Senate Bill 0940e1

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    CS for CS for SB 940                           First Engrossed



  1                      A bill to be entitled

  2         An act relating to delivery of health care

  3         services; creating a pharmaceutical expense

  4         assistance program; providing eligibility;

  5         prescribing duties of the Agency for Health

  6         Care Administration and other entities;

  7         providing for rules; requiring a report;

  8         prescribing prerequisites that drug

  9         manufacturers must meet in order for their drug

10         products to be covered under the program or

11         Medicaid; requiring pharmaceutical

12         manufacturers to file disclosure reports to the

13         Agency for Health Care Administration for

14         certain expenditures on certain licensed health

15         care professionals; requiring reimbursements

16         under the program to be the same as those for

17         Medicaid; requiring pharmacies that participate

18         in the program or in Medicaid to agree to

19         limitations on compensation for Medicare

20         beneficiaries; providing appropriations;

21         directing the use of rebates received;

22         providing an effective date.

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

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26         Section 1.  Pharmaceutical expense assistance.--

27         (1)  PROGRAM ESTABLISHED.--There is established a

28  program to provide pharmaceutical expense assistance to

29  certain low-income elderly individuals.

30         (2)  ELIGIBILITY.--Eligibility for the program is

31  limited to those individuals who qualify for limited


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    CS for CS for SB 940                           First Engrossed



  1  assistance under the Florida Medicaid program as a result of

  2  being dually eligible for both Medicare and Medicaid, but

  3  whose limited assistance or Medicare coverage does not include

  4  any pharmacy benefit. Specifically eligible are low-income

  5  senior citizens who:

  6         (a)  Are Florida residents age 65 and over;

  7         (b)  Have an income between 90 and 120 percent of the

  8  federal poverty level;

  9         (c)  Are eligible for both Medicare and Medicaid;

10         (d)  Are not enrolled in a Medicare health maintenance

11  organization that provides a pharmacy benefit; and

12         (e)  Request to be enrolled in the program.

13         (3)  BENEFITS.--Medications covered under the

14  pharmaceutical expense assistance program are those covered

15  under the Medicaid program in section 409.906(20), Florida

16  Statutes. Monthly benefit payments shall be limited to $80 per

17  program participant. Participants are required to make a

18  10-percent coinsurance payment for each prescription purchased

19  through this program.

20         (4)  ADMINISTRATION.--The pharmaceutical expense

21  assistance program shall be administered by the Agency for

22  Health Care Administration, in consultation with the

23  Department of Elderly Affairs.

24         (a)  The Agency for Health Care Administration and the

25  Department of Elderly Affairs shall develop a single-page

26  application for the pharmaceutical expense assistance program.

27         (b)  The Agency for Health Care Administration shall,

28  by rule, establish for the pharmaceutical expense assistance

29  program eligibility requirements, limits on participation,

30  benefit limitations, a requirement for generic-drug

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    CS for CS for SB 940                           First Engrossed



  1  substitution, and other program parameters comparable to those

  2  of the Medicaid program.

  3         (c)  By January 1 of each year, the Agency for Health

  4  Care Administration shall report to the Legislature on the

  5  operation of the program. The report shall include information

  6  on the number of individuals served, use rates, and

  7  expenditures under the program. The report shall also address

  8  the impact of the program on reducing unmet pharmaceutical

  9  drug needs among the elderly and recommend programmatic

10  changes.

11         (5)  NONENTITLEMENT.--The pharmaceutical expense

12  assistance program established by this section is not an

13  entitlement.

14         (6)  PHARMACEUTICAL MANUFACTURER PARTICIPATION.--In

15  order for a drug product to be covered under Medicaid or this

16  program, the product's manufacturer shall:

17         (a)  Provide a rebate to the state equal to the rebate

18  required by the Medicaid program; and

19         (b)  Make the drug product available to the program for

20  the best price that the manufacturer makes the drug product

21  available in the Medicaid program.

22         (c)  File an annual report with the Agency for Health

23  Care Administration which discloses the amount the

24  manufacturer spent on gifts, payments, subsidies, or other

25  financial inducements, other than complimentary samples of

26  medicinal drugs, to physicians licensed under the Board of

27  Medicine, the Board of Osteopathic Medicine, the Board of

28  Podiatric Medicine, and the Board of Dentistry in this state

29  that do not primarily and directly entail a benefit to

30  patients and are of a substantial value. The manufacturer must

31  also disclose any gifts, payments, subsidies, or other


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    CS for CS for SB 940                           First Engrossed



  1  financial inducements that exceed $100 per single practitioner

  2  per instance and any cumulative gifts, payments, subsidies, or

  3  other financial inducements that exceed $250 per single

  4  practitioner per year.

  5         (7)  REIMBURSEMENT.--Reimbursements to pharmacies

  6  participating in the pharmaceutical expense assistance program

  7  established under this section shall be equivalent to

  8  reimbursements under the Medicaid program.

  9         Section 2.  Medicare prescription discount program.--As

10  a condition of participation in the Medicaid program or the

11  pharmacy benefit program, a pharmacy must charge a price no

12  greater than the average wholesale price minus 9 percent, plus

13  a dispensing fee of $4.50, when any Florida resident, who is a

14  Medicare beneficiary, shows a Medicare card when presenting a

15  prescription. However, this section does not prohibit a

16  pharmacy from offering its own senior-citizen

17  prescription-drug discount program that provides a greater

18  discount.

19         Section 3.  For fiscal year 2000-2001, the sum of $15

20  million is appropriated from the General Revenue Fund to the

21  Agency for Health Care Administration for the purpose of

22  implementing the pharmaceutical expense assistance program

23  effective January 1, 2001. Rebates collected under subsection

24  (6) of section 1 of this act shall be used to provide

25  additional benefits or serve additional people in the program.

26         Section 4.  For fiscal year 2000-2001, the sum of

27  $250,000 is appropriated from the General Revenue Fund to the

28  Agency for Health Care Administration to administer the

29  pharmaceutical expense assistance program.

30         Section 5.  This act shall take effect July 1, 2000.

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