71st OREGON LEGISLATIVE ASSEMBLY--2001 Regular Session
 
NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .
 
LC 3950
 
                         House Bill 3568
 
Sponsored by Representative SCHRADER; Representative V WALKER (at
  the request of Bob Post)
 
 
                             SUMMARY
 
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
 
  Creates Senior Prescription Drug Benefit Program in Department
of Human Services.
  Appropriates moneys from General Fund to Department of Human
Services for program.
  Declares emergency, effective July 1, 2001.
 
                        A BILL FOR AN ACT
Relating to Senior Prescription Drug Benefit Program;
  appropriating money; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + As used in sections 1 to 4 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 of not more than 135 percent of
the federal poverty guidelines; and
  (c) Is not covered under any public or private prescription
drug benefit program.
  (2) 'Enrollee' means an eligible person who is enrolled in the
Senior Prescription Drug Benefit Program created in section 2 of
this 2001 Act.
  (3) 'Federal poverty guidelines' means the most recent poverty
income level 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) 'Medical assistance' has the meaning given that term in ORS
414.025.
  (6) 'Practitioner' has the meaning given that term in ORS
689.005.
  (7) 'Public assistance' has the meaning given that term in ORS
411.010. + }
  SECTION 2.  { + (1) The Senior Prescription Drug Benefit
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) The Senior Prescription Drug Benefit Program shall provide
reimbursement to a pharmacy in the same manner as, and for the
same prescription drugs covered by, the medical assistance
program operated under ORS chapter 414.
 
  (3) The department shall develop a single-page application for
the Senior Prescription Drug Benefit Program and issue a program
card to enrollees. The department shall assist applicants in
applying for public assistance programs for which they may
qualify.
  (4) For each prescription, an enrollee shall be responsible for
a copayment of:
  (a) Not more than $8 per prescription drug in the generic form;
  (b) Not more than $15 per prescription drug in the nongeneric
form if a generic substitution is not available; and
  (c) Not more than $15 per prescription and 30 percent of the
cost of the drug in nongeneric form if a generic form is
available.
  (5) An enrollee with an income between 100 percent and 135
percent of the federal poverty guidelines shall pay a deductible
of $500 per year before being eligible for benefits under the
Senior Prescription Drug Benefit Program.
  (6)(a) This section applies to any pharmacy that uses an
electronic claims processing or claims management system that
incorporates on-line points of sale.
  (b) The on-line point of sale system shall be administered by a
pharmacy benefits manager. + }
  SECTION 3.  { + (1) At the time of enrollment in the Senior
Prescription Drug Benefit Program, an enrollee shall designate a
primary pharmacy to dispense prescription drugs prescribed by a
practitioner and covered by the program.
  (2) Notwithstanding subsection (1) of this section, an enrollee
may obtain prescription drugs at a pharmacy other than the
primary pharmacy designated under subsection (1) of this section
if:
  (a) The enrollee is more than 25 miles from the designated
primary pharmacy and a practitioner indicates to another pharmacy
that the prescription drug is medically necessary; or
  (b) A practitioner indicates to another pharmacy that a
prescription drug is required for a medical emergency. + }
  SECTION 4.  { + The Department of Human Services shall adopt
rules necessary to implement and administer sections 1 to 4 of
this 2001 Act. + }
  SECTION 5.  { + In addition to and not in lieu of any other
appropriation, there is appropriated to the Department of Human
Services, for the biennium beginning July 1, 2001, out of the
General Fund, the amount of $_____, for the purposes of sections
1 to 4 of this 2001 Act. + }
  SECTION 6.  { + 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 July 1,
2001. + }
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