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Senate File 2131

Partial Bill History

Bill Text

PAG LIN
  1  1    Section 1.  NEW SECTION.  135M.1  PHARMACEUTICAL ASSISTANCE
  1  2 PROGRAM ESTABLISHED.
  1  3    1.  For the purposes of this section, unless the context
  1  4 otherwise requires:
  1  5    a.  "Department" means the Iowa department of public
  1  6 health.
  1  7    b.  "Eligible person" means a person, sixty-five years of
  1  8 age or older, with an annual net income of not more than two
  1  9 hundred percent of the federal poverty level for a family of
  1 10 one, as defined by the most recent poverty income guidelines
  1 11 published by the United States department of health and human
  1 12 services, or a person sixty-five years of age or older who,
  1 13 with the person's spouse, has an annual net income of not more
  1 14 than two hundred fifty percent of the federal poverty level
  1 15 for a family of two as defined by the most recent poverty
  1 16 income guidelines published by the United States department of
  1 17 health and human services.  "Eligible person" does not include
  1 18 a person who is eligible for financial assistance for the
  1 19 purchase of prescription drugs under another local, state, or
  1 20 federal program to the extent that the other program provides
  1 21 financial assistance for the purchase of prescription drugs
  1 22 and does not include a person who is covered under or who
  1 23 voluntarily lost coverage within the prior six months under a
  1 24 health benefit plan which provides coverage for the purchase
  1 25 of prescription drugs.
  1 26    c.  "Prescription drug" means a prescription drug as
  1 27 defined in section 155A.3.
  1 28    d.  "Program" means the pharmaceutical assistance program
  1 29 established in this section.
  1 30    e.  "Reasonable cost" means a charge which is equal to the
  1 31 average wholesale cost of the prescription drug and the
  1 32 additional dispensing pharmacy's usual fee, not to exceed the
  1 33 seventy-fifth percentile of usual and customary fees in this
  1 34 state, as determined by the department.
  1 35    2.  A pharmaceutical assistance program is established
  2  1 within the department to provide for subsidization of
  2  2 prescription drug purchases by eligible persons.  The director
  2  3 of public health shall appoint an advisory committee to make
  2  4 recommendations regarding the establishment of the program and
  2  5 the adoption of rules to administer the program.
  2  6    3.  The department shall adopt rules to administer this
  2  7 section.  The rules shall provide for, but are not limited to,
  2  8 all of the following:
  2  9    a.  A means to determine the eligibility of a person,
  2 10 including proof of the person's date of birth, proof of the
  2 11 person's actual and anticipated annual net income, evidence of
  2 12 complete or partial payment for the costs of prescription
  2 13 drugs from a provider other than the program, and other
  2 14 provisions consistent with this section.
  2 15    b.  Issuance by the department of a participation card,
  2 16 upon approval of an application.  The participation card shall
  2 17 include a conspicuous notation of the penalties for violation
  2 18 of this section.
  2 19    c.  A prescription copayment based on the reasonable cost
  2 20 of the prescription.  The eligible person may choose to
  2 21 participate in either an annual limited fee plan or a
  2 22 deductible plan with annual limits on copayments.
  2 23    d.  A provision that if the cost of the prescription drug
  2 24 exceeds the reasonable cost and the prescription drug is
  2 25 available under a generic name, the eligible person may obtain
  2 26 the trade name drug rather than the generic drug by paying the
  2 27 difference in the cost of the trade name drug and the generic
  2 28 drug.  However, if the prescribing practitioner indicates on
  2 29 the prescription that a substitution of the trade name drug is
  2 30 prohibited, the eligible person is subject only to payment of
  2 31 the copayment amount.
  2 32    e.  A reimbursement system that includes on-line point of
  2 33 service claims transmission and adjudication, with utilization
  2 34 review.
  2 35    f.  A requirement that prescriptions contain the name,
  3  1 address, and identification number of the eligible person.
  3  2    g.  A provision to ensure choice of pharmaceutical services
  3  3 by the eligible person.
  3  4    4.  A person who supplies false information to establish
  3  5 eligibility for the program or to obtain reimbursement is
  3  6 guilty of a serious misdemeanor.
  3  7    5.  This section does not create an entitlement to any
  3  8 funds available for the program, and the department may expend
  3  9 funds only to the extent funds are available and within its
  3 10 discretion to expend under the program.
  3 11    Sec. 2.  APPROPRIATION.  There is appropriated from the
  3 12 tobacco settlement fund created in section 12.65, to the Iowa
  3 13 department of public health for the fiscal year beginning July
  3 14 1, 2000, and ending June 30, 2001, the following amount, or so
  3 15 much thereof as is necessary, to be used for the purpose
  3 16 designated:
  3 17    For the pharmaceutical assistance program established in
  3 18 section 135M.1:  
  3 19 .................................................. $ 10,000,000
  3 20                           EXPLANATION
  3 21    This bill creates a pharmaceutical assistance program in
  3 22 the Iowa department of public health to provide for
  3 23 subsidization of prescription drug purchases by eligible
  3 24 persons 65 years of age and older with limited incomes, as
  3 25 established in the bill.  The department is required to
  3 26 develop a reasonable cost, which includes a dispensing fee,
  3 27 for prescription drugs.  The Iowa department of public health
  3 28 is required to adopt rules regarding copayments, reimbursement
  3 29 policies for generic and trade name drugs, a reimbursement
  3 30 system for dispensers, and requirements for information
  3 31 included in a prescription.  A person who supplies false
  3 32 information in order to become eligible for the program or to
  3 33 obtain reimbursement is guilty of a serious misdemeanor.  The
  3 34 bill provides that the program does not establish an
  3 35 entitlement.  The bill also provides an appropriation from the
  4  1 tobacco settlement fund of $10 million to the Iowa department
  4  2 of public health for the program.  
  4  3 LSB 6284XS 78
  4  4 pf/cf/24.1
     

Text: SF02130                           Text: SF02132
Text: SF02100 - SF02199                 Text: SF Index
Bills and Amendments: General Index     Bill History: General Index

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