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2004 SESSION

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HB 197 Prescription drugs; assistance for senior citizens.

Introduced by: Harry R. Purkey | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Department of Medical Assistance Services; Virginia Insurance Plan for Seniors (VIPS); prescription drug assistance. Establishes the VIPS to provide assistance in the purchase of prescription drugs for those persons who are dually eligible for Medicaid and Medicare but who do not qualify for prescription coverage under Medicaid. Payment assistance is limited to $80 per month per eligible person, but unused amounts may be rolled over and credited to that person for future use. However, no direct cash payment will be made to any eligible person. Participants must pay a $10 copayment for each prescription. They are also required to use generic drugs unless they are willing to pay the difference between the generic and brand-name drug. Approved drugs in the Plan are those manufactured by pharmaceutical companies that agree to provide manufacturer rebates equal to the rebate required by the Medicaid program and to make the drug product available to the Plan for the best price that the manufacturer makes the drug available in the Medicaid program. Any licensed pharmacist may participate according to the rules adopted for the program and will be paid a reasonable reimbursement to cover the cost of the drug and costs for dispensing; payments to pharmacists will not vary based on the size of the entity dispensing the prescription. Beneficiary cost-sharing amounts will not vary based on the source of dispensing or method of distribution of the prescription. Three enactment clauses require the Board of Medical Assistance Services to promulgate emergency regulations; the Department of Medical Assistance Services to seek a waiver for VIPS from the Centers for Medicare and Medicaid Services, if necessary; and set the effective date of the act as July 1, 2005, with implementation to occur on the earlier of 90 days following the adoption of emergency regulations or July 1, 2006.


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