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