PRIOR PRINTER'S NOS. 1044, 1816 PRINTER'S NO. 1836
No. 888 Session of 2003
INTRODUCED BY VANCE, EACHUS, KENNEY, WALKO, E. Z. TAYLOR,
GRUCELA, ADOLPH, BARD, BALDWIN, BARRAR, BASTIAN, BROWNE,
BUTKOVITZ, BUXTON, CAPPELLI, CASORIO, CORNELL, CORRIGAN,
COSTA, DAILEY, DALLY, J. EVANS, FEESE, FLICK, FREEMAN, GABIG,
GERGELY, GILLESPIE, GINGRICH, HARHAI, HARPER, HASAY,
HENNESSEY, HERMAN, HERSHEY, HORSEY, JAMES, KELLER, KIRKLAND,
LAUGHLIN, LEH, LEWIS, MACKERETH, MAHER, MARSICO, McCALL,
McGILL, McNAUGHTON, MELIO, MICOZZIE, R. MILLER, S. MILLER,
MUNDY, NAILOR, NICKOL, O'NEILL, PALLONE, PETRARCA, PETRI,
PICKETT, PISTELLA, RAYMOND, READSHAW, ROBERTS, ROSS, RUBLEY,
SAINATO, SAYLOR, SCAVELLO, SCHRODER, SEMMEL, SHANER, SOLOBAY,
STEIL, R. STEVENSON, T. STEVENSON, J. TAYLOR, THOMAS, TIGUE,
TRAVAGLIO, TURZAI, WANSACZ, WATSON, WEBER, WILT, WRIGHT,
YOUNGBLOOD, YUDICHAK, ZUG AND FABRIZIO, MARCH 13, 2003
AS AMENDED, COMMITTEE ON HEALTH AND HUMAN SERVICES, HOUSE OF
REPRESENTATIVES, MAY 12, 2003
AN ACT
1 Providing for pharmaceutical assistance for the elderly, for
2 pharmaceutical purchasing, for limited prescription drug
3 redistribution within certain health care facilities and, for <--
4 pharmaceutical practices and cost control program AND FOR THE <--
5 PHARMACEUTICAL ASSISTANCE CLEARINGHOUSE; imposing additional
6 powers and duties on the Department of Aging, the Department
7 of Health, the Department of Public Welfare and the Secretary
8 of Administration; and making repeals.
9 TABLE OF CONTENTS
10 Chapter 1. Preliminary Provisions
11 Section 101. Short title.
12 Chapter 3. Pharmaceutical Matters
13 Subchapter A. Pharmaceutical Assistance for the Elderly
14 Section 301. Legislative findings.
1 Section 302. Definitions.
2 Section 303. Determination of eligibility.
3 Section 304. Physician and pharmacy participation.
4 Section 305. Drug utilization review system.
5 Section 306. Reduced assistance.
6 Section 307. Rebates for expenses prohibited.
7 Section 308. Request for proposal.
8 Section 309. Program generally.
9 Section 310. Generic drugs.
10 Section 311. Supply.
11 Section 312. Mail order system.
12 Section 313. Indication of price.
13 Section 314. Reimbursement.
14 Section 315. Nonliability.
15 Section 316. Income verification.
16 Section 317. Contract.
17 Section 318. The Pharmaceutical Assistance Contract for the
18 Elderly Needs Enhancement Tier.
19 Section 319. Board.
20 Section 320. Penalties.
21 Section 321. Prescription Drug Education Program.
22 Section 322. Outreach program.
23 Section 323. Accountability.
24 Subchapter B. Prudent Pharmaceutical Purchasing
25 Section 341. Definitions.
26 Section 342. Rebate agreement.
27 Section 343. Disposition of funds.
28 Subchapter C. Pharmacy Best Practices and Cost Control
29 Program
30 Section 361. Definitions.
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1 Section 362. Committee.
2 Section 363. Program.
3 SUBCHAPTER D. PHARMACEUTICAL ASSISTANCE CLEARINGHOUSE <--
4 SECTION 371. DEFINITIONS.
5 SECTION 372. PHARMACEUTICAL ASSISTANCE CLEARINGHOUSE.
6 SECTION 373. TOLL-FREE TELEPHONE NUMBER.
7 SECTION 374. ASSISTANCE AVAILABLE.
8 SECTION 375. REPORTING.
9 Chapter 51. Miscellaneous Provisions
10 Section 5101. Federal programs.
11 Section 5102. Repeals.
12 Section 5103. Effective date.
13 The General Assembly of the Commonwealth of Pennsylvania
14 hereby enacts as follows:
15 CHAPTER 1
16 PRELIMINARY PROVISIONS
17 Section 101. Short title.
18 This act shall be known and may be cited as the
19 Pharmaceutical Reform Act.
20 CHAPTER 3
21 PHARMACEUTICAL MATTERS
22 SUBCHAPTER A
23 PHARMACEUTICAL ASSISTANCE FOR THE ELDERLY
24 Section 301. Legislative findings.
25 Finding that an increasing number of this Commonwealth's
26 elderly citizens who are living on fixed incomes are
27 experiencing difficulties in meeting the costs of life-
28 sustaining prescription drugs, the General Assembly, in its
29 responsibilities to provide for the health, welfare and safety
30 of the residents of this Commonwealth, hereby continues a
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1 limited State pharmaceutical assistance program for the elderly.
2 Section 302. Definitions.
3 The following words and phrases when used in this subchapter
4 shall have the meanings given to them in this section unless the
5 context clearly indicates otherwise:
6 "A-rated generic therapeutically equivalent drug." A drug
7 product that the Commissioner of Food and Drugs of the United
8 States Food and Drug Administration has approved as safe and
9 effective and has determined to be therapeutically equivalent,
10 as listed in "The Approved Drug Products with Therapeutic
11 Equivalence Evaluations" (Food and Drug Administration "Orange
12 Book"), with a specific "A" code designation only.
13 "Average wholesale cost." The cost of a dispensed drug based
14 upon the price published in a national drug pricing system in
15 current use by the Department of Aging as the average wholesale
16 price of a prescription drug in the most common package size.
17 "Average wholesale price." Average wholesale cost.
18 "Board." The Pharmaceutical Assistance Review Board.
19 "CMS." Center for Medicare and Medicaid Services.
20 "Department." The Department of Aging of the Commonwealth.
