Text: S03306 Text: S03308 Text: S03300 - S03399 Text: S Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Amend House File 737, as amended, passed, and 1 2 reprinted by the House, as follows: 1 3 #1. Page 18, by inserting before line 12 the 1 4 following: 1 5 "Sec. . NEW SECTION. 231.61 PHARMACEUTICAL 1 6 ASSISTANCE PROGRAM ESTABLISHED. 1 7 1. For the purposes of this section, unless the 1 8 context otherwise requires: 1 9 a. "Eligible person" means a person, sixty-five 1 10 years of age or older with an annual net income of not 1 11 more than one hundred fifty percent of the federal 1 12 poverty level, as defined by the most recent poverty 1 13 income guidelines published by the United States 1 14 department of health and human services, or a person 1 15 sixty-five years of age or older, who with the 1 16 person's spouse has an annual net income of not more 1 17 than one hundred fifty percent of the federal poverty 1 18 level, as defined by the most recent poverty income 1 19 guidelines published by the United States department 1 20 of health and human services. "Eligible person" does 1 21 not include a person who is eligible for financial 1 22 assistance for the purchase of prescription drugs 1 23 under another local, state, or federal program to the 1 24 extent that the other program provides financial 1 25 assistance for the purchase of prescription drugs. 1 26 b. "Prescription drug" means a prescription drug 1 27 as defined in section 155A.3. 1 28 c. "Program" means the pharmaceutical assistance 1 29 program established in this section. 1 30 d. "Reasonable cost" means a charge which is equal 1 31 to the average wholesale cost of the prescription drug 1 32 and the additional dispensing pharmacy's usual fee, 1 33 not to exceed the seventy-fifth percentile of usual 1 34 and customary fees in this state, as determined by the 1 35 Iowa department of public health. 1 36 2. A pharmaceutical assistance program is created 1 37 within the department to provide for subsidization of 1 38 the prescription drug costs of eligible persons in 1 39 rural and urban areas throughout the state. 1 40 3. The director shall appoint an advisory 1 41 committee to make recommendations regarding the 1 42 creation of the program and in adoption of rules to 1 43 implement the program. These recommendations shall be 1 44 submitted to the commission, which shall forward the 1 45 recommendations to the general assembly with a target 1 46 date for implementation of July 1, 2001. The Iowa 1 47 pharmacy association shall assist the commission in 1 48 the creation and implementation of the program. 1 49 4. The commission shall adopt rules to implement 1 50 this section. The rules shall provide for all of the 2 1 following: 2 2 a. A means to determine the eligibility of a 2 3 person, including proof of the person's actual and 2 4 anticipated annual net income, evidence of complete or 2 5 partial payment for the costs of prescription drugs 2 6 from a provider other than the program, and other 2 7 provisions consistent with this section. 2 8 b. Issuance by the department of a participation 2 9 card upon approval of an application. The annual fee 2 10 for participation in the program is eighty dollars. 2 11 An initial application shall be accompanied by proof 2 12 of the date of birth of the person. 2 13 c. A prescription copayment of twenty percent of 2 14 the reasonable cost of the prescription which shall be 2 15 collected from the person participating in the program 2 16 by the dispensing pharmacy not to exceed eight hundred 2 17 dollars in prescription costs for each calendar year. 2 18 Thereafter, a copayment of forty percent of the 2 19 reasonable cost of prescriptions in excess of eight 2 20 hundred dollars for the remainder of any calendar year 2 21 shall be collected. The balance of the reasonable 2 22 costs shall be paid by the department to the 2 23 dispensing pharmacy after submission of a claim to the 2 24 department. 2 25 d. A provision that if the cost of the 2 26 prescription drug exceeds the reasonable cost and the 2 27 prescription drug is available under a generic name, 2 28 the eligible person may obtain the trade name drug 2 29 rather than the generic drug by paying the difference 2 30 in the amounts of the trade name drug and generic name 2 31 drug. However, if the prescribing practitioner 2 32 indicates on the prescription that a substitution of 2 33 the trade name drug is prohibited, the eligible person 2 34 is subject only to payment of the copayment amount. 2 35 e. A reimbursement system which includes on-line 2 36 point of service claims transmission and adjudication, 2 37 with utilization review. 2 38 f. A form of identification for persons to use in 2 39 proving eligibility. The form of identification shall 2 40 include a conspicuous notation of the penalties for 2 41 violation of this section. 2 42 g. A requirement that prescriptions contain the 2 43 name, address, and identification number of the 2 44 eligible person. 2 45 h. A provision to ensure choice of pharmaceutical 2 46 services by the eligible person. 2 47 5. A person who supplies false information to 2 48 establish eligibility for the program or to obtain 2 49 reimbursement is guilty of a serious misdemeanor." 2 50 #2. By renumbering as necessary. 3 1 3 2 3 3 3 4 PATRICIA HARPER 3 5 HF 737.708 78 3 6 rn/sc/14
Text: S03306 Text: S03308 Text: S03300 - S03399 Text: S Index Bills and Amendments: General Index Bill History: General Index
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