Maryland Health - General Section 15-124.1

CAUTION: READ FULL TEXT OF SECTION FOR SPECIAL NOTE

      (a)      (1)      In this section the following words have the meanings indicated.

            (2)      "Enrollee" means an individual who is enrolled in the Medicare Option Prescription Drug Program.

            (3)      "Program" means the Medicare Option Prescription Drug Program established under this section.

      (b)      There is a Medicare Option Prescription Drug Program within the Maryland Medical Assistance Program.

      (c)      The purpose of the Program is to improve the health status of Medicare beneficiaries who lack prescription drug coverage by providing access to lower cost, medically necessary, prescription drugs.

      (d)      The Program shall be administered and operated by the Department as permitted by federal law or waiver.

      (e)      (1)      The Program shall be open to Medicare beneficiaries who lack other public or private prescription drug coverage.

            (2)      Notwithstanding paragraph (1) of this subsection, enrollment in the Maryland Medbank Program established under § 15-124.2 of this subtitle or the Maryland Pharmacy Assistance Program established under § 15-124 of this subtitle does not disqualify an individual from being eligible for the Program.

      (f)      (1)      Subject to subsection (g) of this section, an enrollee may purchase medically necessary prescription drugs that are covered under the Maryland Medical Assistance Program from any pharmacy that participates in the Maryland Medical Assistance Program at a price that is based on the price paid by the Maryland Medical Assistance Program, minus the aggregate value of any federally mandated manufacturers' rebates.

            (2)      Subject to subsection (g) of this section, and to the extent authorized under federal waiver, an enrollee whose annual household income is at or below 175 percent of the federal poverty guidelines may receive a discount subsidized by the Department that is equal to 35 percent of the price paid by the Maryland Medical Assistance Program for each medically necessary prescription drug purchased under the Program.

      (g)      The Department may establish mechanisms to:

            (1)      Recover the administrative costs of the Program;

            (2)      Reimburse participating pharmacies in an amount equal to the Maryland Medical Assistance price, minus the copayment paid by the enrollee for each prescription filled under the Program; and

            (3)      Allow participating pharmacies to collect a $1 processing fee, in addition to any authorized dispensing fee, for each prescription filled for an enrollee under the Program.

      (h)      The Secretary shall adopt regulations to implement the Program.

** SPECIAL NOTE: CONTINGENCY - CHAPTERS 280 AND 418 - 2005 **

** SPECIAL NOTE: SECTION DUE TO BE REPEALED - EFFECTIVE - LATER OF JANUARY 1, 2006 OR AVAILABILITY OF RX BENEFITS - CHAPTERS 281 AND 282 OF 2005 **

      (a)      (1)      In this section the following words have the meanings indicated.

            (2)      "Enrollee" means an individual who is enrolled in the Medicare Option Prescription Drug Program.

            (3)      "Program" means the Medicare Option Prescription Drug Program established under this section.

      (b)      There is a Medicare Option Prescription Drug Program within the Maryland Medical Assistance Program.

      (c)      The purpose of the Program is to improve the health status of lower-income individuals who are not Medicare beneficiaries and who lack prescription drug coverage by providing access to lower cost, medically necessary, prescription drugs.

      (d)      The Program shall be administered and operated by the Department as permitted by federal law or waiver.

      (e)      (1)      The Program shall be open to individuals who are not Medicare beneficiaries, who lack other public or private prescription drug coverage, and who have an annual household income below 200% of the federal poverty level guidelines.

            (2)      Notwithstanding paragraph (1) of this subsection, enrollment in the Maryland Medbank Program established under § 15-124.2 of this subtitle or the Maryland Pharmacy Assistance Program established under § 15-124 of this subtitle does not disqualify an individual from being eligible for the Program.

      (f)      Subject to subsection (g) of this section, an enrollee may purchase medically necessary prescription drugs that are covered under the Maryland Medical Assistance Program from any pharmacy that participates in the Maryland Medical Assistance Program at a price that is based on the price paid by the Maryland Medical Assistance Program, minus the aggregate value of any federally mandated manufacturers' rebates and any State contribution amount.

      (g)      The Department may establish mechanisms to:

            (1)      Recover the administrative costs of the Program;

            (2)      Reimburse participating pharmacies in an amount equal to the Maryland Medical Assistance price, minus the copayment paid by the enrollee for each prescription filled under the Program; and

            (3)      Allow participating pharmacies to collect a $1 processing fee, in addition to any authorized dispensing fee, for each prescription filled for an enrollee under the Program.

      (h)      The Secretary shall adopt regulations to implement the Program.