21 "Eligible claimant." A resident of this Commonwealth for no
22 less than 90 days, who is 65 years of age and older, whose
23 annual income is less than the maximum annual income and who is
24 not otherwise qualified for public assistance under the act of
25 June 13, 1967 (P.L.31, No.21), known as the Public Welfare Code.
26 "FDA." The United States Food and Drug Administration of the
27 Public Health Service of the Department of Health and Human
28 Services.
29 "Income." All income from whatever source derived,
30 including, but not limited to, salaries, wages, bonuses,
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1 commissions, income from self-employment, alimony, support
2 money, cash public assistance and relief, the gross amount of
3 any pensions or annuities, including railroad retirement
4 benefits, all benefits received under the Social Security Act
5 (49 Stat. 620, 42 U.S.C. § 301 et seq.) except Medicare
6 benefits, all benefits received under State unemployment
7 insurance laws and veterans' disability payments, all interest
8 received from the Federal Government or any state government or
9 any instrumentality or political subdivision thereof, realized
10 capital gains, rentals, workmen's compensation and the gross
11 amount of loss of time insurance benefits, life insurance
12 benefits and proceeds, except the first $5,000 of the total of
13 death benefits payments, and gifts of cash or property, other
14 than transfers by gift between members of a household, in excess
15 of a total value of $300, but does not include surplus food or
16 other relief in kind supplied by a government agency or property
17 tax rebate.
18 "Mail service program." A program set forth in section 312
19 to dispense prescription drugs by postal delivery service
20 designated and administered by the department and any entity
21 with which it contracts, upon an enrollee's submission of a
22 prescription and the applicable copayment.
23 "Maintenance drug." A prescription drug prescribed to an
24 individual for a chronic condition the use of which is medically
25 necessary for a consecutive period of at least 60 days.
26 "Maximum annual income." For PACE eligibility, annual income
27 which shall not exceed $14,000 in the case of single persons nor
28 $17,200 in the case of the combined annual income of persons
29 married to each other. Persons may, in reporting income to the
30 Department of Aging, round the amount of each source of income
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1 and the income total to the nearest whole dollar, whereby any
2 amount which is less than 50¢ is eliminated.
3 "PACE." The Pharmaceutical Assistance Contract for the
4 Elderly program provided for in this subchapter.
5 "PACENET." The Pharmaceutical Assistance Contract for the
6 Elderly Needs Enhancement Tier provided for in this subchapter.
7 "Pharmacy." A pharmacy licensed by the Commonwealth.
8 "Prescription drug." All drugs requiring a prescription in
9 this Commonwealth, insulin, insulin syringes and insulin
10 needles. Experimental drugs or drugs prescribed for wrinkle
11 removal or hair growth are prohibited.
12 "Private contractor." A person, partnership or corporate
13 entity that enters into a contract with the Commonwealth to
14 provide services under the provisions of this subchapter.
15 "Program." The Pharmaceutical Assistance Contract for the
16 Elderly (PACE) and the Pharmaceutical Assistance Contract for
17 the Elderly Needs Enhancement Tier (PACENET) as established by
18 this subchapter, unless otherwise specified.
19 "Provider." A pharmacy or dispensing physician enrolled as a
20 provider in the program.
21 Section 303. Determination of eligibility.
22 The department shall adopt regulations relating to the
23 determination of eligibility of prospective claimants and
24 providers, including dispensing physicians, and the
25 determination and elimination of program abuse. To this end, the
26 department shall establish a compliance unit staffed
27 sufficiently to fulfill this responsibility. The department
28 shall have the power to declare ineligible any claimant or
29 provider who abuses or misuses the established prescription
30 plan. The department shall have the power to investigate cases
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1 of suspected provider or recipient fraud.
2 Section 304. Physician and pharmacy participation.
3 Any physician, pharmacist, pharmacy or corporation owned in
4 whole or in part by a physician or pharmacist enrolled as a
5 provider in the program or that has prescribed medication for a
6 claimant in the program who is precluded or excluded for cause
7 from the Department of Public Welfare's medical assistance
8 program shall be precluded or excluded from participation in the
9 program. No physician precluded or excluded from the Department
10 of Public Welfare's medical assistance program shall have claims
11 resulting from prescriptions paid for by the program.
12 Section 305. Drug utilization review system.
13 The department shall ensure that a state-of-the-art
14 therapeutic drug utilization review system is established to
15 monitor and correct misutilization of drug therapies.
16 Section 306. Reduced assistance.
17 Any eligible claimant whose prescription drug costs are
18 covered in part by any other plan of assistance or insurance may
19 be required to receive reduced assistance under the provisions
20 of this subchapter.
21 Section 307. Rebates for expenses prohibited.
22 A system of rebates or reimbursements to the claimant for
23 prescription drugs shall be prohibited.
24 Section 308. Request for proposal.
25 (a) General.--The department shall prepare a request for
26 proposal for the purpose of providing pharmaceutical assistance
27 for the elderly within this Commonwealth. Upon the adoption of
28 the General Fund budget, the Department of Revenue shall be
29 authorized to transmit the appropriated funds in the State
30 Lottery Fund to the State Treasurer to be deposited in the
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1 Pharmaceutical Assistance Contract for the Elderly Fund. This
2 fund shall consist of appropriations and interest and shall be
3 created by the State Treasurer to fund the operations of the
4 program by the department and the private contractor. Funds not
5 expended in the fiscal year in which they were appropriated
6 shall not lapse and shall be available for use in the next
7 fiscal year.
8 (b) Additional requests.--To provide for the continued
9 operation of the program, the department shall prepare, as
10 needed, requests for proposals, in addition to that set forth in
11 subsection (a), for the purpose of providing pharmaceutical
12 assistance for the elderly within this Commonwealth. A request
13 for proposal shall require potential private contractors to
14 submit a proposal for a period of time and with monetary
15 limitations as determined by the department. Upon the enactment
16 of an appropriation from the State Lottery Fund, the Department
17 of Revenue shall be authorized to transmit the appropriated
18 amount to the State Treasurer to be deposited in the
19 Pharmaceutical Assistance Contract for the Elderly Fund. Funds
20 not expended in the fiscal year in which they were appropriated
21 shall not lapse and shall be available for use in the next
22 fiscal year.
23 Section 309. Program generally.
24 (a) Parameters of program.--The program shall include the
25 following:
26 (1) Participating pharmacies shall be paid within 21
27 days of the contracting firm receiving the appropriate
28 substantiation of the transaction. Pharmacies shall be
29 entitled to interest for payment not made within the 21-day
30 period at a rate approved by the board.
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1 (2) Collection of the copayment by pharmacies shall be
2 mandatory.
3 (3) Senior citizens participating in the program are not
4 required to maintain records of each transaction.
5 (4) A system of rebates or reimbursements to eligible
6 claimants for pharmaceutical expenses shall be prohibited.
7 (5) There shall be the following copayments:
8 (i) For generic drugs - $5.
