Chapter 230

2007 -- H 6187 SUBSTITUTE A

Enacted 07/03/07

A N A C T

RELATING TO HUMAN SERVICES -- PHARMACEUTICALS

Introduced By: Representative Carol A. Mumford

Date Introduced: March 21, 2007

It is enacted by the General Assembly as follows:

     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 two hundred and ten (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. section 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 one dollar ($1.00) for generic drug prescriptions and three dollars ($3.00) for brand

name drug prescriptions in accordance with the provisions of 42 U.S.C. section 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 subdivision (ii) above,

those regulations shall be effective upon filing.

     SECTION 2. This act shall take effect upon passage.

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LC02381/SUB A

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