HB 1641 -- Senior Prescription Drug Benefits

Sponsor:  Page

This bill coordinates the benefits for the federal Medicare
Prescription Drug Improvement and Modernization Act of 2003.  In
its main provisions, the bill:

(1)  Establishes the Missouri Senior Prescription Drug Plan
within the Department of Health and Senior Services and makes the
plan the payer of last resort;

(2)  Repeals the Missouri Senior Rx Program 30 days after notice
has been given to the Revisor of Statutes by the department that
the state plan has been fully implemented;

(3)  Requires the plan to pay 75% of the 2006 federal standard
drug benefit coverage gap of $2,850.  Eligible individuals must
have an income within 150% to 200% of the federal poverty level
or an income below 150% of the federal poverty level and fail to
meet the federal asset test.  This provision is effective January
1, 2006, and is subject to appropriations;

(4)  Establishes a nine-member Missouri Senior Prescription Plan
Commission within the department.  The commission is responsible
for governing the implementation of the plan.  The bill specifies
the composition and terms of the commission members;

(5)  Requires applications for the plan to be conducted jointly
with applications for the federal Medicare Part-D benefit.  The
commission is required to verify eligibility of the applicants on
an annual basis.  This provision is effective November 15, 2005;

(6)  Requires the plan to provide coverage for prescription drugs
that are covered in the provider's formulary established for the
federal Medicare prescription drug benefit;

(7)  Prohibits the plan from providing coverage for certain drugs
and classes of drugs.  Prescription drugs which are not
reasonable and necessary are excluded from coverage under the
plan;

(8)  Prohibits the state from being charged any amount in excess
of the amount charged by providers of the federal program;

(9)  Requires the commission to apply to the United States
Department of Health and Human Services for applicable waivers.
The commission must also apply for public and private grants; and

(10)  Establishes the Missouri Senior Prescription Drug Plan
Clearinghouse within the commission.  The commission can require
proposals for the third party administration of the
clearinghouse.  The bill also specifies the purposes of the
clearinghouse.

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:16 am