9 (ii) For preferred drug list drugs - $10.
10 (iii) For drugs which are not on the preferred drug
11 list - $15.
12 (6) Payments as follows:
13 (i) Except as provided in subparagraph (ii), to
14 pharmacies on behalf of eligible claimants for costs of
15 the prescription drug in excess of the copayment as
16 provided in subsections (b) and (c), plus a dispensing
17 fee of $3.50 or the dispensing fee established by the
18 department by regulation, whichever is greater.
19 (ii) For A-rated generic therapeutically equivalent
20 drugs, to pharmacies on behalf of eligible claimants for
21 the upper limits established under 42 CFR § 447.332
22 (relating to upper limits for multiple source drugs),
23 plus a dispensing fee of $4 or the dispensing fee
24 established by the department by regulations, whichever
25 is greater.
26 (7) In no case shall the Commonwealth or any person
27 enrolled in the program be charged more than the price of the
28 drug at the particular pharmacy on the date of the sale.
29 (b) Multiple-source drugs.--Except for brand name drugs that
30 are certified in accordance with subsection (d), the department
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1 payment for multiple-source drugs must not exceed the amount
2 that would result from the application of the specific limits
3 established in accordance with subsection (e). If a specific
4 limit has not been established under subsection (e), then the
5 rule for "other drugs" set forth in subsection (c) applies.
6 (c) Other drugs.--The department payments for brand name
7 drugs certified in accordance with subsection (d) and drugs
8 other than multiple-source drugs for which a specific limit has
9 been established under subsection (e) must not exceed in the
10 aggregate payment levels that the department has determined by
11 applying the lower of the:
12 (1) Estimated acquisition costs plus reasonable
13 dispensing fees established by the department.
14 (2) Providers' usual and customary charges to the
15 general public.
16 (d) Certification of brand-name drugs.--
17 (1) The upper limit for payments for multiple-source
18 drugs for which a specific limit has been established under
19 subsection (e) does not apply if a physician certifies in his
20 or her own handwriting that a specific brand is medically
21 necessary for a particular recipient.
22 (2) The department must decide what certification form
23 and procedure are used.
24 (3) A checkoff box on a form is not acceptable but a
25 notation like "brand necessary" is allowable.
26 (4) The department may allow providers to keep the
27 certification forms if the forms will be available for
28 inspection by the department.
29 (e) Establishment and issuance of a listing of multiple-
30 source drugs.--
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1 (1) The department will use the CMS listings that
2 identify and set upper limits for multiple-source drugs that
3 meet the following requirements:
4 (i) All of the formulations of the drug approved by
5 the Food and Drug Administration (FDA) have been
6 evaluated as therapeutically equivalent in the most
7 current edition of their publication, Approved Drug
8 Products with Therapeutic Equivalence Evaluations,
9 including supplements or in successor publications.
10 (ii) At least three suppliers list the drug, which
11 has been classified by the FDA as category "A" in its
12 publication, Approved Drug Products with Therapeutic
13 Equivalence Evaluations, including supplements or in
14 successor publications, based on all listings contained
15 in current editions, or updates, of published compendia
16 of cost information for drugs available for sale
17 nationally IN THIS COMMONWEALTH. <--
18 (2) The department publishes the list of multiple-source
19 drugs for which upper limits have been established and any
20 revisions to the list in Medicaid program instructions.
21 (3) The department will identify the sources used in
22 compiling these lists.
23 Section 310. Generic drugs.
24 (a) General.--Notwithstanding any other statute or
25 regulation, if an A-rated generic therapeutically equivalent
26 drug is available for dispensing to a claimant, the provider
27 shall dispense the A-rated generic therapeutically equivalent
28 drug to the claimant. The department shall not reimburse
29 providers for brand name products except in the following
30 circumstances:
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1 (1) There is no A-rated generic therapeutically
2 equivalent drug available on the market. This paragraph does
3 not apply to the lack of availability of an A-rated generic
4 therapeutically equivalent drug in the providing pharmacy
5 unless it can be shown to the department that the provider
6 made reasonable attempts to obtain the A-rated generic
7 therapeutically equivalent drug or that there was an
8 unforeseeable demand and depletion of the supply of the A-
9 rated generic therapeutically equivalent drug. In either
10 case, the department shall reimburse the provider for 90% of
11 the average wholesale cost plus a dispensing fee based on the
12 least expensive A-rated generic therapeutically equivalent
13 drug for the brand drug dispensed.
14 (2) An A-rated generic therapeutically equivalent drug <--
15 is deemed by the department, in consultation with a
16 utilization review committee, to have too narrow a
17 therapeutic index for safe and effective dispensing in the
18 community setting. The department shall notify providing
19 pharmacies of A-rated generic therapeutically equivalent
20 drugs that are identified pursuant to this paragraph on a
21 regular basis.
22 (3) (2) The Department of Health has determined that a
23 drug shall not be recognized as an A-rated generic
24 therapeutically equivalent drug for purpose of substitution
25 under section 5(b) of the act of November 24, 1976 (P.L.1163,
26 No.259), referred to as the Generic Equivalent Drug Law.
27 (4) (3) At the time of dispensing, the provider has a <--
28 prescription on which the brand name drug dispensed is billed
29 to the program by the provider at a usual and customary
30 charge which is equal to or less than the least expensive
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1 usual and customary charge of any A-rated generic
2 therapeutically equivalent drug reasonably available on the
3 market to the provider.
4 (b) Copayment.--If a claimant chooses not to accept the A-
5 rated generic therapeutically equivalent drug required by
6 subsection (a), the claimant shall be liable for the copayment
7 and 70% of the average wholesale cost of the brand name drug.
8 (c) Substitution or construction.--The dispensing of an A-
9 rated generic therapeutically equivalent drug in accordance with
10 this subchapter shall not be deemed incorrect substitution under
11 section 6(a) of the Generic Equivalent Drug Law.
12 (d) Medical exception.--A medical exception process shall be
13 established by the department, which shall be published as a
14 notice in the Pennsylvania Bulletin and distributed to providers
15 and recipients in the program.
16 Section 311. Supply.
17 (a) Requirement.--Except as set forth in subsection (b),
18 prescription benefits for any single prescription shall be
19 limited to a 30-day supply of the prescription drug or 100
20 units, whichever is less for acute conditions.
21 (b) Exceptions.--
22 (1) In the case of diagnosis for acute conditions,
23 prescription benefits for any single prescription shall be
24 limited to a 15-day supply.
25 (2) Subsection (a) shall not apply to topical ointments
26 or gels which are not available in containers which meet the
27 size and supply restrictions set forth in subsection (a).
28 (c) Subsection (a) does not apply to contracts under section
29 312(c).
