[atlas:bill]

AN ACT Relating to creating a senior pharmacy assistance program; adding a new section to chapter 41.05 RCW; and creating new sections.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. A new section is added to chapter 41.05 RCW to read as follows:

(1) The administrator must establish a senior pharmacy assistance program in accordance with the provisions of this section. The senior pharmacy assistance program provides financial assistance to eligible individuals for the purchase of prescription drugs.

(2) Individuals sixty-five years old and older with a household income above the eligibility standard for medicaid categorically needy coverage and below three hundred percent of the federal poverty guidelines are eligible for the senior pharmacy assistance program if they:

(a) Do not qualify for any other local, state medicaid categorically needy program, or federal prescription drug program;

(b) Are not covered under any private prescription reimbursement plan;

(c) Have not voluntarily canceled a local, state, or federal prescription drug program or a private prescription reimbursement plan within the six months prior to application for enrollment in the senior pharmacy assistance program;

(d) Pay a coinsurance amount of ten dollars, for eligible individuals with an income above the eligibility standard for medicaid categorically needy coverage and up to one hundred twenty-five percent of the federal poverty guidelines; and

(e) Pay a coinsurance amount of twenty percent, for eligible individuals with an income above one hundred twenty-five and up to three hundred percent of the federal poverty guidelines.

(3) Each eligible individual may receive a maximum annual drug benefit of one thousand five hundred dollars.

(4) The administrator must adopt rules necessary to implement the senior pharmacy assistance program, including the prescription drugs eligible for reimbursement under the senior pharmacy assistance program, the amount of the pharmacy dispensing fee, procedures for limiting enrollment, selecting participating pharmacies, and establishing a period of open enrollment that may not be less than thirty days, including an enrollment period for those who become age eligible during the year.

(5) If the administrator determines that the funds appropriated for the senior pharmacy assistance program are not sufficient to serve all individuals who qualify for assistance, the administrator must take those steps necessary to limit program expenditures to an amount equal to appropriated funds.

(6) The administrator may contract for the operation of the senior pharmacy assistance program.

(7) When an enrollee fails to report income or income changes accurately or fails to report participation in any publicly funded prescription drug plan or coverage under any private prescription reimbursement plan, the administrator shall have the authority either to bill the enrollee for the amounts overpaid by the state or to impose civil penalties of up to two hundred percent of the amount of subsidy overpaid due to the enrollee incorrectly reporting income. The administrator shall adopt rules to define the appropriate application of these sanctions and the processes to implement the sanctions provided in this subsection, within available resources.

NEW SECTION. Sec. 2. The administrator of the Washington state health care authority shall design a catastrophic prescription drug benefit for the senior pharmacy assistance program and present it to the appropriate committees of the senate and house of representatives no later than December 15, 2001.

NEW SECTION. Sec. 3. (1) If federal funding becomes available for senior prescription drug assistance on or before March 1, 2002, it shall be used to fund the provisions of this act, subject to the provisions and limitations of section 1(5) of this act.

(2) If federal funding becomes available for prescription drug assistance for individuals without access to prescription drug coverage or who have access to prescription drug assistance through state funded programs on or before March 1, 2002, it shall be appropriated for the purposes specified in the operating budget adopted by the legislature.

NEW SECTION. Sec. 4. If the state does not receive federal funding for the purposes of section 3 of this act by March 1, 2002, this act is null and void.

NEW SECTION. Sec. 5. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.