PRINTER'S NO. 30
No. 47 Session of 2003
INTRODUCED BY GREENLEAF, ERICKSON, PUNT, WAGNER, KITCHEN,
RHOADES, LOGAN, KASUNIC, D. WHITE, LEMMOND AND WAUGH,
JANUARY 22, 2003
REFERRED TO AGING AND YOUTH, JANUARY 22, 2003
AN ACT
1 Amending the act of August 26, 1971 (P.L.351, No.91), entitled
2 "An act providing for a State Lottery and administration
3 thereof; authorizing the creation of a State Lottery
4 Commission; prescribing its powers and duties; disposition of
5 funds; violations and penalties therefor; exemption of prizes
6 from State and local taxation and making an appropriation,"
7 further providing for pharmaceutical assistance eligibility.
8 The General Assembly of the Commonwealth of Pennsylvania
9 hereby enacts as follows:
10 Section 1. Section 519 of the act of August 26, 1971
11 (P.L.351, No.91), known as the State Lottery Law, added November
12 21, 1996 (P.L.741, No.134), is amended to read:
13 Section 519. The Pharmaceutical Assistance Contract for the
14 Elderly Needs Enhancement Tier.
15 (a) Establishment.--There is hereby established within the
16 department a program to be known as the Pharmaceutical
17 Assistance Contract for the Elderly Needs Enhancement Tier
18 (PACENET).
19 (b) PACENET eligibility.--
20 (1) A claimant with an annual income [of not less than
1 $14,000 and not more than $16,000 in the case of a single
2 person and of not less than $17,200 and not more than $19,200
3 in the case of the combined income of persons married to each
4 other] which is within the limits of the following levels
5 shall be eligible for enhanced pharmaceutical assistance
6 under this section[.]:
7 (i) Level 1 - Annual income shall not be less than
8 $14,000 nor more than $16,000 in the case of a single
9 person, nor less than $17,200 nor more than $19,200 in
10 the case of the combined annual income of married
11 persons.
12 (ii) Level 2 - Annual income shall not be less than
13 $16,001 nor more than $19,000 in the case of a single
14 person, nor less than $19,201 nor more than $22,200 in
15 the case of the combined annual income of married
16 persons.
17 (iii) Level 3 - Annual income shall not be less than
18 $19,001 nor more than $22,000 in the case of a single
19 person, nor less than $22,201 nor more than $25,200 in
20 the case of the combined annual income of married
21 persons.
22 (iv) Level 4 - Annual income shall not be less than
23 $22,001 nor more than $25,000 in the case of a single
24 person, nor less than $25,201 nor more than $28,200 in
25 the case of the combined annual income of married
26 persons.
27 (v) Level 5 - Annual income shall not be less than
28 $25,001 nor more than $28,000 in the case of a single
29 person, nor less than $28,201 nor more than $31,200 in
30 the case of the combined annual income of married
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1 persons.
2 (vi) Level 6 - Annual income shall not be less than
3 $28,001 nor more than $32,000 in the case of a single
4 person, nor less than $31,201 nor more than $35,200 in
5 the case of the combined annual income of married
6 persons.
7 (vii) Level 7 - Annual income shall not be less than
8 $32,001 nor more than $36,000 in the case of a single
9 person, nor less than $35,201 nor more than $39,200 in
10 the case of the combined annual income of married
11 persons.
12 (2) The deductible required under subsection (c) and the
13 copayment required under subsection (d) shall correspond to
14 these maximum annual income limits.
15 (3) A person may, in reporting income to the department,
16 round the amount of each source of income and the income
17 total to the nearest whole dollar, whereby any amount which
18 is less than 50¢ is eliminated.
19 (c) Deductible.--
20 (1) Upon enrollment in PACENET, eligible claimants in
21 the income ranges set forth in subsection (b) shall be
22 required to meet an annual deductible [in unreimbursed
23 prescription drug expenses of $500 per person.] as follows:
24 (i) Level 1 - $0.
25 (ii) Level 2 - $100.
26 (iii) Level 3 - $200.
27 (iv) Level 4 - $300.
28 (v) Level 5 - $400.
29 (vi) Level 6 - $500.
30 (vii) Level 7 - $600.
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1 (2) To qualify for the deductible set forth in this
2 subsection the prescription drug must be purchased for the
3 use of the eligible claimant from a provider as defined in
4 this chapter.
5 (3) The department, after consultation with the board,
6 may approve an adjustment in the deductible on an annual
7 basis.
8 (d) Copayment.--
9 (1) For eligible claimants under this section, the
10 copayment schedule, which may be adjusted by the department
11 on an annual basis after consultation with the board, shall
12 be:
13 [(i) eight dollars for noninnovator multiple source
14 drugs as defined in section 702; or
15 (ii) fifteen dollars for single-source drugs and
16 innovator multiple-source drugs as defined in section
17 702.]
18 (i) Level 1 and level 2 participants shall make a
19 copayment for each prescription at the rate of $8 for a
20 generic drug and $15 for a brand name drug.
21 (ii) Level 3 and level 4 participants shall make a
22 copayment for each prescription at the rate of $10 for a
23 generic drug and $17 for a brand name drug.
24 (iii) Level 5 participants shall make a copayment
25 for each prescription at the rate of $12 for a generic
26 drug and $19 for a brand name drug.
27 (iv) Level 6 participants shall make a copayment for
28 each prescription at the rate of $14 for a generic drug
29 and $21 for a brand name drug.
30 (v) Level 7 participants shall make a copayment for
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1 each prescription at the rate of $16 for a generic drug
2 and $23 for a brand name drug.
3 (2) In no case shall a pharmacy collect a copayment in
4 an amount greater than the price of the drug at the
5 particular pharmacy on the date of the sale.
6 Section 3. This act shall take effect immediately.
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