30 Section 312. Mail service program.
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1 (a) General rule.--The department shall require ENCOURAGE <--
2 the use of a mail service program for maintenance drugs for
3 eligible claimants. Only mail order pharmacy services provided
4 by pharmacies which are licensed by the Commonwealth and which
5 have their principal place of business within this Commonwealth
6 may participate as providers under the program.
7 (b) Minimum standards of practice.--The department shall
8 develop and promulgate specific regulations governing the
9 practice of mail order pharmacy and other enrolled providers to
10 include the following minimum standards of practice to ensure
11 the health, safety and welfare of program participants:
12 (1) The appropriate method by which pharmacies verify
13 the identity of the eligible claimant and the authenticity of
14 prescriptions received.
15 (2) The appropriate method by which pharmacies mail or
16 deliver prescription drugs ensuring, to the maximum extent
17 possible, that the intended eligible claimant is the actual
18 ultimate recipient of any prescription dispensed.
19 (3) The appropriate method by which pharmacies
20 communicate with eligible claimants in emergency situations.
21 (c) Ninety-day supply.--The department shall negotiate mail
22 order contracts to provide a 90-day supply of drugs to eligible
23 claimants at a single copayment rate equal to a 30-day supply
24 for each order.
25 (d) Requirement.--An EXCEPT AS SET FORTH IN SUBSECTION (E), <--
26 AN eligible claimant shall use the mail service program if the
27 eligible claimant:
28 (1) utilizes a maintenance drug;
29 (2) has filled a prescription; and
30 (3) has refilled the prescription under paragraph (2) at
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1 least once.
2 (E) EXCEPTION.--SUBSECTION (D) SHALL NOT APPLY TO AN <--
3 ELIGIBLE CLAIMANT WHO SUBMITS TO THE DEPARTMENT, IN A FORM
4 ACCEPTABLE TO THE DEPARTMENT, A WRITTEN STATEMENT ASSERTING THE
5 ELIGIBLE CLAIMANT'S RIGHT TO FILL PRESCRIPTIONS AT THE PHARMACY
6 CHOSEN BY THE ELIGIBLE CLAIMANT.
7 (e) (F) Rebates.--A mail order contract must include a <--
8 rebate from the prescription drug manufacturer. The rebate must
9 be at least as much as follows:
10 (1) For a brand-name drug, the sum of subparagraphs (i)
11 and (ii):
12 (i) A dispensing fee of at least $6.
13 (ii) The difference between:
14 (A) the average wholesale price; and
15 (B) 20% of that price.
16 (2) For a generic drug, the sum of subparagraphs (i) and
17 (ii):
18 (i) A dispensing fee of at least $6.
19 (ii) The difference between:
20 (A) the average wholesale price; and
21 (B) 50% of that price.
22 (f) (G) Negotiated payments.--The department shall not <--
23 discriminate against a pharmacy that agrees to accept negotiated
24 payment levels with the same terms and conditions and to adhere
25 to quality standards established by the PACE and PACENET
26 programs.
27 Section 313. Indication of price.
28 The retail price of the prescription shall be indicated on
29 the label of the prescription container or furnished by separate
30 receipt.
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1 Section 314. Reimbursement.
2 (A) INDICATION.--THE DEPARTMENT SHALL INDICATE THIRD-PARTY <--
3 COVERAGE FOR EACH ELIGIBLE CLAIMANT.
4 (B) RESULT.--For-profit third-party insurers and not-for- <--
5 profit prescription plans shall be responsible for any payments
6 made to a providing pharmacy on behalf of a claimant covered by
7 such a third party.
8 Section 315. Nonliability.
9 (a) General.--Any person rendering service as a member of a
10 utilization review committee for this program shall not be
11 liable for any civil damages as a result of any acts or
12 omissions in rendering the service as a member of any such
13 committee except any acts or omissions intentionally designed to
14 harm or any grossly negligent acts or omissions which result in
15 harm to the person receiving such service.
16 (b) Department personnel.--Any officer or employee of the
17 department rendering service as a member of a utilization review
18 committee for this program shall not be liable for any civil
19 damages as a result of any acts or omissions in rendering the
20 service as a member of any such committee or as a result of any
21 decision or action in connection with the program except any
22 acts or omissions intentionally designed to harm or any grossly
23 negligent acts or omissions which result in harm to the person
24 receiving such service.
25 Section 316. Income verification.
26 (a) General.--The department shall annually verify the
27 income of eligible claimants by requiring income documentation
28 from the claimants. An application for benefits under this
29 subchapter shall constitute a waiver to the department of all
30 relevant confidentiality requirements relating to the claimant's
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1 Pennsylvania State income tax information in the possession of
2 the Department of Revenue. The Department of Revenue shall
3 provide the department with the necessary income information
4 shown on the claimant's Pennsylvania State income tax return
5 solely for income verification purposes.
6 (b) Unlawful act.--It shall be unlawful for any officer,
7 agent or employee of the department to divulge or make known in
8 any manner whatsoever any information gained through access to
9 the Department of Revenue information except for official income
10 verification purposes under this subchapter.
11 (c) Penalty.--A person who violates this chapter commits a
12 misdemeanor and shall, upon conviction, be sentenced to pay a
13 fine of not more than $1,000 or to imprisonment for not more
14 than one year, or both, together with the cost of prosecution,
15 and, if the offender is an officer or employee of the
16 Commonwealth, he shall be dismissed from office or discharged
17 from employment.
18 (d) Coordination of effort.--To the extent possible, the
19 department and the Department of Public Welfare shall coordinate
20 efforts to facilitate the application and enrollment of eligible
21 older people in the Medicaid Healthy Horizons Program by
22 processing these applications at senior citizens centers and
23 other appropriate facilities providing services to the elderly.
24 Section 317. Contract.
25 The department is authorized to enter into a contract
26 providing for prescription drugs to eligible persons pursuant to
27 this subchapter. The department shall select a proposal that
28 includes, but is not limited to, the criteria set forth in this
29 subchapter.
30 Section 318. The Pharmaceutical Assistance Contract for the
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1 Elderly Needs Enhancement Tier.
2 (a) Establishment.--There is hereby established within the
3 department a program to be known as the Pharmaceutical
4 Assistance Contract for the Elderly Needs Enhancement Tier
5 (PACENET).
6 (b) Eligibility.--A claimant with an annual income of not
7 less than $17,000 and not more than $20,000 in the case of a
8 single person and of not less than $20,001 and not more than
9 $23,200 in the case of the combined income of persons married to
10 each other shall be eligible for enhanced pharmaceutical
11 assistance under this section. A person may, in reporting income
12 to the department, round the amount of each source of income and
13 the income total to the nearest whole dollar, whereby any amount
14 which is less than 50¢ is eliminated.
