PRINTER'S NO. 3352
No. 2346 Session of 2006
INTRODUCED BY GILLESPIE, ALLEN, ARGALL, BALDWIN, BARRAR,
BELARDI, BELFANTI, BENNINGHOFF, BEYER, BOYD, BUNT,
CALTAGIRONE, CAPPELLI, CAUSER, CAWLEY, COHEN, CORNELL, COSTA,
CREIGHTON, DeLUCA, DeWEESE, DIVEN, FABRIZIO, FAIRCHILD,
FLEAGLE, FRANKEL, FREEMAN, GEIST, GINGRICH, GOOD, GOODMAN,
GRUCELA, HALUSKA, HARHAI, HARHART, HARPER, HARRIS, HASAY,
HERMAN, HESS, JAMES, KAUFFMAN, KENNEY, LaGROTTA, LEDERER,
LEH, MAITLAND, MANDERINO, MANN, MARKOSEK, MARSICO, McGEEHAN,
McILHATTAN, McILHINNEY, McNAUGHTON, MICOZZIE, MILLARD,
R. MILLER, MUNDY, MUSTIO, NAILOR, NICKOL, PAYNE, PETRARCA,
PHILLIPS, PICKETT, PYLE, RAPP, RAYMOND, READSHAW, REICHLEY,
RUBLEY, SAMUELSON, SATHER, SAYLOR, SCAVELLO, SCHRODER,
SEMMEL, SHANER, SIPTROTH, B. SMITH, SONNEY, STABACK,
R. STEVENSON, SURRA, E. Z. TAYLOR, THOMAS, TIGUE, WALKO,
WANSACZ, WOJNAROSKI AND YOUNGBLOOD, JANUARY 3, 2006
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES,
JANUARY 3, 2006
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 PACENET 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, amended
12 November 26, 2003 (P.L.212, No.37), is amended to read:
13 Section 519. The Pharmaceutical Assistance Contract for the
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) PACENET eligibility.--[A]
7 (1) Subject to the annual adjustments under paragraph
8 (2), a claimant with an annual income of not less than
9 $14,500 and not more than $23,500 in the case of a single
10 person and of not less than $17,700 and not more than $31,500
11 in the case of the combined income of persons married to each
12 other shall be eligible for enhanced pharmaceutical
13 assistance under this section. A person may, in reporting
14 income to the department, round the amount of each source of
15 income and the income total to the nearest whole dollar,
16 whereby any amount which is less than 50¢ is eliminated.
17 (2) Notwithstanding any other law, the minimum and
18 maximum income levels under paragraph (1) shall be adjusted
19 annually to reflect the maximum annual Social Security cost-
20 of-living adjustment. Each year's adjustment shall be based
21 on the prior year's adjusted minimum and maximum income
22 levels. The adjustment required under this paragraph shall
23 reflect calendar years 2003, 2004, 2005 and each calendar
24 year thereafter.
25 (c) Deductible.--Upon enrollment in PACENET, eligible
26 claimants in the income ranges set forth in subsection (b) shall
27 be required to meet a deductible in unreimbursed prescription
28 drug expenses of $40 per person per month. The $40 monthly
29 deductible shall be cumulative and shall be applied to
30 subsequent months to determine eligibility. The cumulative
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1 deductible shall be determined on an enrollment year basis for
2 an annual total deductible not to exceed $480 in a year. To
3 qualify for the deductible set forth in this subsection the
4 prescription drug must be purchased for the use of the eligible
5 claimant from a provider as defined in this chapter. The
6 department, after consultation with the board, may approve an
7 adjustment in the deductible on an annual basis.
8 (d) Copayment.--
9 (1) For eligible claimants under this section, the
10 copayment schedule shall be:
11 (i) eight dollars for noninnovator multiple source
12 drugs as defined in section 702; or
13 (ii) fifteen dollars for single-source drugs and
14 innovator multiple-source drugs as defined in section
15 702.
16 (2) The department shall annually calculate the
17 copayment schedules based on the Prescription Drugs and
18 Medical Supplies Consumer Price Index. When the aggregate
19 impact of the Prescription Drugs and Medical Supplies
20 Consumer Price Index equals or exceeds $1, the department
21 shall adjust the copayment schedules. Each copayment schedule
22 shall not be increased by more than $1 in a calendar year.
23 Section 2. This act shall be retroactive to December 1,
24 2005.
25 Section 3. This act shall take effect immediately.
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