A N A C T
RELATING TO PHARMACEUTICAL ASSISTANCE TO THE ELDERLY ACT
It is enacted by the General Assembly as follows:
SECTION 1. Section 42-66.2-6 of the General Laws in Chapter 42-66.2 entitled "Pharmaceutical Assistance to the Elderly Act" is hereby amended to read as follows:
42-66.2-6. Responsibilities of department of elderly affairs -- (a) Determination of eligibility.. - The department shall adopt regulations relating to the determination of eligibility of prospective consumers and the determination and elimination of program abuse. The department has the power to declare ineligible any consumer who abuses or misuses the established prescription plan. The department has the power to investigate cases of suspected provider or consumer fraud.
(b) Rebates for expenses prohibited.. - A system of rebates or reimbursements to the consumer for pharmaceutical expenses shall be prohibited.
This shall not be interpreted to exclude other consumers not participating in the Pharmaceutical Assistance to the Elderly Program from receiving financial offers or redeemable coupons that are available to only those who have paid for the service or product through direct cash payment, insurance premiums, or cost sharing with an employer.
(c) Program criteria.. - The program includes the following criteria:
(1) Collection of the co-payment by pharmacies is mandatory;
(2) Senior citizens participating in the program are not required to maintain records of each transaction but shall sign a receipt for eligible drugs;
(3) A system of rebates or reimbursements to the consumer for pharmaceutical expenses is prohibited;.
This shall not be interpreted to exclude other consumers from receiving financial offers or redeemable coupons that are available to only those who have paid for the service or product through direct cash payment, insurance premiums, or cost sharing with an employer.
(4) Prescription benefits for any single prescription may be dispensed in the amounts authorized by the physician, and agreed to by the consumer, up to a maximum of a one hundred (100) day supply or two hundred (200) doses, whichever is less and/or a one hundred (100) day supply or one quart of liquid, whichever is less; provided, however, that disposable insulin syringes are dispersed in a quantity of one hundred (100);
(5) Experimental drugs are excluded from the program.
(6) A system of mail order delivery for prescriptions is prohibited under this program; and
(7) Eligible drugs must be dispensed within one year of the original prescription order.
(d) The director shall issue an eligibility card containing a program ID number and the time period for which the card is valid.
(e) The director shall institute and conduct an educational outreach program and shall provide a mechanism, within the department, to handle all public inquiries concerning the program.
(f) The director shall establish a process, in accordance with the Administrative Procedures Act, chapter 35 of this title, to provide an appeals hearing on the determination of eligibility.
(g) The director shall forward to the contractor a list of all eligible consumers.
SECTION 2. This act shall take effect upon passage.
