Sec. 1. 22 MRSA §3174-M, as renumbered by RR 1993, c. 1, §53, is amended to read:

§3174-M. Medicaid drug management programs

1. Authority. The department has the authority to determine which prescription and over-the-counter drugs are subject to reimbursement and coverage under the Medicaid program and to establish procedures for the use and management of those drugs.

2. Drug committee. In order to make determinations under subsection 1, the department shall establish a drug formulary committee by rule adopted pursuant to the Maine Administrative Procedure Act. The department must receive approval from the committee prior to establishing any limitations, prior authorizations, preferred drug programs or other mechanisms to monitor or restrict the manner in which physicians prescribe drugs or Medicaid program recipients have access to drugs.

A. The drug formulary committee must have at least 2 nonvoting consumer members and 2 psychiatrist members, one of whom must be a child psychiatrist and one of whom must be an adult psychiatrist, to be appointed by the Medicaid Advisory Committee established pursuant to 42 Code of Federal Regulations, Section 431.12 (1993).

B. A vote of 2/3 of the drug formulary committee members present is required to add or delete a drug from the list of drugs that are subject to reimbursement and coverage under the Medicaid program.

C. A determination under rules adopted pursuant to subsection 3 that a drug or category of drug is not covered by the Medicaid program is a final agency action subject to review under the Maine Administrative Procedure Act.

3. Procedures; emergency. Drugs determined not covered by Medicaid pursuant to this section are subject to review and approval based upon a prior approval procedure established by rule by the department. Prior approval must be given retroactively if an emergency, as determined by a physician, requires that the drug be dispensed immediately for the patient's well-being. Any drug provided under this emergency procedure is considered a Medicaid-covered service pending departmental action.

4. Rulemaking. Rules adopted pursuant to section 3174-J prior to its repeal are effective as of the effective date of