2003 -- S 0177

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LC00953

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2003

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A N A C T

RELATING TO PHARMACEUTICAL ASSISTANCE TO THE ELDERLY

     Introduced By: Senators Felag, Walaska, McBurney, Paiva-Weed, and Perry

     Date Introduced: January 29, 2003

     Referred To: Senate Finance

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 42-66.2-5 of the General Laws in Chapter 42-66.2 entitled

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"Pharmaceutical Assistance to the Elderly Act" is hereby amended to read as follows:

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     42-66.2-5. Persons eligible. -- (a) Persons eligible for assistance under the provisions of

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this chapter include any resident of the state who is at least sixty-five (65) years of age. State and

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consumer co-payment shares for these persons shall be determined as follows:

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      (1) For unmarried persons or married persons living separate and apart whose income for

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the calendar year immediately preceding the year in which assistance is sought is:

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      (i) Less than fifteen thousand nine hundred and thirty-two dollars ($15,932) twenty

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thousand dollars ($20,000) the state shall pay sixty percent (60%) of the cost of the prescriptions

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and the consumer shall pay forty percent (40%) of the cost of the prescriptions;

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      (ii) More than fifteen thousand nine hundred and thirty-two dollars ($15,932) twenty

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thousand dollars ($20,000) and less than twenty thousand dollars ($20,000), the state shall pay

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thirty percent (30%) of the cost of the prescriptions and the consumer shall pay seventy percent

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(70%) of the cost of the prescriptions; and

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      (iii) More than twenty thousand dollars ($20,000) twenty-five thousand dollars ($25,000)

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and less than thirty-five thousand dollars ($35,000) thirty-eight thousand dollars ($38,000), the

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state shall pay fifteen percent (15%) of the cost of prescriptions and the consumer shall pay

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eighty-five percent (85%) of the cost of prescriptions.

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      (2) For married persons whose income for the calendar year immediately preceding the

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year in which assistance is sought hereunder when combined with any income of the person's

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spouse in the same year is:

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      (i) Nineteen thousand nine hundred and sixteen dollars ($19,916) twenty-five thousand

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dollars ($25,000) or less, the state shall pay sixty percent (60%) of the cost of the prescriptions

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and the consumer shall pay forty percent (40%) of the cost of the prescriptions;

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      (ii) More than nineteen thousand nine hundred and sixteen dollars ($19,916) twenty-five

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thousand dollars ($25,000) and less than twenty-five thousand dollars ($25,000) thirty thousand

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dollars ($30,000), the state shall pay thirty percent (30%) of the cost of the prescriptions and the

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consumer shall pay seventy percent (70%) of the cost of prescriptions; and

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      (iii) More than twenty-five thousand dollars ($25,000) thirty thousand dollars ($30,000)

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and less than forty thousand dollars ($40,000) forty-three thousand one hundred dollars

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($43,100), the state shall pay fifteen percent (15%) of the cost of prescriptions and the consumer

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shall pay eighty-five percent (85%) of the cost of prescriptions.

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      (3) Eligibility may also be determined by using income data for the ninety (90) days

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prior to application for benefits and projecting that income on an annual basis. The income levels

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shall not include those sums of money expended for medical and pharmaceutical that exceed

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three percent (3%) of the applicant's annual income or three percent (3%) of the applicant's

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preceding ninety (90) day income computed on an annual basis.

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      (b) On July 1 of each year, the maximum amount of allowable income for both

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unmarried and married residents set forth in subsection (a) shall be increased by a percentage

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equal to the percentage of the cost of living adjustment provided for social security recipients.

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      (c) Notwithstanding the foregoing provisions of this section, no person whose

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prescription drug expenses are paid or reimbursable, either in whole or in part, by any other plan

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of assistance or insurance is eligible for assistance under this section, until the person's

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prescription drug coverage is exhausted during a benefit year, and as provided in subsection (d).

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      (d) The fact that some of a person's prescription drug expenses are paid or reimbursable

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under the provisions of medicare, part B, shall not disqualify that person, if he or she is otherwise

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eligible, to receive assistance under this chapter. In those cases, the state shall pay sixty percent

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(60%) of the cost of those prescriptions for qualified drugs for which no payment or

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reimbursement is made by the federal government.

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      (e) Eligibility for receipt of any other benefit under any other provisions of the Rhode

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Island general laws as a result of eligibility for the pharmaceutical assistance program authorized

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under this section shall be limited to those persons whose income qualify them for a sixty percent

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(60%) state co-payment share of the cost of prescriptions.

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      (f) Between fifty-five (55) and sixty-five (65) years of age and receiving social security

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disability benefits. These persons shall pay one hundred percent (100%) of the cost of

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prescriptions set forth in section 42-66.2-4.

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      (g) For all additional drugs, the consumer shall pay one hundred percent (100%) of the

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cost of prescriptions as set forth in section 42-66.2-4.

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     SECTION 2. This act shall take effect upon passage.

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LC00953

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO PHARMACEUTICAL ASSISTANCE TO THE ELDERLY

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     This act would raise the income levels in determining the percentage of state and

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consumer co-payments under the pharmaceutical assistance to the elderly act.

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     This act would take effect upon passage.

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LC00953

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