Senate Bill 2610

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    Florida Senate - 2000                                  SB 2610

    By Senator Forman





    32-1453A-00

  1                      A bill to be entitled

  2         An act relating to health care; creating the

  3         Senior Pharmaceutical Assistance Act; requiring

  4         the Department of Elderly Affairs to establish

  5         a program to enable senior residents to receive

  6         state funds to pay for prescription drugs;

  7         providing enrollment periods; providing

  8         conditions; providing qualifications; requiring

  9         the department to inform the public; requiring

10         county property appraisers to provide

11         information; providing an advisory panel;

12         providing membership and duties; providing

13         guidelines for drugs to be considered eligible

14         for payment under the program; providing for

15         enrollee assessments and copayments; providing

16         for future legislative review; providing an

17         effective date.

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19  Be It Enacted by the Legislature of the State of Florida:

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21         Section 1.  (1)  This section may be cited as the

22  "Senior Pharmaceutical Assistance Act."

23         (2)  The Department of Elderly Affairs shall establish

24  a statewide program to enable residents 65 years of age or

25  older to receive state funds to pay for prescription drugs as

26  provided in this section.

27         (3)(a)  Enrollment in the program will be open for 90

28  days beginning January 1, 2001, for all residents of the state

29  who are 65 years of age or older during this 90-day period.

30  Thereafter, such residents are ineligible for enrollment.

31  Residents of the state who reach age 65 after the 90-day open

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    Florida Senate - 2000                                  SB 2610
    32-1453A-00




  1  enrollment period have 90 days from the date of their 65th

  2  birthday to enroll in the program. Thereafter, such residents

  3  are ineligible to enroll in the program. Persons who become

  4  residents of the state and are 65 years of age or older

  5  subsequent to the close of the open enrollment period have 90

  6  days from the date they apply for homestead exemption to

  7  enroll in the program. Thereafter, such residents are

  8  ineligible to enroll in the program.

  9         (b)  Assistance under this act shall not be granted to

10  any person who, at the time of enrollment, is receiving

11  medical assistance under any other provision of law of this

12  state or to any person receiving equivalent or better coverage

13  from any other public or private third-party payment source or

14  insurance plan than those benefits provided for under this

15  act.

16         (c)  An individual who is determined eligible for

17  assistance under this act whose prescription costs are covered

18  in part by any public or private plan may receive reduced

19  assistance under this act. In such cases, benefits provided

20  through this act shall be considered payments of last resort.

21         (d)  The fact that some of an individual's prescription

22  drug expenses are paid or reimbursable under Medicare or any

23  other public or private third-party payment source or

24  insurance plan shall not disqualify an individual from

25  receiving assistance under this act. In such cases, the state

26  shall pay the portion of the cost of those prescriptions for

27  qualified drugs for which no payment or reimbursement is made

28  by Medicare or any other public or private third-party payment

29  source or insurance plan, less the participant's copayment

30  required on the amount not paid by Medicare. In such cases,

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    Florida Senate - 2000                                  SB 2610
    32-1453A-00




  1  benefits provided through this act shall be considered

  2  payments of last resort.

  3         (4)  The Department of Elderly Affairs shall provide

  4  information through the media to the public concerning the

  5  benefits and enrollment qualifications of the program. The

  6  department shall provide such information to all county

  7  property appraisers. A county property appraiser shall

  8  distribute this information to each applicant for homestead

  9  exemption.

10         (5)(a)  There is created an advisory panel to be

11  staffed by the Department of Elderly Affairs. This panel shall

12  be made up of the following members:

13         1.  A practicing physician, a practicing pharmacist, a

14  practicing dentist, one representative of a health insurer,

15  one representative of a health maintenance organization, one

16  representative of a Medicare supplement plan, two residents

17  who are 65 years of age or older, and one representative of a

18  pharmaceutical manufacturer appointed by the President of the

19  Senate.

20         2.  A practicing physician, a practicing pharmacist, a

21  practicing dentist, one representative of a health insurer,

22  one representative of a health maintenance organization, one

23  representative of a Medicare supplement plan, two residents

24  who are 65 years of age or older, and one representative of a

25  pharmaceutical manufacturer appointed by the Speaker of the

26  House of Representatives.

27         3.  The Secretary of the Department of Elderly Affairs

28  or the secretary's designee.

29         4.  The Executive Director of the Agency for Health

30  Care Administration or the executive director's designee.

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    Florida Senate - 2000                                  SB 2610
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  1         (b)  The advisory panel must be appointed no later than

  2  August 1, 2000. The panel shall develop a list of prescription

  3  drugs that may be used by enrollees in the program and paid

  4  for by funds appropriated to the department for that purpose.

  5  The panel shall develop this formulary for use by January 1,

  6  2001. The panel shall consider only those drugs with a

  7  manufacturer's rebate. The formulary must include diabetic

  8  glucose monitoring supplies. Drugs are subject to copayments.

  9  Medicaid pricing must be used for the costs of the drugs.

10         (6)  Each enrollee in the program must be assessed a

11  premium of $50 per month.

12         (a)  The department shall pay the entire premium for an

13  enrollee whose income is 150 percent of the federal poverty

14  level.

15         (b)  The department shall pay one-half of the premium

16  for an enrollee whose income is over 150 percent of the

17  federal poverty level but less than 200 percent of the federal

18  poverty level.

19         (c)  An enrollee whose income is 200 percent or more of

20  the federal poverty level shall pay 100 percent of the

21  premium.

22         (7)  An enrollee is responsible for a copayment for

23  drugs. The generic brand drug and diabetic glucose monitoring

24  supplies will be the same as that in the State Group Insurance

25  Plan. There must be a copayment of 20 percent of the costs for

26  brand-name drugs.

27         (8)  The program may not authorize payment for 90-day

28  prescriptions for maintenance drugs unless a long-term drug

29  selection has been made by the enrollee and his or her

30  physician.

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    Florida Senate - 2000                                  SB 2610
    32-1453A-00




  1         Section 2.  The Legislature shall review this act if

  2  the Federal Government enacts legislation that authorizes

  3  payment for prescription drugs.

  4         Section 3.  This act shall take effect upon becoming a

  5  law.

  6

  7            *****************************************

  8                          SENATE SUMMARY

  9    Creates the Senior Pharmaceutical Assistance Act.
      Requires the Department of Elderly Affairs to establish a
10    program to enable senior residents to receive state funds
      to pay for prescription drugs. Provides enrollment
11    periods. Provides qualifications. Provides for
      distribution of information concerning the program to the
12    public. Creates an advisory panel and provides duties and
      membership. Provides guidelines for drugs to be
13    considered eligible for payment under the program.
      Provides for enrollee copayments and assessments.
14    Provides for future legislative review.

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