House of Representatives

HB 2607

prescription medication; coverage

Sponsors: Representatives Gullett, Hanson, Huppenthal

DPA	Committee on Health
X	Committee on Appropriations
	Caucus and COW	This bill as introduced contains an Appropriation clause.
	As Passed the House

HB 2607 creates a prescription medication benefit program for low-income seniors administered by the Arizona Health Care Cost Containment System (AHCCCS).

A proposed strike-everything amendment to HB 2607 will be offered in the Health Committee. The proposed strike-everything creates a prescription medication benefit pilot program for low-income seniors with catastrophic drug costs in counties without a Medicare Health Maintenance Organization (HMO) or a Medicare HMO that does not provide prescription drug coverage.

Provisions

· Establishes a two-year pilot program through AHCCCS to cover fifty percent of the cost of prescription medication for eligible participants. Eligible participants must be all of the following:

1. At least sixty-five years of age and a resident of Arizona.

2. Within 100 - 250% of the Federal Poverty Level.

3. A resident of a county that does not have a Medicare HMO or a Medicare HMO that does not provide prescription medication coverage.

4. Spent at least $2,000 out-of-pocket for prescription medication during the calendar year.

Eligible participants submit copies of sales receipts for prescription medication purchases to AHCCCS. Program benefits begin at the time of enrollment and continue until the end of the calendar year. Reimbursement payments are distributed on a quarterly basis.

· Allows AHCCCS to annually adjust the deductible amount required for eligibility to cover inflation costs. AHCCCS will cover fifty percent of the inflation cost increase.

· Stipulates that AHCCCS provide reimbursement retroactive to January 1, 2001. AHCCCS will determine the official start-up date for the program.

· Allows AHCCCS to contract with a Pharmaceutical Benefit Management Company to administer the program.

· Appropriates $4,300,000 in FY 2001-2002 and $4,500,000 in FY 2002-2003 from the state general fund for prescription drug coverage. An additional $1,000,000 for administration costs is appropriated from the state general fund in FY 2001-2002 and FY 2002-2003.

· Establishes a mechanism for repealing the program should a federal program be implemented that provides medication coverage equal to or greater than the program coverage.

· Exempts AHCCCS from rule making requirements.

The strike-everything amendment to HB 2607 was amended in the Health Committee as follows:

· Changes appropriates to $3,300,000 in FY 2001-2002 and $3,500,000 in FY 2002-2003 from the state general fund for prescription drug coverage.

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45th Legislature

First Regular Session 2 February 26, 2001

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