- Introduced -

SB 1371 - This act will close the standard drug benefit coverage gap for certain seniors that was created due to the enactment of the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

The "Missouri Senior Prescription Drug Plan" is created within the Department of Health and Senior Services. This plan is not an entitlement and is only a payer of last resort. Beginning January 1, 2006 and subject to appropriations, the state shall pay seventy-five percent of the standard drug benefit coverage gap of $2850 for eligible individuals whose income is within 150% to 200% of the federal poverty level or for eligible individuals whose income is 150% below the federal poverty level and who fail the asset test.

The plan shall provide coverage for only the prescription drugs covered in the providers' formulary under the federal program. The plan shall not include coverage for any of the following drugs:

-those used for anorexia and weight gain;

-those used to promote fertility;

-those used for cosmetic purposes or hair growth;

-those used for coughs or colds;

-prescription vitamins;

-nonprescription drugs;

-barbiturates; and

-benzodiazepines.

The plan shall also exclude any drugs that are not "reasonable and necessary" as defined pursuant to the federal program. The plan shall not be charged any amount in excess of the amount that the providers charge the federal program.

A new Section 208.582 creates the "Missouri Senior Prescription Drug Plan Commission", which shall be composed of nine members. Members appointed by the Governor shall serve for three years, legislative members shall serve for their current term of office, and all other members shall serve for as long as they hold the position which made them eligible for appointment.

The Commission shall have rule-making authority for the implementation of the plan and shall apply for any applicable federal waivers or grants. Members of the Commission shall receive no compensation, but may be reimbursed for any expenses incurred. The Commission may also employ administrative staff as necessary to assist the Commission.

Beginning November 15, 2005, applications for the program will be conducted jointly with applications for the Medicare Part D benefit. The Commission shall verify annually the eligibility of applicants for the plan.

A new Section 208.584 establishes the "Missouri Senior Prescription Drug Plan Clearinghouse" within the Commission. The purpose of the Clearinghouse is to assist all Missourians in accessing prescription drugs programs, to educate the public on quality drug programs, to maintain a toll-free number, and to provide information on eligibility, enrollment, and benefits for the plan on the Department's website.

Sections 208.550 to 208.571 pertaining to the Missouri Senior Rx Program shall terminate thirty days after notice is provided to the Revisor of Statutes that the Medicare Prescription Drug, Improvement and Modernization Act of 2003 has been fully implemented.

LORIE TOWE