Senate Bill sb0420c1

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    Florida Senate - 2001                            CS for SB 420

    By the Committee on Health, Aging and Long-Term Care; and
    Senators Brown-Waite and Klein




    317-1532-01

  1                      A bill to be entitled

  2         An act relating to the pharmacy discount

  3         program; amending s. 409.906, F.S.; authorizing

  4         as a new optional Medicaid service the pharmacy

  5         discount program, to be administered by the

  6         Agency for Health Care Administration;

  7         directing the Agency for Health Care

  8         Administration to seek a federal Medicaid

  9         waiver for the pharmacy discount program;

10         specifying program eligibility and eligibility

11         determination; specifying the means of deriving

12         the subsidy for program participants; providing

13         an effective date.

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

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17         Section 1.  Subsection (25) is added to section

18  409.906, Florida Statutes, to read:

19         409.906  Optional Medicaid services.--Subject to

20  specific appropriations, the agency may make payments for

21  services which are optional to the state under Title XIX of

22  the Social Security Act and are furnished by Medicaid

23  providers to recipients who are determined to be eligible on

24  the dates on which the services were provided.  Any optional

25  service that is provided shall be provided only when medically

26  necessary and in accordance with state and federal law.

27  Nothing in this section shall be construed to prevent or limit

28  the agency from adjusting fees, reimbursement rates, lengths

29  of stay, number of visits, or number of services, or making

30  any other adjustments necessary to comply with the

31  availability of moneys and any limitations or directions

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    Florida Senate - 2001                            CS for SB 420
    317-1532-01




  1  provided for in the General Appropriations Act or chapter 216.

  2  If necessary to safeguard the state's systems of providing

  3  services to elderly and disabled persons and subject to the

  4  notice and review provisions of s. 216.177, the Governor may

  5  direct the Agency for Health Care Administration to amend the

  6  Medicaid state plan to delete the optional Medicaid service

  7  known as "Intermediate Care Facilities for the Developmentally

  8  Disabled."  Optional services may include:

  9         (25)  PHARMACY DISCOUNT PROGRAM.--Subject to specific

10  federal authorization, the agency shall administer a program

11  to provide subsidized discounts for Medicare-covered and

12  uninsured individuals, for the purchase of prescribed drugs

13  pursuant to the terms of a federal waiver for such services.

14  The program shall serve to provide a subsidy to those who

15  purchase prescription drugs via the program, and shall not

16  create an entitlement.

17         Section 2.  The Agency for Health Care Administration

18  shall submit to the federal Health Care Financing

19  Administration a request for a service coverage waiver

20  specific to a pharmacy discount program for those residents of

21  this state age 65 and over who are eligible for Medicare and

22  who have incomes up to 300 percent of the federal poverty

23  level who do not have a health insurance program that includes

24  a prescription drug benefit, or any separate prescription drug

25  benefit. The Department of Children and Family Services shall

26  determine eligibility for the pharmacy discount program.

27  Individuals in this expanded coverage group shall receive a

28  financial subsidy for prescription drugs equal to the average

29  rebate, and any supplemental rebate, paid to the Medicaid

30  program by pharmaceutical manufacturers.

31         Section 3.  This act shall take effect October 1, 2001.

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    Florida Senate - 2001                            CS for SB 420
    317-1532-01




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 420

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  4  The bill no longer establishes a medication purchasing
    cooperative administered by the Agency for Health Care
  5  Administration. The bill creates the Pharmacy Discount
    Program, a new optional Medicaid service, subject to specific
  6  federal authorization. Under the program, eligible individuals
    will receive a financial subsidy for prescription drugs equal
  7  to the average rebate and any supplemental rebate paid to the
    Medicaid program by pharmaceutical manufacturers. Eligibility
  8  for the program is extended to Medicare beneficiaries and
    uninsured persons who are Florida residents age 65 and over
  9  and who have incomes up to 300 percent of the federal poverty
    level and who do not have a health insurance program that
10  includes a prescription drug benefit or any separate
    prescription drug benefit.
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    The Agency for Health Care Administration must submit a
12  request to the federal Health Care Financing Administration
    for a service coverage waiver specific to the pharmacy
13  discount program. The Department of Children and Family
    Services must determine eligibility for the pharmacy discount
14  program.

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