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2005 SESSION

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SB 841 Prescription Drug Payment Assistance Program; created, report.

Introduced by: R. Creigh Deeds | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED:

Health; implementation of federal Medicare Part D benefit; task force on prescription drug assistance for low-income Virginians. Directs the Board of Medical Assistance Services to promulgate necessary regulations to implement the provisions of the Medicare Part D prescription drug benefit that becomes effective January 1, 2006. Upon implementation of the Medicare Part D program, the Department of Medical Assistance Services shall convene a task force to assist the Department in evaluating the Medicare Part D benefit and to make recommendations for enhancing, coordinating, and integrating the existing pharmacy assistance programs for low-income Virginians and the Medicare Part D benefit. The Department shall report its findings and recommendations to the Governor and General Assembly by November 1, 2006. Authority for emergency regulations is included. This bill is identical to HB 1624.

SUMMARY AS PASSED SENATE:

Health; implementation of federal Medicare Part D benefit; task force on prescription drug assistance for low-income Virginians.  Directs the Board of Medical Assistance Services to promulgate necessary regulations to implement the provisions of the Medicare Part D prescription drug benefit that becomes effective January 1, 2006.  Upon implementation of the Medicare Part D program, the Department of Medical Assistance Services shall convene a task force to assist the Department in evaluating the Medicare Part D benefit and to make recommendations for enhancing, coordinating, and integrating the existing pharmacy assistance programs for low-income Virginians and the Medicare Part D benefit.  Authority for emergency regulations is included.

SUMMARY AS INTRODUCED:

Health; Virginia Prescription Drug Payment Assistance Plan.  Establishes a program to be administered by the Department of Medical Assistance Services (DMAS), modeled on Delaware's Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. DMAS may contract with third-party administrators to provide administrative services that include enrollment, outreach, eligibility determination, data collection, financial oversight, and reporting. The benefit is limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible persons must have incomes at or below 150 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of their annual income, as set forth in the appropriation act. They must also be age 65 or older or eligible for Federal Old-Age, Survivors and Disability Insurance Benefits, not be receiving a prescription drug benefit through a Medicare supplemental policy or other third-party payor prescription benefit at the time they are to be enrolled in the program, and be ineligible for Medicaid prescription benefits. However, nothing shall prohibit the enrollment of a person in the program during the period in which his Medicaid eligibility is determined. Eligible enrollees will receive an identification card to be presented to pharmacists and will start receiving the benefit the month after their eligibility is determined. Benefits will be paid to pharmacies under a point-of-service claims procedure to be established by DMAS. Participants are required to make a co-payment for each prescription, which will not exceed 25 percent of the cost, but will be no less than $5. Money to pay the claims will come from The newly established Prescription Assistance Fund will be financed by 10 percent of the proceeds received by the Commonwealth under the Master Tobacco Settlement Agreement and any federal funds available for this purpose. Administrative costs are to be paid from the pharmaceutical manufacturer rebates to the extent available and the $20 annual enrollment fees. The Board shall develop a comprehensive statewide community-based outreach plan to enroll eligible persons and DMAS shall report annually on the program's implementation. No entitlement to prescription drug coverage on the part of any eligible person or any right or entitlement to participation is created and such coverage shall only be available to the extent that funds are appropriated therefor.