserve	1215
records regarding the Ohio's best Rx program in accordance with	1216
rules adopted under section 5110.35 of the Revised Code. This	1217
section applies to the department's or administrator's use and	1218
preservation of records received or generated by the department,	1219
any other government entity, or any person.	1220

Sec. 5110.99. Whoever violates division (B) of section	1221
5110.58 of the Revised Code is guilty of a misdemeanor of the	1222
first degree.	1223

Section 2. That existing sections 127.16 and 2921.13 of the	1224
Revised Code are hereby repealed.	1225

Section 3. It is not the intention of the General Assembly to	1226
establish an entitlement program through the enactment of Chapter	1227
5110. of the Revised Code by this act.	1228

Section 4. All items in this section are hereby appropriated	1229
as designated out of any moneys in the state treasury to the	1230
credit of the General Revenue Fund and the State Special Revenue	1231
Fund Group. For all appropriations made in this act, those in the	1232
first column are for fiscal year 2004 and those in the second	1233
column are for fiscal year 2005. The appropriations made in this	1234
act are in addition to any other appropriations made for the	1235
2003-2005 biennium.	1236

JFS DEPARTMENT OF JOB AND FAMILY SERVICES

1237

General Revenue Fund

1238

State Special Revenue Fund Group

1241

OHIO'S BEST RX START-UP COSTS

1245

The foregoing appropriation item 600-440, Ohio's Best Rx	1246
Start-Up Costs, shall be used by the Department of Job and Family	1247
Services to pay for the administrative and operational expenses	1248
for the creation and operation of the Ohio's Best Rx Program in	1249
accordance with Chapter 5110. of the Revised Code including costs	1250
associated with the duties assigned by the department to the	1251
Ohio's Best Rx Program Administrator and making payments to	1252
participating terminal distributors until sufficient cash exists	1253
to make payments from the accounts created in sections 5110.32 and	1254
5110.33 of the Revised Code. Of the foregoing appropriation item	1255
600-440, Ohio's Best Rx Start-up Costs, not more than $450,000 in	1256
fiscal year 2004 and not more than $750,000 in fiscal year 2005	1257
may be used by the department for administrative and operational	1258
costs, excluding outreach, that are not associated with the Ohio's	1259
Best Rx Program Administrator or the payments to participating	1260
terminal distributors.	1261

If the Director of the Department of Job and Family Services	1262
estimates that the appropriation is insufficient to fully cover	1263
start-up costs, the Director shall, in consultation with the	1264
Director of the Office of Budget and Management, submit a letter	1265
to the Governor, President of the Senate, Speaker of the House of	1266
Representatives, and the Minority Leaders of the Senate and House	1267
of Representatives. The letter shall declare the additional	1268
appropriation authority estimated to be needed and shall show a	1269
breakdown of how the additional appropriation authority will be	1270
used. The Director of Job and Family Services shall obtain the	1271
approval of the Controlling Board for any supplemental	1272
appropriation, if required. The amount approved by the Controlling	1273
Board is hereby appropriated. The use of state funds for start-up	1274
costs shall in no way obligate the state to fund further program	1275
costs, as the program is a discount program, not an entitlement	1276
program. Any unspent appropriations from fiscal year 2004 may be	1277
carried over to fiscal year 2005.	1278

OHIO'S BEST RX ADMINISTRATION

1279

The foregoing appropriation item 600-673, Ohio's Best Rx	1280
Administration, shall be used on an ongoing basis to cover	1281
expenses associated with the Ohio's Best Rx Program defined in	1282
section 5110.33 of the Revised Code. If receipts to the fund	1283
exceed the appropriated amounts, the Director of Job and Family	1284
Services may request that the Director of Budget and Management	1285
increase the appropriation authority of this fund. Upon approval	1286
from the Director of Budget and Management, the additional amounts	1287
are hereby appropriated.	1288

Within the limits set forth in this act, the Director of	1289
Budget and Management shall establish accounts indicating source	1290
and amount of funds for each appropriation made in this act, and	1291
shall determine the form and manner in which appropriation	1292
accounts shall be maintained. Expenditures from appropriations	1293
contained in this act shall be accounted for as though made in Am.	1294
Sub. H.B. 95 of the 125th General Assembly.	1295

The appropriations made in this act are subject to all	1296
provisions of Am. Sub. H.B. 95 of the 125th General Assembly that	1297
are generally applicable to such appropriations.	1298

Section 5. The codified and uncodified sections of law	1299
contained in this act, and the items of law of which they are	1300
composed, are not subject to the referendum. Therefore, under Ohio	1301
Constitution, Article II, Section 1d and section 1.471 of the	1302
Revised Code, the codified and uncodified sections of law	1303
contained in this act, and the items of law of which they are	1304
composed, go into immediate effect when this act becomes law.	1305