SB 0096

AN ACT establishing a pharmacy discount program for seniors and disabled persons and making an appropriation therefor.

SPONSORS: Sen. Larsen, Dist 15; Sen. Barnes, Dist 17; Sen. Estabrook, Dist 21; Sen. Cohen, Dist 24; Sen. Foster, Dist 13; Sen. Gatsas, Dist 16; Rep. Pilliod, Belk 31; Rep. Emerton, Hills 48; Rep. Miller, Straf 72

This bill requires the department of health and human services to establish a pharmacy discount program for certain seniors and disabled persons.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT establishing a pharmacy discount program for seniors and disabled persons and making an appropriation therefor.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Subdivision; Pharmacy Discount Program. Amend RSA 167 by inserting after section 97 the following new subdivision:

167:98 Program Established. There is hereby established the pharmacy discount program for New Hampshire seniors and disabled persons below 200 percent of the federal poverty level. The department is hereby authorized to administer this program.

II. "Drugs" means all prescription drugs that have been approved as safe and effective by the federal Food and Drug Administration or are otherwise legally marketed in the United States, including insulin, insulin syringes, and insulin needles.

(b) Is 18 years of age or older and has been determined to be "disabled" by the Social Security Administration; and

(c) Has a gross annual household income of not more than 200 percent of the federal poverty level. For the purposes of determining eligibility under this section, annual income shall not include the cost of Medicare Part B premiums unless the cost of the premium is paid by the department.

IV. "Enrollee" means an eligible individual who receives benefits under the pharmacy assistance program established by this subdivision.

V. "Program" means the pharmacy discount program established under this subdivision.

I. The department of health and human services shall administer the pharmacy discount program for eligible persons who lack coverage for necessary prescription drugs. Enrollment in the program shall be voluntary.

II. The department shall verify the income of applicants for the program according to the most recent income tax returns for the applicant. If an applicant is not required to pay income tax, the department shall verify the applicant's income through submission of monthly checks received by said applicant.

III. The department shall conduct outreach marketing efforts to ensure that eligible senior citizens and people with disabilities are aware of the availability of the program, to provide eligible individuals with the guidelines of the program, and to maximize enrollment in the program.

IV. The department shall hold harmless, from any financial costs, all pharmacies participating in the program. At a minimum, the state shall reimburse pharmacies for their actual costs for participating in the program.

167:101 Federal Waiver. The pharmacy discount program authorized by this subdivision shall be implemented under a section 1115 Medicaid waiver, wherein the state makes a payment toward the cost of the drugs dispensed to individuals enrolled in this program of at least 2 percent of the cost of each prescription and refill, consistent with the appropriation for the program established in this subdivision.

167:102 Rulemaking. The department shall adopt rules, pursuant to RSA 541-A, in order to implement the program established in this subdivision.

167:103 Report. The department shall make a report on or before January 1 each year, commencing January 1, 2005, relative to the program established in this subdivision to the senate president, the speaker of the house of representatives, and the governor.

2 Appropriation. There is hereby appropriated the sum of $10 for the fiscal year ending June 30, 2004, and the sum of $10 for the fiscal year ending June 30, 2005, to the department of health and human services to implement the pharmacy discount program established by this act. The governor is authorized to draw a warrant for said sums out of any money in the treasury not otherwise appropriated.

AN ACT establishing a pharmacy discount program for seniors and disabled persons and making an appropriation therefor.

The Department of Health and Human Services indicated this bill, as amended by the Senate (Senate Amendment #2003-1111s), will have an indeterminable fiscal impact on state revenue and expenditures in FY 2004 and in each year thereafter. There will be no fiscal impact on county and local revenue or expenditures.

This bill appropriates $10 in FY 2004 and $10 in FY 2005 in general funds to the Department of Health and Human Services to implement the pharmacy discount program.

The Department indicated this bill establishes a pharmacy discount program for uninsured elderly and disabled residents, and will require federal approval of a Medicaid 1115 demonstration waiver. This program will require a state contribution to prescription and refill costs for administrative costs, and will extend Medicaid price discounts to the individuals by taking advantage of the drug manufacturer's rebates. The Department stated that the program described in this bill is similar to a program established by the State of Maine. Maine is presently renegotiating the terms of its waiver with the federal government as a result of a legal challenge by drug manufacturers. In considering the impact of this bill, the Department made the following assumptions:

· Operation of the program will be contingent upon federal approval of a Medicaid 1115 waiver application.

· The New Hampshire program will be based on the program that the federal government approves for the State of Maine. Maine's current program is under review and will need revision before final approval is granted.

· This program will start in January of 2004 consistent with the effective date of the bill.

· Based on U.S. Census data, the Department expects 80,000 individuals will be eligible for the program in FY 2004.

Additional state contributions beyond the existing appropriation currently in this bill would be necessary to obtain federal approval and to establish the program.