House of Representatives

SB 1118

prescription drug coverage

Sponsors: Senators Hamilton, Guenther, Solomon, et al.

 

DP

Committee on Public Institutions & Rural Affairs

DPA S/e

Committee on Appropriations

W/D

Committee on Judiciary

DPA

Caucus and COW

 

X

As Transmitted To The Governor

 

SB 1118 establishes a prescription medication benefit pilot program for low-income seniors and disabled persons 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

·          Creates a two-year pilot program through the Arizona Health Care Cost Containment System (AHCCCS) to cover fifty percent of the costs of prescription medication for eligible participants.  Eligible participants must be all of the following:

1.      Eligible for Medicare and a resident of Arizona.

2.      Within 100 – 200 percent of the Federal Poverty Level (FPL).

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.      For eligible participants 100 – 149 percent of FPL, spent at least $500 out-of-pocket for prescription medication.

5.      For eligible participants 150 – 200 percent of FPL, spent at least $1,000 out-of-pocket for prescription medication.

6.      Paid an enrollment fee.

·            Requires participants to buy into the program.  Participants receive an enrollment card that tracks out-of-pocket spending and provides a fifty-percent discount once a person has meet the deductible.  Enrollment cards are valid for one year from the date the card is issued.

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

·          Stipulates that pharmacies be paid prompt reimbursement upon receipt of claims.

·          Allows AHCCCS to lower the deductible required for eligibility up to $300 in the second fiscal year, if less than seventy-five percent of the appropriation from the previous year has not been spent.

·          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.  Enrollment cards will not be issued after December 30, 2002 and the program terminates on October 1, 2003.

·          Appropriates $3,900,000 in FY 2001-2002 and $4,100,000 in FY 2002-2003 from the tobacco tax medically account for prescription drug coverage.  An additional $400,000 for administration costs is appropriated from the tobacco tax medically account in FY 2001-2002 and FY 2002-2003.

·          Exempts AHCCCS from rule making requirements.

 

 

 

---------- DOCUMENT FOOTER ---------

45th Legislature                                                                                                                                   

First Regular Session                                       3                                                               May 8, 2001

 

---------- DOCUMENT FOOTER ---------