Text: S05368 Text: S05370 Text: S05300 - S05399 Text: S Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Amend Senate File 2280 as follows: 1 2 #1. Page 20, by inserting after line 7 the 1 3 following: 1 4 "Sec. 100. NEW SECTION. 231.61 PHARMACEUTICAL 1 5 ASSISTANCE PROGRAM ESTABLISHED. 1 6 1. For the purposes of this section, unless the 1 7 context otherwise requires: 1 8 a. "Eligible person" means a person, sixty-five 1 9 years of age or older with an annual net income of not 1 10 more than one hundred fifty percent of the federal 1 11 poverty level, as defined by the most recent poverty 1 12 income guidelines published by the United States 1 13 department of health and human services, or a person 1 14 sixty-five years of age or older, who with the 1 15 person's spouse has an annual net income of not more 1 16 than one hundred fifty percent of the federal poverty 1 17 level, as defined by the most recent poverty income 1 18 guidelines published by the United States department 1 19 of health and human services. "Eligible person" does 1 20 not include a person who is eligible for financial 1 21 assistance for the purchase of prescription drugs 1 22 under another local, state, or federal program to the 1 23 extent that the other program provides financial 1 24 assistance for the purchase of prescription drugs. 1 25 b. "Prescription drug" means a prescription drug 1 26 as defined in section 155A.3. 1 27 c. "Program" means the pharmaceutical assistance 1 28 program established in this section. 1 29 d. "Reasonable cost" means a charge which is equal 1 30 to the average wholesale cost of the prescription drug 1 31 and the additional dispensing pharmacy's usual fee, 1 32 not to exceed the seventy-fifth percentile of usual 1 33 and customary fees in this state, as determined by the 1 34 Iowa department of public health. 1 35 2. A pharmaceutical assistance program is created 1 36 within the department of elder affairs to provide for 1 37 subsidization of the prescription drug costs of 1 38 eligible persons in rural and urban areas throughout 1 39 the state. The director shall appoint an advisory 1 40 committee to make recommendations to the commission in 1 41 the creation of the program and in adoption of rules 1 42 to implement the program. The Iowa pharmaceutical 1 43 association shall assist the commission in the 1 44 creation and implementation of the program. 1 45 3. The commission shall adopt rules to implement 1 46 this section. The rules shall provide for all of the 1 47 following: 1 48 a. A means to determine the eligibility of a 1 49 person, including proof of the person's actual and 1 50 anticipated annual net income, evidence of complete or 2 1 partial payment for the costs of prescription drugs 2 2 from a provider other than the program, and other 2 3 provisions consistent with this section. 2 4 b. Issuance by the department of a participation 2 5 card upon approval of an application. The annual fee 2 6 for participation in the program is eighty dollars. 2 7 An initial application shall be accompanied by proof 2 8 of the date of birth of the person. 2 9 c. A prescription copayment of twenty percent of 2 10 the reasonable cost of the prescription which shall be 2 11 collected from the person participating in the program 2 12 by the dispensing pharmacy not to exceed eight hundred 2 13 dollars in prescription costs for each calendar year. 2 14 Thereafter, a copayment of forty percent of the 2 15 reasonable cost of prescriptions in excess of eight 2 16 hundred dollars for the remainder of any calendar year 2 17 shall be collected. The balance of the reasonable 2 18 costs shall be paid by the department to the 2 19 dispensing pharmacy after submission of a claim to the 2 20 department. 2 21 d. A provision that if the cost of the 2 22 prescription drug exceeds the reasonable cost and the 2 23 prescription drug is available under a generic name, 2 24 the eligible person may obtain the trade name drug 2 25 rather than the generic drug by paying the difference 2 26 in the amounts of the trade name drug and generic name 2 27 drug. However, if the prescribing practitioner 2 28 indicates on the prescription that a substitution of 2 29 the trade name drug is prohibited, the eligible person 2 30 is subject only to payment of the copayment amount. 2 31 e. A reimbursement system which includes on-line 2 32 point of service claims transmission and adjudication, 2 33 with utilization review. 2 34 f. A form of identification for persons to use in 2 35 proving eligibility. The form of identification shall 2 36 include a conspicuous notation of the penalties for 2 37 violation of this section. 2 38 g. A requirement that prescriptions contain the 2 39 name, address, and identification number of the 2 40 eligible person. 2 41 h. A provision to ensure choice of pharmaceutical 2 42 services by the eligible person. 2 43 4. A person who supplies false information to 2 44 establish eligibility for the program or to obtain 2 45 reimbursement is guilty of a serious misdemeanor." 2 46 #2. By renumbering as necessary. 2 47 2 48 2 49 2 50 PATRICIA HARPER 3 1 SF 2280.514 77 3 2 rn/jw/28
Text: S05368 Text: S05370 Text: S05300 - S05399 Text: S Index Bills and Amendments: General Index Bill History: General Index
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