HS/HCS/HB 824 - This act creates the pharmaceutical investment program for seniors. The current prescription drug tax credit established in Section 135.095 terminates as of December 31, 2001.

A new Section 208.550 is created to require the Department of Social Services to establish the "Pharmaceutical Investment Program for Seniors" to aid seniors in paying the cost of prescription drugs. This section will go into effect on July 1, 2002. Participants may include:

1) Persons sixty-five years of age or older; 2) Persons with a household income at or below $15,000 for individuals and $25,000 for couples; 3) Persons with annual prescription drug costs that exceed the total deductible for twelve months; 4) Persons sixty-five or older who do not qualify under the income requirements, but who spend ten percent of their household income on pharmaceuticals. Such persons may receive up to $6000 per year after expending the required ten percent; 5) Married couples with at least one spouse sixty-five or older who do not qualify under the income requirements, but who spend ten percent of their household income on pharmaceuticals. Such couples may receive up to $12,000 per year after expending the required ten percent.

Medicaid participants are not eligible for this program, unless their Medicaid benefits do not include pharmaceutical coverage. This program is a payer of last resort. If a senior carries coverage through another plan, then the senior may only receive certain benefits after meeting the deductible. If eligible, a participant may cost-share by paying a monthly deductible based on certain guidelines. Participants will pay specific copayments for generic or brand name drugs and will pay an annual $25 administrative copayment.

The Department may not contract with private entities for program administration. The Department must submit quarterly reports. Benefits provided by this program will be limited to the funds appropriated and the Department must utilize cost control measures to reduce projected costs, if necessary. Any future federal pharmaceutical benefit program will cover costs first and this program will cover any additional costs.

Section 208.800 requires the Department to apply for necessary Medicaid waivers to establish a pharmacy discount program.
ERIN MOTLEY