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 3129
B-Engrossed
Senate Bill 9
Ordered by the Senate July 6
Including Senate Amendments dated May 10 and July 6
Sponsored by Senator DERFLER; Senators ATKINSON, FERRIOLI,
FISHER, HARTUNG, MESSERLE, MINNIS, NELSON, STARR
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.
Creates Patient Prescription Drug Assistance Program
{ - in - } { + to be operated by + } College of Pharmacy at
Oregon State University { + until June 30, 2003. Provides that
on or after July 1, 2003, Department of Human Services may
contract with college of pharmacy or any pharmacy provider to
operate program. Specifies that purpose of program is + } to
assist low-income Oregonians in gaining access to prescription
drug assistance programs offered by pharmaceutical companies if
patient is not eligible for publicly funded prescription drug
benefit.
Appropriates moneys to Department of Higher Education for
program.
{ + Creates Senior Prescription Drug Assistance Program.
Provides that person is eligible for program if person is 65
years of age or older, has gross annual income that does not
exceed lesser of amount established by Department of Human
Services by rule or 185 percent of federal poverty guidelines and
meets other criteria. Requires pharmacy to charge enrollee in
program specified price plus specified dispensing fee. Requires
department to adopt rules identifying critical access pharmacies
and providing for additional reimbursement to critical access
pharmacies. Authorizes critical access pharmacy to charge
enrollee a fee of not more than $2 per prescription. + }
Declares emergency, effective { - July 1, 2001 - } { + on
passage + }.
A BILL FOR AN ACT
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. + }
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