HB 1560-FN-A-LOCAL – AS INTRODUCED
2008 SESSION
01/09
HOUSE BILL 1560-FN-A-LOCAL
AN ACT relative to the pharmaceutical assistance program and making an appropriation therefor.
SPONSORS: Rep. Ehlers, Merr 9; Rep. Donovan, Sull 4; Rep. DeJoie, Merr 11; Rep. Case, Rock 1; Rep. Nord, Rock 1
COMMITTEE: Health, Human Services and Elderly Affairs
This bill allows nursing home residents who are enrolled in Medicare Part D or a Medicare Advantage Plan with prescription coverage to participate in the New Hampshire pharmaceutical assistance program. This bill also makes an appropriation to purchase pharmaceuticals for nursing home residents who are eligible for services under both Medicaid and Medicare.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
08-2053
01/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT relative to the pharmaceutical assistance program and making an appropriation therefor.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Statement of Purpose. The general court recognizes that there is often a gap in coverage for pharmaceuticals when a resident of a nursing home is prescribed a drug that is not on the resident’s prescription drug plan under Medicare Part D or a Medicare Advantage Plan with prescription coverage. In this case, the nursing home or the resident’s family pay for the drug to comply with physician orders. Therefore, the general court hereby allows nursing home residents enrolled in Medicare Part D and/or a Medicare Advantage Plan with prescription coverage to participate in the New Hampshire pharmaceutical assistance program and makes an appropriation to assist such residents.
2 Repeal. RSA 161-K:2, I(d), relative to being a member of a Medicare Advantage Plan, is repealed.
3 Appropriation; Pharmaceutical Assistance. Up to the sum of $500,000 for the fiscal year ending June 30, 2009 is hereby continually appropriated to the department of health and human services, for the purposes of providing pharmaceutical assistance to residents of nursing homes who need pharmaceuticals which are denied upon appeal to Medicare Part D or a Medicare Advantage Plan with prescription drug coverage. This appropriation shall be nonlapsing. The governor is authorized to draw a warrant for said sum out of any money in the treasury not otherwise appropriated.
4 Effective Date. This act shall take effect July 1, 2008.
LBAO
08-2053
12/11/07
HB 1560-FN-A-LOCAL - FISCAL NOTE
AN ACT relative to the pharmaceutical assistance program and making an appropriation therefor.
FISCAL IMPACT:
The Department of Health and Human Services states this bill would increase state expenditures by an indeterminable amount in FY 2009 and each year thereafter. This bill will have no fiscal impact on state, county, and local revenue, or county and local expenditures.
This bill appropriates the sum of up to $500,000 from the state general fund to the Department in FY 2009 for the purposes of this bill.
METHODOLOGY:
The Department of Health and Human Services states this bill seeks to expand the State Pharmacy Assistance Plan (SPAP) outlined n RSA 161-K to provide coverage to nursing home residents who cannot otherwise get coverage from their Medicare Part D plan for drugs they require. The Department has no data regarding the prevalence of this problem, and cannot estimate how many residents are without coverage for necessary medications due to limits in Part D coverage, or the average cost of uncovered pharmaceuticals. Presently the Department provides “wrap around” coverage to individuals who are considered dually eligible to receive both Medicare and Medicaid assistance. Because certain drugs are not covered at all by any Medicare Part D plans, or in certain instances the drug is not on the individual’s Part D plan but is part of the Medicaid formulary, the state has provided coverage through Medicaid to cover these drugs. The Department also provides supplemental coverage for individuals as they transition to Part D if the enrollment is delayed, which is provided for with 100% state general funds. The Department states most nursing home residents will not reach the “donut hole” where Part D ceases to provide coverage, so the Department assumes that the provisions of the bill are not intended to cover drugs in these instances. These drugs are rarely covered after appeal to Medicare. This bill provides for an appropriation of up to $500,000 in FY 2009 to the Department. The Department cannot estimate what amount could be appropriated, or what would happen if requests for coverage exceeded $500,000. The Department states that since they have no other funds from which to draw upon for this purpose, the program would have to cease until the next provision of funding, impose a waiting list, or both. The Department is unable to estimate the exact fiscal impact at this time.