15 (c) Requirements.--Upon enrollment in PACENET, eligible
16 claimants in the income ranges set forth in subsection (b) shall
17 be required to meet a monthly deductible in unreimbursed
18 prescription drug expenses of $50 $40 per person per month. To <--
19 qualify for the deductible set forth in this subsection the
20 prescription drug must be purchased for the use of the eligible
21 claimant from a provider as defined in this subchapter. The
22 department, after consultation with the board, may approve an
23 adjustment in the deductible on an annual basis.
24 (d) Copayments.--The following are the copayments:
25 (1) For generic drugs - $6.
26 (2) For preferred drug list drugs - $12.
27 (3) For drugs which are not on the preferred drug list -
28 $18.
29 Section 319. Board.
30 (a) General.--The Pharmaceutical Assistance Review Board is
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1 continued to ensure that the program is providing and continues
2 to provide the assistance intended in a fiscally responsible
3 manner without excessively hampering the pharmaceutical PHARMACY <--
4 industry.
5 (b) Membership.--The board shall be comprised of the
6 following eight persons:
7 (1) The Secretary of Aging, who shall serve as its
8 chairman.
9 (2) The Secretary of Revenue.
10 (3) The Secretary of Health.
11 (4) Five public members, one appointed by the President
12 pro tempore of the Senate, one appointed by the Minority
13 Leader of the Senate, one appointed by the Speaker of the
14 House of Representatives, one appointed by the Minority
15 Leader of the House of Representatives and one appointed by
16 the Governor. Those appointed by the legislative officers
17 shall include two senior citizens who have not been a part of
18 the pharmaceutical PHARMACY industry to serve as consumer <--
19 advocates, and two representatives of the pharmaceutical <--
20 industry, at least one of whom is a ONE REPRESENTATIVE OF THE <--
21 PHARMACY INDUSTRY AND ONE practicing Pennsylvania pharmacist.
22 The individual appointed by the Governor must be a physician.
23 A public member who misses two consecutive meetings without
24 good cause acceptable to the chairman shall be replaced by
25 the appointing authority.
26 (c) Annual review.--Using the annual report submitted by the
27 department pursuant to section 2102 of the act of August 26,
28 1971 (P.L.351, No.91), known as the State Lottery Law, and other
29 appropriate data sources, the board shall conduct an annual
30 review. The board shall develop recommendations concerning any
20030H0888B1836 - 19 -
1 changes in the level of copayment, deductible or in the level of
2 fees paid to participating pharmacists. The board shall review
3 the department's therapeutic drug utilization review program on
4 an ongoing basis. The board may also recommend other changes in
5 the structure of the program and direct the department to enter
6 into discussions with the private contractor concerning
7 amendments to the contract, or the department may enter into
8 such discussion if it deems necessary. The copayment or
9 deductible schedule shall only be adjusted on an annual basis.
10 (d) Meetings.--The board shall meet at least two times per
11 year.
12 Section 320. Penalties.
13 (a) General.--It shall be unlawful for any person to:
14 (1) Submit a false or fraudulent claim or application
15 under this subchapter, including, but not limited to:
16 (i) aiding or abetting another in the submission of
17 a false or fraudulent claim or application;
18 (ii) receiving benefits or reimbursement under a
19 Federal, state or a private program for prescription
20 assistance and claiming or receiving duplicative benefits
21 hereunder;
22 (iii) soliciting, receiving, offering or paying any
23 kickback, bribe or rebate, in cash or in kind, from or to
24 any person in connection with the furnishing of services
25 under this subchapter;
26 (iv) engaging in a pattern of submitting claims that
27 repeatedly uses incorrect National Drug Code numbers for
28 the purpose of obtaining wrongful enhanced reimbursement;
29 or
30 (v) otherwise violating any provision of this
20030H0888B1836 - 20 -
1 subchapter.
2 (2) Charge a copay if the amount of the copay exceeds
3 the actual cost of the drug purchased.
4 (b) Civil penalty.--In addition to any appropriate criminal
5 penalty for prohibited acts under this subchapter whether or not
6 that act constitutes a crime under 18 Pa.C.S. (relating to
7 crimes and offenses), a provider who violates this section may
8 be liable for a civil penalty, which shall be collected by the
9 department, in an amount not less than $500 and not more than
10 $10,000 for each violation of this chapter. Each violation
11 constitutes a separate offense. If the department collects three
12 or more civil penalties against the same provider, the provider
13 shall be ineligible to participate in either PACE or PACENET for
14 a period of one year. If more than three civil penalties are
15 collected from any provider, the department may determine that
16 the provider is permanently ineligible to participate in PACE or
17 PACENET.
18 (c) Suspension.--The license of any provider who has been
19 found guilty under this subchapter shall be suspended for a
20 period of one year. The license of any provider who has
21 committed three or more violations of this subchapter may be
22 suspended for a period of one year.
23 (d) Reparation.--Any provider, recipient or other person who
24 is found guilty of a crime for violating this subchapter shall
25 repay three times the value of the material gain received. In
26 addition to the civil penalty authorized pursuant to subsection
27 (b), the department may require the provider, recipient or other
28 person to repay up to three times the value of any material gain
29 to PACE or PACENET.
30 Section 321. Prescription Drug Education Program.
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1 The department, in cooperation with the Department of Health,
2 shall develop and implement a Statewide prescription drug
3 education program designed to inform older adults of the dangers
4 of prescription drug abuse and misuse. The prescription dug
5 education program shall include, but not be limited to,
6 information concerning the following:
7 (1) The hazards of prescription drug overdose.
8 (2) The potential dangers of mixing prescription drugs.
9 (3) The danger of retaining unused prescription drugs
10 after the need to take them no longer exists.
11 (4) The necessity to carefully question physicians and
12 pharmacists concerning the effects of taking prescription
13 drugs, including the differences between brand-name drugs and <--
14 generically equivalent drugs.
15 (5) The advisability of maintaining a prescription drug
16 profile or other record of prescription drug dosage and
17 frequency of dosage.
18 (6) The desirability of advising family members of the
19 types and proper dosage of prescription drugs which are being
20 taken.
21 (7) The dangers of taking prescription drugs in excess
22 of prescribed dosages.
23 (8) The need to obtain complete, detailed directions
24 from the physician or pharmacist concerning the time period a
25 prescription drug should be taken.
