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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