Representative Reinstein of Revere, Kafka of Stoughton, Fagan of Taunton, L’Italien of Andover, Guyer of Dalton, Sannicandro of Ashland, Smith of Everett, Koczera of New Bedford, Brownsberger of Belmont, Linsky of Natick, O’Day of West Boylston, Lantigua of Lawrence, Fernandes of Milford, Haddad of Somerset, Rush of Boston, Fresolo of Worcester, Callahan of Sutton, Wolf of Cambridge, Canessa of New Bedford, McCarthy of East Bridgewater, Verga of Gloucester, Speliotis of Danvers, Allen of Boston, Ayers of Quincy, Keenan of Salem, Provost of Somerville, and Binienda of Worcester move to amend the bill by adding the following section:
“SECTION . Chapter 175 of the acts of 2005, as amended by Section 86 of Chapter 139 of the Acts of 2006, is hereby amended by striking sections 7A and 7B and inserting in place thereof the following 4 sections:-
Section 7A. Notwithstanding any general or special law to the contrary, the subsidized catastrophic prescription drug insurance program established in section 39 of chapter 19A of the General Laws shall provide coverage for a 1-time supply of prescribed medications in the amount prescribed, up to a 30 day supply, between July 1, 2008 and June 30, 2009, to enrollees who are also eligible for Medicare prescription drug coverage. After an enrollee exhausts the availability of the 1-time 30-day supply of a medication under this section the program shall provide coverage, free of charge, for a 1-time, 72-hour supply of the medication. Both the 30-day supply and the 72-hour supply shall be available in all instances in which the pharmacist cannot bill a Medicare prescription drug plan at the time the prescription is presented. Any co-pay or deductible that would have been charged to the enrollee under section 39 of chapter 19A shall apply to the 1-time 30 day supply.
Section 7B. Notwithstanding any general or special law to the contrary, the secretary of health and human services, in consultation with the director of Medicaid, shall authorize MassHealth payment for a 1-time supply of prescribed medications in the amount prescribed, up to a 30 day supply, between July 1, 2008 and June 30, 2009, to beneficiaries under chapter 118E of the General Laws who are also eligible for Medicare prescription drug coverage. After a beneficiary exhausts the availability of the 1-time 30-day supply of a medication under this section MassHealth shall provide coverage, free of charge, for a 1-time, 72-hour supply of the medication. Both the 30-day supply and the 72-hour supply shall be available in all instances in which the pharmacist cannot bill a Medicare prescription drug plan at the time the prescription is presented. Any co-pay or deductible that would have been charged to the beneficiary under MassHealth shall apply to the 1-time 30 day supply.
Section 7C. Notwithstanding section 7D or any general or special law to the contrary, between July 1, 2008 and June 30, 2009, in the event that the Medicare prescription drug plan covers the prescribed medication at the time the prescription is presented, but charges a co-pay or deductible that exceeds the amount federal Medicare law permits the plan to charge a non-institutionalized full benefit dual eligible member with income less than or equal to 100% of the federal poverty line, MassHealth shall pay the amount of such excess and the beneficiary shall pay the balance.
Section 7D. Notwithstanding any general or special law to the contrary, in the event that the Medicare prescription drug plan covers the prescribed medication at the time the prescription is presented, but charges a co-pay or deductible to a MassHealth member whose MassHealth co-payment would be zero, MassHealth shall pay the entire amount. In the event that the Medicare prescription drug plan covers the prescribed medication at the time the prescription is presented, but charges a co-pay or deductible in excess of what would have been charged to the beneficiary under MassHealth, MassHealth shall pay the excess amount and the beneficiary shall pay what would be payable under MassHealth.”