26 Section 322. Outreach program.
27 The department, in consultation with appropriate Commonwealth
28 agencies, shall coordinate the development of an outreach plan
29 to inform potential contractors, providers and enrollees
30 regarding eligibility and available benefits of the PACE and
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1 PACENET programs. The plan shall include provisions for reaching
2 special populations, including nonwhite and non-English-speaking
3 people; for reaching different geographic areas, including rural
4 and inner-city areas; and for assuring that special efforts are
5 coordinated within the overall outreach activities throughout
6 this Commonwealth.
7 Section 323. Accountability.
8 (a) Audits.--The PACE and PACENET programs shall be subject
9 to an audit by an independent entity at least once each fiscal
10 year. This subsection shall include fiscal audits, provider
11 claims audits, benefits manager administration audits and
12 manufacturer's rebate audits.
13 (b) Conduct of audit.--The audit shall be conducted in
14 accordance with generally accepted auditing standards as
15 prescribed by the American Institute of Certified Public
16 Accountants, the Governmental Accounting Standards Board, the
17 United States General Accounting Office or other professionally
18 recognized entities that prescribe auditing standards.
19 (c) Access.--The auditor shall be entitled to have access to
20 all of the books, accounts, confidential or nonconfidential
21 reports, vouchers or other records of information in the
22 department and its contractors including access to all
23 electronic data. The auditor shall have access to copyrighted or
24 restricted information obtained by the department and its
25 contractors under subscription agreements and utilized in the
26 preparation of economic estimates only for audit purposes.
27 (d) Purpose and report.--The audit shall determine the
28 following:
29 (1) Whether the records, books and accounts of the
30 department and its contractors accurately reflect the
20030H0888B1836 - 23 -
1 financial and fiscal operations.
2 (2) Whether effective accounting control over revenues,
3 obligations, expenditures, assets and liabilities is
4 maintained.
5 (3) Whether the department and its contractors have
6 obligated, expended, received and used State funds in
7 accordance with the purpose for which those funds have been
8 appropriated.
9 (4) Whether the records, books and accounts of the
10 department and its contractors fairly and accurately reflect
11 the financial and fiscal operations relating to the
12 obligation receipt, expenditure and use of State funds.
13 (5) Whether the department and its contractors are
14 managing and utilizing resources, personnel, property,
15 equipment and space in an economical and efficient manner
16 including causes of inefficiencies or uneconomical practices,
17 inadequacies in management information systems, internal and
18 administrative procedures, organizational structure, use of
19 resources, allocation of personnel, purchasing policies and
20 equipment.
21 (6) Whether financial, program and statistical reports
22 of the department and its contractors contain useful data and
23 are fairly presented.
24 (7) Whether the objectives and intended benefits are
25 being achieved efficiently and effectively.
26 (8) Whether the programs are being performed and
27 administered as authorized and required by law.
28 (9) Whether the benefits manager and pharmacy providers
29 are accurately transmitting and billing PACE and PACENET
30 prescription claims.
20030H0888B1836 - 24 -
1 (e) Report.--The auditor shall submit an annual report of
2 its findings, conclusions and recommendations to the department
3 and its contractors and to the Aging and Youth Committee, the
4 Appropriations Committee and the Public Health and Welfare
5 Committee of the Senate and the Aging and Older Adult Services
6 Committee, the Appropriations Committee and the Health and Human
7 Services Committee of the House of Representatives.
8 (f) Response.--The Department of Aging shall respond to the
9 audit report within 30 days of its release.
10 (G) CONTRACT.--THE DEPARTMENT SHALL CONTRACT FOR THE AUDIT <--
11 AS FOLLOWS:
12 (1) THE AUDITOR SHALL EARN A BASIC FEE NOT TO EXCEED
13 $200,000. THIS FEE SHALL BE CREDITED TO THE DEPARTMENT IF THE
14 AUDITOR IS COMPENSATED UNDER PARAGRAPH (2) IN THE AMOUNT OF
15 AT LEAST $600,000.
16 (2) THE AUDITOR SHALL EARN 30% OF THE FUNDS COLLECTED BY
17 THE DEPARTMENT AS A RESULT OF THE AUDIT.
18 SUBCHAPTER B
19 PRUDENT PHARMACEUTICAL PURCHASING
20 Section 341. Definitions.
21 The following words and phrases when used in this subchapter
22 shall have the meanings given to them in this section unless the
23 context clearly indicates otherwise:
24 "Covered prescription drug." A legend drug, insulin, an
25 insulin syringe or an insulin needle eligible for payment by the
26 Commonwealth under PACE, PACENET or designated pharmaceutical
27 programs.
28 "Designated pharmaceutical programs." The general assistance
29 program and the Special Pharmaceutical Benefit Program in the
30 Department of Public Welfare and the End Stage Renal Dialysis
20030H0888B1836 - 25 -
1 Program in the Department of Health.
2 "PACE." The program under Subchapter A.
3 "PACENET." The program established under section 318.
4 Section 342. Rebate agreement.
5 PACE, PACENET and designated pharmaceutical programs shall
6 reimburse for any covered prescription drug with a rebate
7 agreement drafted on the same basis as provided in section 1927
8 of Title XIX of the Social Security Act (49 Stat. 620, 42 U.S.C.
9 § 1396 r-8).
10 Section 343. Disposition of funds.
11 (a) PACE and PACENET.--Money received under this subchapter
12 in connection with PACE and PACENET shall be deposited in the
13 Pharmaceutical Assistance Contract for the Elderly Fund.
14 (b) Pharmaceutical programs.--Money received under this
15 subchapter in connection with designated pharmaceutical programs
16 shall be treated as a refund of expenditures to the
17 appropriation which originally provided the funding for the
18 pharmaceutical purchase.
19 SUBCHAPTER C
20 PHARMACY BEST PRACTICES AND COST CONTROL PROGRAM
21 Section 361. Definitions.
22 The following words and phrases when used in this subchapter
23 shall have the meanings given to them in this section unless the
24 context clearly indicates otherwise:
25 "Committee." The Pharmacy Best Practices and Cost Control
26 Advisory Committee established in section 362.
27 "Department." The Department of Aging of the Commonwealth.
28 "Program." The Pharmacy Best Practices and Cost Control
29 Program established in section 363.
30 "Secretary." The Secretary of Aging of the Commonwealth.
20030H0888B1836 - 26 -
1 § 362. Advisory committee.
2 (a) Establishment.--The Pharmacy Best Practices and Cost
3 Control Advisory Committee is established in the department.
4 (b) Members.--The committee is comprised of the following:
5 (1) The secretary or a designee, who shall serve as
6 chairperson.
7 (2) Four members appointed by the Governor. Members
8 under this paragraph must possess expertise in medicine or
9 pharmacy.
10 (3) One member appointed by the President pro tempore of
11 the Senate and one member appointed by the Minority Leader of
12 the Senate.
