208.786. Authority of department in providing benefits--start of program benefits, when.
Authority of department in providing benefits--start of programbenefits, when.
208.786. 1. In providing program benefits, the department shall havethe authority to:
(1) Adopt, amend, and rescind such rules and regulations necessary toperform its duties under this law to maximize the benefits;
(2) Enter into a contract with one or more prescription drug plans tocoordinate the prescription benefits of the Missouri Rx plan and the MedicarePart D prescription benefit;
(3) Require that pharmaceutical manufacturers provide Medicaid level orgreater rebates for enrollees at or below two hundred percent of the federalpoverty level who also meet the asset test for Medicare Part D prescriptionbenefit in order for the manufacturer's products to be available to theenrollees of the Missouri Rx plan. These rebates shall be no less than thoseprovided to Medicaid under Section 1927 of Title XIX of the Social SecurityAct, 42 U.S.C. Section 1396r-8. If revenue is generated for the program fromsources other than appropriation, the additional revenue shall be deposited inthe Missouri Rx plan fund. This additional revenue shall be used to fundprogram benefits and make payments, as may be required, under the MedicarePrescription Drug, Improvement and Modernization Act of 2003, P.L. 108-173;
(4) Preliminarily enroll beneficiaries into a preferred Medicare Part Dprescription drug plan, with an opt-out provision for the individual.Individuals who opt out of the preferred PDP shall remain enrolled in theMissouri Rx plan unless they choose to withdraw from the program;
(5) Prescribe the application and enrollment procedures for prospectiveenrollees in the Missouri Rx plan;
(6) Select in accordance with applicable procurement laws, a contractorto assist in the administration of the Missouri Rx plan or negotiate theprovision of administrative function for the Missouri Rx plan.
2. Program benefits shall begin January 1, 2006. For persons meetingthe eligibility requirements in section 208.784, the program may, subject toappropriation and contingent upon available funds, pay all or some of thedeductibles, coinsurance payments, premiums, and co-payments required underthe Medicare Part D pharmacy benefit.
(L. 2005 S.B. 539)Sunset date 8-28-11, unless reauthorized (see § 208.798)