HBA-MSH H.B. 2241 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2241 By: Menendez Public Health 3/20/2001 Introduced BACKGROUND AND PURPOSE While prescription drug prices are rising, Medicare does not cover outpatient prescriptions. This forces some seniors to neglect or share prescriptions or skip doses which endangers their health. Those over 65 years of age are significantly more likely to be regular users of prescription drugs and to have numerous prescriptions in their medicine cabinets. At the same time, they are less likely to have prescription drug coverage and more likely to have a problem paying for prescription drugs. The Medicaid Vendor Drug Program provides prescription drugs to Medicaid recipients statewide through contracts with about 3,800 pharmacies which are mostly retail stores. Medicaid allows some seniors to receive three prescriptions through a Medicare cost-sharing program. In many cases, this is not sufficient for proper treatment of a serious illness. Several states have recognized this problem and implemented prescription drug programs to assist the elderly and the seriously ill. House Bill 2241 creates a prescription drug program for certain Medicare recipients. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Health and Human Services Commission in SECTION 1 (Sections 531.302, 531.304 and 531.305, Government Code) of this bill. ANALYSIS House Bill 2241 amends the Government Code to require the Health and Human Services Commission (HHSC) to develop and implement a state prescription drug program (program) that operates in the same manner as the vendor drug program in providing prescription drug benefits to recipients of medical assistance. The bill provides that a person is eligible to receive prescription drug benefits (benefits) if the person is a qualified Medicare beneficiary or a specified low-income Medicare beneficiary who is eligible for Medicare cost-sharing payments through Medicaid. The bill provides that prescription drugs under the state program may be funded only with state money unless block grant funds are available under federal law to fund all or part of the program. The bill requires HHSC to adopt rules necessary for the implementation of the program. The bill prohibits HHSC from requiring a person who is eligible for benefits to pay a premium, a deductible, or another cost-sharing payment. The bill authorizes the commission to provide in it rules for the program for the prescription of generic equivalents of a prescribed drug. The bill requires HHSC to modify by rule the program to comply with federal law for receiving federal block grant funds. The bill requires HHSC to develop and implement the program by January 1, 2002. EFFECTIVE DATE September 1, 2001.