13 (4) One member appointed by the Speaker of the House of
14 Representatives and one member appointed by the Minority
15 Leader of the House of Representatives.
16 (c) Terms.--Terms are as follows:
17 (1) The secretary shall serve ex officio.
18 (2) A member under subsection (b)(2) shall serve a term
19 of six years.
20 (3) A member under subsection (b)(3) shall serve a term
21 of four years but may be removed at the pleasure of the
22 appointing authority.
23 (4) A member under subsection (b)(4) shall serve a term
24 of two years but may be removed at the pleasure of the
25 appointing authority.
26 (5) An appointment to fill a vacancy shall be for the
27 period of the unexpired term or until a successor is
28 appointed and qualified.
29 (d) Quorum.--A majority of the members of the committee
30 constitutes a quorum.
20030H0888B1836 - 27 -
1 (e) Compensation.--Members shall receive no payment for
2 their services. Members who are not employees of State
3 government shall be reimbursed for necessary and reasonable
4 expenses incurred in the course of their official duties.
5 Section 363. Program.
6 (a) Establishment.--The secretary shall establish a Pharmacy
7 Best Practices and Cost Control Program for PACE and PACENET
8 enrollees designed to reduce the cost of providing prescription
9 drugs, while maintaining high quality in prescription drug
10 therapies. The program shall be implemented consistent with
11 section 1927 of the Social Security Act (49 Stat. 620, 42 U.S.C.
12 § 1396r-8). The program shall include all of the following:
13 (1) A preferred list of covered prescription drugs which
14 identifies preferred choices within selected therapeutic
15 classes for particular diseases and conditions, including
16 generic alternatives. Therapeutic classes and drugs to be
17 preferred in the classes shall be selected by the department
18 upon recommendations by the committee.
19 (2) Utilization review procedures, including a prior
20 authorization review process which meets the requirements of
21 section 1927(d)(5) of the Social Security Act (42 U.S.C. §
22 1396r-8(d)(5)).
23 (3) A supplemental rebate program or any other strategy
24 designed to negotiate with pharmaceutical manufacturers to
25 lower the cost of prescription drugs for the department's
26 Medicaid program.
27 (4) Education programs, including a counterdetailing
28 program, designed to provide information and education on the
29 therapeutic and cost-effective utilization of prescription
30 drugs to physicians, pharmacists and other health care
20030H0888B1836 - 28 -
1 professionals authorized to prescribe and dispense
2 prescription drugs.
3 (5) Any other cost containment activity adopted by the
4 department which is designed to reduce the cost of providing
5 prescription drugs while maintaining high quality in
6 prescription drug therapies.
7 (b) Pooling.--The secretary shall evaluate the benefits of
8 participating, but is not required to participate, in joint
9 prescription drug purchasing agreements or pooling arrangements
10 with other states. Such actions shall include:
11 (1) The execution of any lawful joint purchasing or
12 pooling agreements with other participating states which the
13 secretary determines will lower the Medicaid cost of
14 prescription drugs while maintaining high quality in
15 prescription drug therapies.
16 (2) Renegotiation and amendment of existing contracts to
17 which the department is a party if renegotiation and
18 amendment will be of economic benefit to the department.
19 (c) Reports.--The secretary shall report quarterly to the
20 committee on the department's progress in securing participation
21 in joint purchasing or pooling agreements.
22 (d) Authorized coverage.--The program shall authorize
23 pharmacy benefit coverage when a patient's health care provider
24 prescribes a prescription drug not on the preferred drug list or
25 a prescription drug which is not the list's preferred choice
26 under the same terms as coverage for preferred choice drugs if
27 any of the following apply:
28 (1) The preferred choice has not been effective or, with
29 reasonable certainty, is not expected to be effective in
30 treating the patient's condition.
20030H0888B1836 - 29 -
1 (2) The preferred choice causes or is reasonably
2 expected to cause adverse or harmful reactions in the
3 patient.
4 (3) Other clinical criteria recommended by the committee
5 and approved by the department is complied with.
6 (4) If the prescriber does not wish substitution to take
7 place, the prescriber shall write "brand necessary" or "no
8 substitution" in the prescriber's own handwriting on the
9 prescription blank, together with a written statement that
10 the generic or therapeutic equivalent has not been effective,
11 or with reasonable certainty is not expected to be effective,
12 in treating the patient's medical condition or causes or is
13 reasonably expected to cause adverse or harmful reactions in
14 the patient. In the case of an unwritten prescription, there
15 shall be no substitution if the prescriber expressly
16 indicates to the pharmacist that the brand name drug is
17 necessary and substitution is not allowed because the generic
18 or therapeutic equivalent has not been effective, or with
19 reasonable certainty is not expected to be effective, in
20 treating the patient's medical condition or causes or is
21 reasonably expected to cause adverse or harmful reactions in
22 the patient.
23 (e) Exclusions.--The department, with recommendations from
24 the committee, shall determine diseases and therapeutic classes
25 relating to treatment for diseases excluded from the program as
26 to Medicaid enrollees already taking specified drugs at the time
27 the program is implemented.
28 (f) Response.--The program's PRESCRIBER-INDICATED prior <--
29 authorization process shall ensure that there will be a response
30 to a request for prior authorization by telephone or other
20030H0888B1836 - 30 -
1 telecommunication device within 24 hours after receipt of the
2 request for prior authorization and that a 72-hour supply of the
3 drug prescribed will be provided in an emergency or when the
4 program does not provide a response within 24 hours. The prior
5 authorization process shall be designed to minimize
6 administrative burdens on prescribers, pharmacists and
7 consumers.
8 (g) Procedure.--The program shall establish procedures for
9 the timely review of prescription drugs newly approved by the
10 Food and Drug Administration, including procedures for the
11 review of newly approved prescription drugs in emergency
12 circumstances.
13 (h) Reports.--The department shall submit annual reports on
14 the programs under subsection (a) and (b) to the Aging and Youth
15 Committee, the Appropriations Committee and the Public Health
16 and Welfare Committee of the Senate and the Aging and Older
17 Adult Services Committee, the Appropriations Committee and the
18 Health and Human Services Committee of the House of
19 Representatives. The reports shall include classes of drugs,
20 exceptions, cost effectiveness, movement of market share and
21 increased utilization of generic drugs.
