Sec. RR-1. 22 MRSA §254, sub-§8, ¶B, as amended by PL 1993, c. 410, Pt. I, §6, is further amended to read:
B. For the quarters beginning October 1, 1992, the rebate percentage is equal to the percentage recommended by the federal Health Care Financing Administration of the manufacturer's wholesale price for the total number of dosage units of each form and strength of a prescription drug that the department reports as reimbursed to providers of prescription drugs, provided payments are not due until 30 days following the manufacturer's receipt of utilization data supplied by the department, including the number of dosage units reimbursed to providers of prescriptions prescription drugs during the period for which payments is are due.
Sec. RR-2. 22 MRSA §254, sub-§8, ¶C is enacted to read:
C. Beginning October 1, 1998, the department shall seek to achieve an aggregate rebate amount from all rebate agreements that is 6 percentage points higher than that required by paragraph B of this subsection, provided such rebates result in a net increase in the rebate revenue available to the elderly low-cost drug program. In the event the department is not able to achieve the rebate amount required by this paragraph without compromising the best interest of recipients of the elderly low-cost drug program, it shall report to the joint standing committee of the Legislature having jurisdiction over health and human services matters and the joint standing committee of the Legislature having jurisdiction over appropriations and financial affairs in the First Regular Session of the 119th Legislature.
Sec. RR-3. 22 MRSA §254-A is enacted to read:
§254-A. Elderly low-cost drug program information
The department shall produce and provide educational materials about the availability of benefits under and application process for the elderly low-cost drug program established under section 254. These materials must include brochures for the Bureau of Revenue Services to mail to eligible residents with drug cards, posters for pharmacies and flyers for pharmacists to include with prescription drug purchases.
Sec. RR-4. 22 MRSA §3174-G, sub-§1-A is enacted to read:
1-A. Elderly prescription drug program. The department shall apply to the federal Health Care Financing Administration for a waiver to provide Medicaid prescription drug benefits to qualified persons 62 years of age or older. The department must seek the highest income level for which the department is able to obtain federal approval. The department shall limit the state share of program costs to the General Fund amounts available to the department from appropriations to the Low Cost Drugs for Maine's Elderly program and funds received pursuant to section 3174-R. The department shall pursue this waiver in the manner most likely to receive federal approval, including packaging this request in a larger waiver request with other Medicaid initiatives for which the department must seek a waiver of any type or another form of approval from the federal Health Care Financing Administration. The waiver request required by this subsection must be submitted to the federal Health Care Financing Administration no later than January 1, 1999. The department shall report its progress in obtaining the waiver to the Joint Standing Committee on Appropriations and Financial Affairs and the Joint Standing Committee on Health and Human Services no later than October 1, 1998. The department shall submit legislation to provide coverage under this section prior to providing such coverage.
Sec. RR-5. 22 MRSA §3174-R is enacted to read:
§3174-R. Medicaid drug rebate program
The department shall enter into a drug rebate agreement with each manufacturer of prescription drugs under the Medicaid program in accordance with Section 1927 of the federal Social Security Act, as long as the agreements are consistent with state and federal law, are approved by the federal Health Care Finance Administration and result in a net increase in rebate revenue available to the Maine Medicaid Program. Individual rebate agreements may vary. The department shall seek to achieve an aggregate rebate amount from all agreements that is at least 6 percentage points higher than the percentage of the total Medicaid drug expenditures that the rebates would otherwise be under Section 1927 of the federal Social Security Act. Any increase in revenue from the Medicaid drug rebate program over accepted estimates as of the effective date of this section that results in a higher percentage of the total Medicaid drug rebates must be reserved to provide coverage pursuant to section 3174-G, subsection 1-A. In the event that the department is not able to achieve the rebate amount required by this section without compromising the best interest of Medicaid recipients and the Medicaid drug rebate program, the department shall report to the joint standing committee of the Legislature having jurisdiction over health and human services matters and the joint standing committee of the Legislature having jurisdiction over appropriations and financial affairs in the next regular session of the 119th Legislature.
Sec. RR-6. 36 MRSA §6162-A, sub-§2, as amended by PL 1995, c. 368, Pt. CCC, §6 and affected by §11, is further amended to read:
2. Income. Eligibility for this program is determined by the same income levels as eligibility for elderly households is determined under chapter 907, except that individuals are also eligible for this program if the household spends at least 40% of its income on unreimbursed direct medical expenses for prescription drugs and the household income is not more than 25% higher than the levels specified in chapter 907. For the purposes of this subsection, the costs of drugs provided to a household under this chapter is considered a cost spent by the household for eligibility determination purposes.
Sec. RR-7. Rules. The Department of Human Services shall adopt rules that specify which drugs,
medications and medical supplies will be added to those currently provided under the elderly low-cost drug program, pursuant to the Maine Revised Statutes, Title 22, section 254, utilizing funds appropriated in section 8 of this Part.
Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter II-A.
Sec. RR-8. Appropriation. The following funds are appropriated from the General Fund to carry out the purposes of this Part.
1998-99
HUMAN SERVICES, DEPARTMENT OF
Low Cost Drugs for Maine's Elderly
All Other $2,000,000
Provides funds to cover the costs of expanding the number of drugs covered by the elderly low-cost drug program.
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