5904-S AMS DOUM BUCH 001

SSB 5904 - S AMD

By Senator Doumit

   On page 1, line 16, strike all of section 2 and insert the following:

   "NEW SECTION. Sec. 1. A new section is added to chapter 74.09 RCW to read as follows:

   (1) To the extent funds are appropriated specifically for this purpose, and subject to any conditions placed on appropriations made for this purpose, the department shall design the medicaid prescription drug assistance program. Neither the benefits of, nor eligibility for, the program is considered to be an entitlement.

   (2) The department is directed to obtain necessary federal waivers to implement this program. Consistent with federal waiver conditions, the department is authorized to charge enrollment fees, premiums, or point-of-service cost-sharing to enrollees of the program.

   (3) Eligibility for this program is limited to persons: (a) Who are eligible for medicare or age sixty-five and older; (b) whose family income does not exceed one hundred seventy five percent of the federal poverty level as adjusted for family size and determined annually by the federal department of health and human services; (c) who do not otherwise have insurance that provides prescription drug coverage; and (d) who are not otherwise eligible under Title XIX of the federal social security act.

   (4) The department is authorized to use a cost-effective prescription drug benefit design. Consistent with federal waiver conditions, this benefit design can be different than the benefit design offered under the medical assistance program. The benefit design may include a deductible benefit that provides coverage when enrollees incur higher prescription drug costs as defined by the department. The department also may offer more than one benefit design.

   (5) The department is authorized to limit enrollment of persons who qualify for the program so as to prevent an overexpenditure of appropriations for this program or to assure necessary compliance with federal waiver budget neutrality requirements. The department shall not reduce existing medical assistance program eligibility or benefits to assure compliance with federal waiver budget neutrality requirements.

   (6) No funds from an approved federal waiver that allows for the collection of premiums from medicaid clients will be used to finance the medicaid prescription drug assistance program.

   (7) This program will be terminated within twelve months after implementation of a prescription drug benefit under Title XVIII of the social security act.

   (8) The department shall provide recommendations to the appropriate committees of the senate and house of representatives by November 15, 2003, on financing options available to support the medicaid prescription drug assistance program. In recommending financing options, the department shall explore every opportunity to maximize federal funding to support the program."

--- END ---

EFFECT: Directs DSHS to seek a waiver to establish a subsidized prescription drug benefit.