22 SUBCHAPTER D <--
23 PHARMACEUTICAL ASSISTANCE CLEARINGHOUSE
24 SECTION 371. DEFINITIONS.
25 THE FOLLOWING WORDS AND PHRASES WHEN USED IN THIS SUBCHAPTER
26 SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS SECTION UNLESS THE
27 CONTEXT CLEARLY INDICATES OTHERWISE:
28 "CLEARINGHOUSE." THE PHARMACEUTICAL ASSISTANCE CLEARINGHOUSE
29 ESTABLISHED IN SECTION 372.
30 "DEPARTMENT." THE DEPARTMENT OF AGING OF THE COMMONWEALTH.
20030H0888B1836 - 31 -
1 "PATIENT ASSISTANCE PROGRAM." A PROGRAM OFFERED BY A
2 PHARMACEUTICAL MANUFACTURER UNDER WHICH THE MANUFACTURER
3 PROVIDES PRESCRIPTION MEDICATIONS AT NO CHARGE OR AT A
4 SUBSTANTIALLY REDUCED COST. THE TERM DOES NOT INCLUDE THE
5 PROVISION OF A DRUG AS PART OF A CLINICAL TRIAL.
6 SECTION 372. PHARMACEUTICAL ASSISTANCE CLEARINGHOUSE.
7 (A) ESTABLISHMENT.--WITHIN 120 DAYS OF THE EFFECTIVE DATE OF
8 THIS SUBCHAPTER, THE DEPARTMENT SHALL ESTABLISH THE
9 PHARMACEUTICAL ASSISTANCE CLEARINGHOUSE. EACH PHARMACEUTICAL
10 MANUFACTURER THAT DOES BUSINESS IN THIS COMMONWEALTH AND OFFERS
11 A PATIENT ASSISTANCE PROGRAM SHALL INFORM THE DEPARTMENT OF ALL
12 OF THE FOLLOWING:
13 (1) THE EXISTENCE OF THE PATIENT ASSISTANCE PROGRAM.
14 (2) THE ELIGIBILITY REQUIREMENTS FOR THE PATIENT
15 ASSISTANCE PROGRAM.
16 (3) THE DRUGS COVERED BY THE PATIENT ASSISTANCE PROGRAM.
17 (4) INFORMATION, SUCH AS A TELEPHONE NUMBER, WHICH MAY
18 BE USED TO APPLY FOR THE PATIENT ASSISTANCE PROGRAM.
19 (B) INFORMATION.--THE CLEARINGHOUSE SHALL MAINTAIN THE
20 INFORMATION SUBMITTED BY PHARMACEUTICAL MANUFACTURERS AND MAKE
21 IT AVAILABLE TO THE PUBLIC.
22 (C) STAFF.--THE DEPARTMENT SHALL ENSURE THAT THE
23 CLEARINGHOUSE IS STAFFED AT LEAST DURING NORMAL BUSINESS HOURS.
24 THE DEPARTMENT SHALL CONTRACT FOR THE SERVICES OF A SCHOOL OF
25 PHARMACY TO STAFF THE CLEARINGHOUSE.
26 SECTION 373. TOLL-FREE TELEPHONE NUMBER.
27 THE DEPARTMENT SHALL ESTABLISH A TOLL-FREE TELEPHONE NUMBER
28 THROUGH WHICH THE MEMBERS OF THE PUBLIC MAY OBTAIN INFORMATION
29 FROM THE CLEARINGHOUSE ABOUT AVAILABLE PATIENT ASSISTANCE
30 PROGRAMS.
20030H0888B1836 - 32 -
1 SECTION 374. ASSISTANCE AVAILABLE.
2 (A) DIRECT.--
3 (1) THE CLEARINGHOUSE SHALL ASSIST ANY INDIVIDUAL IN
4 DETERMINING WHETHER A PATIENT ASSISTANCE PROGRAM IS OFFERED
5 FOR A PARTICULAR DRUG AND WHETHER THE INDIVIDUAL MAY BE
6 ELIGIBLE TO OBTAIN THE DRUG THROUGH A PATIENT ASSISTANCE
7 PROGRAM.
8 (2) THE CLEARINGHOUSE MAY ASSIST AN INDIVIDUAL WHO
9 WISHES TO APPLY FOR A PATIENT ASSISTANCE PROGRAM BY ASSISTING
10 WITH THE PREPARATION OF AN APPLICATION AND COORDINATING
11 COMMUNICATIONS BETWEEN THE INDIVIDUAL'S PHYSICIAN AND A
12 PHARMACEUTICAL MANUFACTURER ON BEHALF OF THE INDIVIDUAL FOR
13 THE PURPOSE OF OBTAINING APPROVAL TO PARTICIPATE IN THE
14 PATIENT ASSISTANCE PROGRAM.
15 (B) REFERRALS.--THE CLEARINGHOUSE SHALL MAKE REFERRALS TO
16 ANY PUBLICLY FUNDED PROGRAM FOR WHICH IT DEEMS A PATIENT
17 ELIGIBLE.
18 SECTION 375. REPORTING.
19 THE DEPARTMENT SHALL REPORT ANNUALLY TO THE GOVERNOR AND THE
20 GENERAL ASSEMBLY ON THE ACTIVITIES OF THE CLEARINGHOUSE. THE
21 REPORT SHALL INCLUDE:
22 (1) THE NUMBER OF INDIVIDUALS WHO HAVE BEEN ASSISTED BY
23 THE CLEARINGHOUSE.
24 (2) THE NUMBER AND BENEFITS OF PATIENT ASSISTANCE
25 PROGRAMS LISTED WITH THE CLEARINGHOUSE.
26 (3) THE NUMBER OF PATIENTS REFERRED TO PUBLICLY FUNDED
27 PROGRAMS UNDER SECTION 374(B). PROGRAMS UNDER THIS PARAGRAPH
28 INCLUDE THE PHARMACEUTICAL ASSISTANCE CONTRACT FOR THE
29 ELDERLY PROGRAM, MEDICAL ASSISTANCE AND PROGRAMS OF THE
30 DEPARTMENT OF VETERANS AFFAIRS.
20030H0888B1836 - 33 -
1 (4) OTHER INFORMATION DEEMED RELEVANT BY THE DEPARTMENT.
2 CHAPTER 51
3 MISCELLANEOUS PROVISIONS
4 Section 5101. Federal programs.
5 If the Federal Government enacts programs similar to PACE or
6 PACENET, the State programs shall be construed to only
7 supplement the Federal programs and all persons qualified for
8 coverage under the Federal program shall utilize that Federal
9 program before utilizing any State program.
10 Section 5102. Repeals.
11 (a) Specific.--Chapters 5 and 7 of the act of August 26,
12 1971 (P.L.351, No.91), known as the State Lottery Law, are
13 repealed.
14 (b) General.--All other acts and parts of acts are repealed
15 insofar as they are inconsistent with this act.
16 Section 5103. Effective date.
17 This act shall take effect immediately.
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