Chapter
128
2003 -- S 0374 AS AMENDED
Enacted 07/09/03
A N A C T
RELATING TO STATE AFFAIRS AND
GOVERNMENT -- PHARMACEUTICAL
ASSISTANCE TO THE ELDERLY ACT
Introduced By: Senators
Roberts, Paiva-Weed, Gibbs, Blais, and P Fogarty
Date
Introduced: February 12, 2003
It is enacted by the General
Assembly as follows:
SECTION
1. Section 42-66.2-5 of the General Laws in Chapter 42-66.2 entitled
"Pharmaceutical Assistance to
the Elderly Act" is hereby amended to read as follows:
42-66.2-5.
Persons eligible. -- (a) Persons eligible for assistance under the
provisions of
this chapter include any resident
of the state who is at least sixty-five (65) years of age. State and
consumer co-payment shares for
these persons shall be determined as follows:
(1)
For unmarried persons or married persons living separate and apart whose income
for
the calendar year immediately
preceding the year in which assistance is sought is:
(i)
Less than fifteen thousand nine hundred and thirty-two dollars ($15,932) the
state
shall pay sixty percent (60%) of
the cost of the prescriptions and the consumer shall pay forty
percent (40%) of the cost of the
prescriptions;
(ii)
More than fifteen thousand nine hundred and thirty-two dollars ($15,932) and
less
than twenty thousand dollars
($20,000), the state shall pay thirty percent (30%) of the cost of the
prescriptions and the consumer
shall pay seventy percent (70%) of the cost of the prescriptions;
and
(iii) More than twenty thousand dollars ($20,000) and less than thirty-five
thousand
dollars ($35,000), the state shall
pay fifteen percent (15%) of the cost of prescriptions and the
consumer shall pay eighty-five
percent (85%) of the cost of prescriptions.
(2)
For married persons whose income for the calendar year immediately preceding
the
year in which assistance is sought
hereunder when combined with any income of the person's
spouse in the same year is:
(i)
Nineteen thousand nine hundred and sixteen dollars ($19,916) or less, the state
shall
pay sixty percent (60%) of the cost
of the prescriptions and the consumer shall pay forty percent
(40%) of the cost of the
prescriptions;
(ii)
More than nineteen thousand nine hundred and sixteen dollars ($19,916) and less
than twenty-five thousand dollars
($25,000), the state shall pay thirty percent (30%) of the cost of
the prescriptions and the consumer
shall pay seventy percent (70%) of the cost of prescriptions;
and
(iii) More than twenty-five thousand dollars ($25,000) and less than forty
thousand
dollars ($40,000), the state shall
pay fifteen percent (15%) of the cost of prescriptions and the
consumer shall pay eighty-five
percent (85%) of the cost of prescriptions.
(3)
Eligibility may also be determined by using income data for the ninety (90)
days
prior to application for benefits
and projecting that income on an annual basis. The income levels
shall not include those sums of
money expended for medical and pharmaceutical that exceed
three percent (3%) of the
applicant's annual income or three percent (3%) of the applicant's
preceding ninety (90) day income
computed on an annual basis.
(b)
On July 1 of each year, the maximum amount of allowable income for both
unmarried and married residents set
forth in subsection (a) shall be increased by a percentage
equal to the percentage of the cost
of living adjustment provided for social security recipients.
(c)
Notwithstanding the foregoing provisions of this section, no person whose
prescription drug expenses are paid
or reimbursable, either in whole or in part, by any other plan
of assistance or insurance is
eligible for assistance under this section, until the person's
prescription drug coverage for a
specific covered prescription medication is exhausted or the
specific prescription medication
is not covered by the plan during a
benefit year, and as provided
in subsection (d).
(d)
The fact that some of a person's prescription drug expenses are paid or
reimbursable
under the provisions of medicare,
part B, shall not disqualify that person, if he or she is otherwise
eligible, to receive assistance
under this chapter. In those cases, the state shall pay sixty percent
(60%) the eligible percentage of the cost of those
prescriptions for qualified drugs for which no
payment or reimbursement is made by
the federal government.
(e)
Eligibility for receipt of any other benefit under any other provisions of the
Rhode
Island general laws as a result of
eligibility for the pharmaceutical assistance program authorized
under this section shall be limited
to those persons whose income qualify them for a sixty percent
(60%) state co-payment share of the
cost of prescriptions.
(f)
Between fifty-five (55) and sixty-five (65) years of age and receiving social
security
disability benefits. These persons
shall pay one hundred percent (100%) of the cost of
prescriptions set forth in section
42-66.2-4.
(g)
For all additional drugs, the consumer shall pay one hundred percent (100%) of
the
cost of prescriptions as set forth
in section 42-66.2-4.
SECTION
2. This act shall take effect upon passage and remain in effect until December
31, 2003.
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LC01760
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