§ 40-8-4 - Direct vendor payment plan.
SECTION 40-8-4
§ 40-8-4 Direct vendor payment plan.– (a) The department shall furnish medical care benefits to eligiblebeneficiaries through a direct vendor payment plan. The plan shall include, butneed not be limited to, any or all of the following benefits, which benefitsshall be contracted for by the director:
(1) Inpatient hospital services, other than services in ahospital, institution, or facility for tuberculosis or mental diseases;
(2) Nursing services for such period of time as the directorshall authorize;
(3) Visiting nurse service;
(4) Drugs for consumption either by inpatients or by otherpersons for whom they are prescribed by a licensed physician;
(5) Dental services; and
(6) Hospice care up to a maximum of two hundred and ten (210)days as a lifetime benefit.
(b) For purposes of this chapter, the payment of federalMedicare premiums or other health insurance premiums by the department onbehalf of eligible beneficiaries in accordance with the provisions of Title XIXof the federal Social Security Act, 42 U.S.C. § 1396 et seq., shall bedeemed to be a direct vendor payment.
(c) With respect to medical care benefits furnished toeligible individuals under this chapter or Title XIX of the federal SocialSecurity Act, the department is authorized and directed to impose:
(i) Nominal co-payments or similar charges upon eligibleindividuals for non-emergency services provided in a hospital emergency room;and
(ii) Co-payments for prescription drugs in the amount of onedollar ($1.00) for generic drug prescriptions and three dollars ($3.00) forbrand name drug prescriptions in accordance with the provisions of 42 U.S.C.§ 1396, et seq.
(d) The department is authorized and directed to promulgaterules and regulations to impose such co-payments or charges and to providethat, with respect to subdivision (ii) above, those regulations shall beeffective upon filing.