Text: S03427 Text: S03429 Text: S03400 - S03499 Text: S Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Amend House File 760, as amended, passed, and
1 2 reprinted by the House, as follows:
1 3 #1. Page 68, by inserting after line 28 the
1 4 following:
1 5 "Sec. . PHARMACEUTICAL ASSISTANCE PROGRAM
1 6 STUDY.
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. "Reasonable cost" means a charge which is equal
1 29 to the average wholesale cost of the prescription drug
1 30 and the additional dispensing pharmacy's usual fee,
1 31 not to exceed the seventy-fifth percentile of usual
1 32 and customary fees in this state, as determined by the
1 33 Iowa department of public health.
1 34 2. The director of human services, in cooperation
1 35 with the directors of public health and elder affairs,
1 36 shall appoint an advisory committee to make
1 37 recommendations regarding the creation of a
1 38 pharmaceutical assistance program to provide for
1 39 subsidization of the prescription drug costs of
1 40 eligible persons in rural and urban areas throughout
1 41 the state. The advisory committee shall submit a
1 42 report of the committee recommendations to the general
1 43 assembly by December 15, 1999.
1 44 3. The advisory committee shall review and make
1 45 recommendations regarding all of the following:
1 46 a. A means to determine the eligibility of a
1 47 person, including proof of the person's actual and
1 48 anticipated annual net income, evidence of complete or
1 49 partial payment for the costs of prescription drugs
1 50 from a provider other than the program, and other
2 1 provisions consistent with this section.
2 2 b. Issuance of a participation card upon approval
2 3 of an application.
2 4 c. An annual fee and a prescription copayment
2 5 amount which is a percentage of the reasonable cost of
2 6 the prescription. The copayment amount shall be
2 7 collected from the person participating in the program
2 8 by the dispensing pharmacy and the balance of the
2 9 reasonable costs shall be paid by the state to the
2 10 dispensing pharmacy after submission of a claim to the
2 11 state.
2 12 d. A provision that if the cost of the
2 13 prescription drug exceeds the reasonable cost and the
2 14 prescription drug is available under a generic name,
2 15 the eligible person may obtain the trade name drug
2 16 rather than the generic drug by paying the difference
2 17 in the amounts of the trade name drug and generic name
2 18 drug. However, if the prescribing practitioner
2 19 indicates on the prescription that a substitution of
2 20 the trade name drug is prohibited, the eligible person
2 21 is subject only to payment of the copayment amount.
2 22 e. A reimbursement system which includes on-line
2 23 point of service claims transmission and adjudication,
2 24 with utilization review.
2 25 f. A form of identification for persons to use in
2 26 proving eligibility. The form of identification shall
2 27 include a conspicuous notation of the penalties for
2 28 violation of this section.
2 29 g. A requirement that prescriptions contain the
2 30 name, address, and identification number of the
2 31 eligible person.
2 32 h. A provision to ensure choice of pharmaceutical
2 33 services by the eligible person.
2 34 4. A penalty for providing false information to
2 35 establish eligibility for the program or to obtain
2 36 reimbursement."
2 37 #3. By renumbering as necessary.
2 38
2 39
2 40
2 41 PATRICIA HARPER
2 42
2 43
2 44
2 45 DENNIS H. BLACK
2 46
2 47
2 48
2 49 JOE BOLKCOM
2 50
3 1
3 2
3 3 MIKE CONNOLLY
3 4
3 5
3 6
3 7 DICK L. DEARDEN
3 8
3 9
3 10
3 11 PATRICK J. DELUHERY
3 12
3 13
3 14
3 15 ROBERT E. DVORSKY
3 16
3 17
3 18
3 19 BILL FINK
3 20
3 21
3 22
3 23 TOM FLYNN
3 24
3 25
3 26
3 27 EUGENE S. FRAISE
3 28
3 29
3 30
3 31 MICHAEL E. GRONSTAL
3 32
3 33
3 34
3 35 JOHNIE HAMMOND
3 36
3 37
3 38
3 39 STEVEN D. HANSEN
3 40
3 41
3 42
3 43 WALLY E. HORN
3 44
3 45
3 46
3 47 JOHN JUDGE
3 48
3 49
3 50
4 1 JOHN P. KIBBIE
4 2
4 3
4 4
4 5 MATT McCOY
4 6
4 7
4 8
4 9 MARK SHEARER
4 10
4 11
4 12
4 13 BETTY A. SOUKUP
4 14
4 15
4 16
4 17 ELAINE SZYMONIAK
4 18 HF 760.539 78
4 19 pf/jw
Text: S03427 Text: S03429 Text: S03400 - S03499 Text: S Index Bills and Amendments: General Index Bill History: General Index
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