Chapter 869 Oregon Laws 2001
AN ACT
SB 9
Relating to prescription
drug assistance; appropriating money; limiting expenditures; and declaring an
emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1.
(1) The Patient Prescription Drug
Assistance Program is established. The purpose of the program is to match
low-income Oregonians who lack prescription drug benefit coverage with
prescription drug assistance programs offered by pharmaceutical companies.
(2) The program shall:
(a) Provide information
on:
(A) Eligibility
requirements and coverage provided by publicly funded prescription drug benefit
programs administered by the Department of Human Services; and
(B) The process for
applying to receive publicly funded prescription drug benefits;
(b) Assist a patient in
applying to pharmaceutical companies for free or discounted prescription drug
medications if the patient is not eligible for any publicly funded prescription
drug benefit program;
(c) Provide information,
in an organized and easily understood manner, to patients, physicians,
pharmacists and pharmacies regarding patient qualifications for prescription
drug assistance programs;
(d) Increase awareness
of the various prescription drug assistance programs offered by pharmaceutical
companies; and
(e) Establish a
toll-free hotline and Internet website to increase public awareness of the
Patient Prescription Drug Assistance Program and to provide public access to
the information and services provided through the program.
(3)(a) The College of
Pharmacy at Oregon State University shall operate the Patient Prescription Drug
Assistance Program until June 30, 2003, and may operate the program thereafter
unless the Department of Human Services enters into a contract described in
paragraph (b) of this subsection.
(b) For periods on or
after July 1, 2003, the Department of Human Services may contract with any
pharmacy provider to operate the Patient Prescription Drug Assistance Program.
SECTION 2.
There is appropriated to the Department
of Higher Education, for the biennium beginning July 1, 2001, out of the
General Fund, the amount of $100,000 for the College of Pharmacy at Oregon
State University to implement section 1 of this 2001 Act.
SECTION 3.
As used in this section and sections 4
and 6 of this 2001 Act:
(1) “Eligible person”
means a resident of this state who:
(a) Is 65 years of age
or older;
(b) Has a gross annual
income that does not exceed the lesser of the maximum amount established by the
Department of Human Services by rule or 185 percent of the federal poverty
guidelines;
(c) Has not been covered
under any public or private prescription drug benefit program for the previous
six months; and
(d) Has less than $2,000
in resources.
(2) “Enrollee” means a
person who has been found to be eligible for the Senior Prescription Drug
Assistance Program, who has paid an enrollment fee of up to $50 and who has a
Senior Prescription Drug Assistance Program enrollment card issued by the
Department of Human Services.
(3) “Federal poverty
guidelines” means the most recent poverty guidelines as published annually in
the Federal Register by the United States Department of Health and Human
Services.
(4) “Income” has the
meaning given that term in ORS 413.005.
(5) “Resources” includes
but is not limited to cash, checking and savings accounts, certificates of
deposit, money market funds, stocks and bonds. “Resources” does not include the
primary residence or car of an eligible person.
(6) “Senior Prescription
Drug Assistance Program price” means the price of a prescription drug paid by
an enrollee that is equal to or less than the Medicaid price.
SECTION 4.
(1) The Senior Prescription Drug
Assistance Program is created in the Department of Human Services. The purpose
of the program is to provide financial assistance to eligible persons for the
purchase of prescription drugs.
(2) A pharmacy shall
charge an enrollee the Senior Prescription Drug Assistance Program price for a
prescription drug upon presentation of a Senior Prescription Drug Assistance
Program enrollment card.
(3) A pharmacy may
charge the enrollee an amount established by the Department of Human Services
to cover the professional dispensing fee, which may not exceed the fee paid by
the state Medicaid program.
(4) This section does
not apply to over-the-counter medications.
(5) The department shall
provide a mechanism to calculate and transmit the Senior Prescription Drug
Assistance Program price to the pharmacy.
(6) A person seeking to
participate in the Senior Prescription Drug Assistance Program shall apply
annually by completing and mailing a one-page application and including payment
of an enrollment fee established by the department, not to exceed $50. The department
shall issue an enrollment card annually to enrollees of the program. Each
individual’s application shall be considered separately, regardless of the
number of persons in the individual’s household.
(7) The maximum
prescription drug assistance available annually to an enrollee is $2,000.
(8) Subject to funds
available, the Department of Human Services may adjust the Senior Prescription
Drug Assistance Program price to subsidize up to 50 percent of the Medicaid
price of the prescription drug, using a sliding scale based on the income and resources
of an enrollee.
(9)(a) The department
shall adopt rules that:
(A) Identify critical
access pharmacies; and
(B) Provide for
additional reimbursement to critical access pharmacies that participate in the
Senior Prescription Drug Assistance Program.
(b) In addition, a
critical access pharmacy may charge an enrollee a fee of not more than $2 per
prescription. The $2 charge shall be annually adjusted for inflation using the
U.S. City Average Consumer Price Index, as defined in ORS 316.037.
SECTION 5.
Notwithstanding ORS 323.455 and section
3, chapter 385, Oregon Laws 1995, if cigarette tax revenues for the biennium
beginning July 1, 2001, that are dedicated to funding the Oregon Health Plan
under ORS 323.455 (4) and section 3 (3), chapter 385, Oregon Laws 1995, equal
$175 million, any additional cigarette tax revenues raised during the biennium
beginning July 1, 2001, that otherwise would be distributed to the Oregon
Health Plan shall be credited to the Senior Prescription Drug Assistance Fund
established under section 6 of this 2001 Act.
SECTION 6.
The Senior Prescription Drug Assistance
Fund is established separate and distinct from the General Fund. The Senior
Prescription Drug Assistance Fund may receive any appropriations, allocations,
federal moneys or gifts designated for the Senior Prescription Drug Assistance
Program. The moneys in the Senior Prescription Drug Assistance Fund are
continuously appropriated to the Department of Human Services and shall be used
to reimburse retail pharmacies for subsidized prices provided to enrollees and
to reimburse the department for the costs of administering the program,
including contracted services costs, computer costs, professional fees paid to
retained pharmacies and other reasonable program costs. Interest earned on the
fund accrues to the fund.
SECTION 7.
Notwithstanding any other law, the
amount of $1 is established for the biennium beginning July 1, 2001, as the
maximum limit for payment of expenses from moneys in the Senior Prescription
Drug Assistance Fund for the Senior Prescription Drug Assistance Program
established under section 4 of this 2001 Act and the expenses of the Department
of Human Services in administering the program.
SECTION 8.
The Department of Human Services shall
adopt rules necessary to implement section 4 of this 2001 Act.
SECTION 9.
The Department of Human Services shall
seek any waivers from the Centers on Medicare and Medicaid Services necessary
to implement section 4 of this 2001 Act.
SECTION 10.
The Department of Human Services may
contract with a pharmacy provider or a pharmacy benefits manager to provide
services under the Senior Prescription Drug Assistance Program established
under section 4 of this 2001 Act.
SECTION 11.
This 2001 Act being necessary for the
immediate preservation of the public peace, health and safety, an emergency is
declared to exist, and this 2001 Act takes effect on its passage.
Approved by the Governor
July 30, 2001
Filed in the office of
Secretary of State July 30, 2001
Effective date July 30, 2001
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