ARTICLE 17 SUBSTITUTE A
RELATING TO HUMAN SERVICES –
PHARMACEUTICALS
SECTION 1. Section 40-8-4
of the General Laws in Chapter 40-8 entitled “Medical Assistance” is hereby
amended to read as follows:
40-8-4. Direct vendor payment plan. – (a) The department shall
furnish medical care benefits to eligible beneficiaries through a direct vendor
payment plan. The plan shall include, but need not be limited to, any or all of
the following benefits, which benefits shall be contracted for by the director:
(1) Inpatient hospital services, other
than services in a hospital, institution, or facility for tuberculosis or
mental diseases;
(2) Nursing services for such period of time as
the director shall authorize;
(3) Visiting nurse service;
(4) Drugs for consumption either by inpatients
or by other persons for whom they are prescribed by a licensed physician;
(5) Dental services; and
(6) Hospice care up to a maximum of 210 days as
a lifetime benefit.
(b) For purposes of this chapter, the payment of
federal Medicare premiums or other health insurance premiums by the department
on behalf of eligible beneficiaries in accordance with the provisions of title
XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., shall be
deemed to be a direct vendor payment.
(c) With respect to medical care benefits
furnished to eligible individuals under this chapter or Title XIX of the
federal Social Security Act, the department is authorized and directed to impose:
(i)
nominal co-payments or similar charges upon eligible individuals for
non-emergency services provided in a hospital emergency room; and
(ii) co-payments for
prescription drugs in the amount of $1.00 for generic drug prescriptions and
$3.00 for brand name drug prescriptions in accordance with the provisions of 42 U.S.C. 1396, et.
seq. , and the
(d) The
department is authorized and directed to promulgate rules and
regulations to impose such co-payments or charges and to provide that, with
respect to (ii) above, those regulations shall be effective upon filing.
SECTION 2. This article shall take effect upon passage.