Establishes the medicaid prescription senior eligibility expansion program

2 Co-sponsors

• George Onorato
• Kevin S. Parker

Title of bill

An act in relation to increasing access to pharmaceuticals for needy seniors and the disabled through the expansion of eligibility for the medicaid program

Purpose or general idea of bill

The purpose of this bill is to increase the access of pharmaceuticals, for needy senior citizens and the disabled by creating a Medicaid Rx Senior Eligibility Expansion Program, to be administered by the Department of Health.

Summary of specific provisions

Establishes a Medicaid prescription senior eligibility expansion program to be administered by the Department of Health. Requires all eligible participants to be: U.S. citizens or lawfully admitted aliens; state residents, at least 65 years old or be individuals between the ages of 19 and 64 who are otherwise eligible for benefits under Title (II) of the Social Security Act; meet the definition of a qualified Medicare beneficiary or specified low-income Medicare beneficiary as set forth in section (c); ineligible for and/or not receiving a prescription drug benefit through a Medicare supplemental policy or any other third party payer prescription benefit.

Individuals eligible for the Medicaid prescription senior eligibility expansion program shall be entitled to the Medicaid prescription drug coverage as provided to Medicaid recipients as set forth in title (XIX) of the Social Security act.

The Department of Health shall apply for a federal Medicare (1115) demonstration waiver from the federal Secretary of Health and Human Services. The department will also promulgate and adopt rules and regulations as are necessary. The department will also submit an annual report to the legislature beginning one year from the date of implementation of the program.

Justification

Roughly, three out of ten Medicare enrollees have no coverage for pharmaceuticals. Furthermore, millions more senior citizens and disabled Medicare enrollees are underinsured for prescription drugs. The bill would improve the access to prescription medicines for disabled and senior citizens, who are economically disadvantaged, the privilege of being entitled to Medicaid prescription drug coverage as set forth in the title (XIX) of the Social Security Act.

The federal (1115) Medicaid waiver, to extend prescription drug coverage to qualified Medicare beneficiaries and special low income Medicare beneficiaries, would provide meaningful access to prescription drugs for the state's poverty stricken and near poverty stricken population. The waiver will allow the state to benefit from well-established state-federal partnerships in Medicaid through access to federal matching funds in addition to state funds.

Prior legislative history

2002 - A.9823 - Referred to Aging; Held for consideration 2003/04 - A.3788 - Referred to Aging 2005/06 - A.1970 - Referred to Aging 2007/08 - A.2249 - Referred to Aging

Fiscal implications for state and local governments

Unknown.

Effective date

The act shall take effect immediately.