Sec. AAA-1. 22 MRSA §254-D, sub-§8 is enacted to read:
8. Emergency drug coverage. The department shall provide emergency drug coverage to an enrollee when:
A. A medically necessary drug prescribed for the enrollee is not on the enrollee's Medicare Part D prescription drug plan formulary, is not provided for in the dosage or amount necessary or is on the formulary as a nonpreferred drug;
B. The enrollee's initial prior authorization request was not approved by the Medicare Part D prescription drug plan; and
C. The drug is available as a preferred drug under either the program or MaineCare or is available from these programs with prior authorization and the enrollee has received or would receive prior authorization approval.
Sec. AAA-2. Report regarding status of state-paid prescription drug coverage. The Department of Health and Human Services shall provide a report to the joint standing committee of the Legislature having jurisdiction over health and human services matters regarding the status of the state-paid prescription drug coverage related to Medicare Part D on a monthly basis for one year and then on a quarterly basis until June 30, 2008.
Sec. AAA-3. Use of unspent federal clawback funding. The Department of Health and Human Services is authorized to use any unspent funds appropriated for fiscal years 2005-06 or 2006-07 under this Part for Medicare Part D clawback payments for the purposes of providing additional Medicare Part D wraparound assistance.
Sec. AAA-4. Transfer of funds. Notwithstanding the Maine Revised Statutes, Title 5, section 1585 or any other provisions of law, available balances of funds appropriated in this Part related to the Medicare Part D prescription drug program may be transferred between the Medical Care - Payments to Providers account and the Low-cost Drugs to Maine's Elderly account by financial order upon the recommendation of the State Budget Officer and approval of the Governor.
Sec. AAA-5. Appropriations and allocations. The following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Low-cost Drugs to Maine's Elderly 0202
Initiative: Appropriates funds for emergency assistance for enrollees denied access to medically necessary drugs.
GENERAL FUND 2005-06 2006-07
All Other $344,310 $1,032,930
____________ ____________
GENERAL FUND TOTAL $344,310 $1,032,930
Low-cost Drugs to Maine's Elderly 0202
Initiative: Appropriates funds for assistance with copayments for medically necessary prescription drugs in cases when the department determines that requiring such a copayment would create an undue financial hardship for the enrollee.
GENERAL FUND 2005-06 2006-07
All Other $534,293 $1,602,879
____________ ____________
GENERAL FUND TOTAL $534,293 $1,602,879
Medical Care - Payments to Providers 0147
Initiative: Provides funding to pay the state share of the Medicare Part D benefit for the MaineCare dual eligibles.
GENERAL FUND 2005-06 2006-07
All Other $3,057,195 $16,126,300
____________ ____________
GENERAL FUND TOTAL $3,057,195 $16,126,300
Low-cost Drugs to Maine's Elderly 0202
Initiative: Provides funding for benefit wraparound services for MaineCare dual eligibles and elderly low-cost drug program members who are transitioning to Medicare Part D.
GENERAL FUND 2005-06 2006-07
All Other $1,900,000 $2,465,773
____________ ____________
GENERAL FUND TOTAL $1,900,000 $2,465,773
Low-cost Drugs to Maine's Elderly 0202
Initiative: Transfers funding from the MaineCare Stabilization Fund program to the Low-cost Drugs to Maine's Elderly program for wraparound services for elderly low-cost drug program members who are transitioning to Medicare Part D.
OTHER SPECIAL REVENUE
FUNDS 2005-06 2006-07
All Other $0 $2,660,907
____________ ____________
OTHER SPECIAL REVENUE
FUNDS TOTAL $0 $2,660,907
Low-cost Drugs to Maine's Elderly 0202
Initiative: Adjusts funding to recognize revenue changes approved by the Revenue Forecasting Committee on March 1, 2006.
GENERAL FUND 2005-06 2006-07
All Other $335,591 $0
____________ ____________
GENERAL FUND TOTAL $335,591 $0
HEALTH AND HUMAN SERVICES,
DEPARTMENT OF
DEPARTMENT TOTALS 2005-06 2006-07
GENERAL FUND $6,171,389 $21,227,882
OTHER SPECIAL REVENUE
FUNDS $0 $2,660,907
____________ ____________
DEPARTMENT TOTAL -
ALL FUNDS $6,171,389 $23,888,789
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