House File 404 - Introduced



                                    HOUSE FILE       
                                    BY  DANDEKAR, FOEGE, HEATON,
                                        PETTENGILL, KRESSIG,
                                        SODERBERG, SCHICKEL, and
                                        REICHERT


    Passed House,  Date               Passed Senate, Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to copayments for prescription drugs under the
  2    medical assistance program.
  3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  4 TLSB 2358HH 81
  5 pf/cf/24

PAG LIN



  1  1    Section 1.  COPAYMENTS FOR PRESCRIPTION DRUGS UNDER THE
  1  2 MEDICAL ASSISTANCE PROGRAM.  The department of human services
  1  3 shall require recipients of medical assistance to pay the
  1  4 following copayments on each prescription filled for a covered
  1  5 prescription drug, including on each refill of such
  1  6 prescription, as follows:
  1  7    1.  A copayment of $1 for each covered nonprescription drug
  1  8 list generic prescription drug.
  1  9    2.  A copayment of $1 for each covered prescription drug
  1 10 list generic or brand=name prescription drug.
  1 11    3.  A copayment of $1 for each covered nonprescription drug
  1 12 list brand=name prescription drug for which the cost to the
  1 13 state is up to and including $25.
  1 14    4.  A copayment of $2 for each covered nonprescription drug
  1 15 list brand=name prescription drug for which the cost to the
  1 16 state is more than $25 and up to and including $50.
  1 17    5.  A copayment of $3 for each covered nonprescription drug
  1 18 list brand=name prescription drug for which the cost to the
  1 19 state is more than $50.
  1 20                           EXPLANATION
  1 21    This bill directs the department of human services to
  1 22 establish copayments in specified amounts for both generic and
  1 23 brand=name prescription drugs and both prescription drug list
  1 24 (PDL) and nonprescription drug list (non=PDL) prescription
  1 25 drugs under the medical assistance program.  The copayments
  1 26 are as follows:
  1 27    1.  For non=PDL generic prescription drugs, PDL generic or
  1 28 brand=name prescription drugs, and non=PDL brand=name
  1 29 prescription drugs for which the cost to the state is up to
  1 30 and including $25, a $1 copayment.
  1 31    2.  For non=PDL brand=name prescription drugs for which the
  1 32 cost to the state is more than $25 and up to and including
  1 33 $50, a $2 copayment.
  1 34    3.  For non=PDL brand=name prescription drugs for which the
  1 35 cost to the state is more than $50, a $3 copayment.
  2  1    Currently, there is no distinction between the copayment
  2  2 for non=PDL and PDL prescription drugs.  The current
  2  3 copayments are as follows:
  2  4    1.  For any generic prescription drug, a copayment of $1.
  2  5    2.  For a brand=name drug for which the cost to the state
  2  6 is $10 or less, a copayment of 50 cents.
  2  7    3.  For a brand=name drug for which the cost to the state
  2  8 is more than $10 and up to and including $25, a copayment of
  2  9 $1.
  2 10    4.  For a brand=name drug for which the cost to the state
  2 11 is more than $25 and up to and including $50, a copayment of
  2 12 $2.
  2 13    5.  For a brand=name drug for which the cost to the state
  2 14 is more than $50, a copayment of $3.
  2 15 LSB 2358HH 81
  2 16 pf:nh/cf/24