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ROBERT L. EHRLICH, JR., Governor Ch. 281
15-124.3.
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(2) "ENROLLEE" MEANS AN INDIVIDUAL WHO IS ENROLLED IN THE
PROGRAM.
(3) "MEDICARE MODERNIZATION ACT" MEANS THE FEDERAL MEDICARE
PRESCRIPTION DRUG, IMPROVEMENT. AND MODERNIZATION ACT OF 2003.
(4) "MEDICARE PART D PRESCRIPTION DRUG BENEFIT" MEANS THE
PRESCRIPTION DRUG BENEFIT ESTABLISHED BY THE MEDICARE MODERNIZATION
ACT UNDER PART D OF THE FEDERAL MEDICARE PROGRAM.
(5) "PRESCRIPTION DRUG PLAN" MEANS A PRIVATE HEALTH PLAN THAT
PROVIDES A MEDICARE PART D PRESCRIPTION DRUG BENEFIT IN ACCORDANCE
WITH THE REQUIREMENTS OF THE MEDICARE MODERNIZATION ACT.
(6) "PROGRAM" MEANS THE MEDICARE OPTION PRESCRIPTION DRUG
PROGRAM ESTABLISHED UNDER THIS SECTION.
(B) THERE IS A MEDICARE OPTION PRESCRIPTION DRUG PROGRAM WITHIN
THE MARYLAND MEDICAL ASSISTANCE PROGRAM.
(C) THE PURPOSE OF THE PROGRAM IS TO:
(1) ASSIST LOW-INCOME MEDICARE ELIGIBLE INDIVIDUALS TO MAKE A
SEAMLESS TRANSITION TO, AND COORDINATE PRESCRIPTION DRUG COVERAGE
WITH, THE MEDICARE PART D PRESCRIPTION DRUG BENEFIT; AND
(2) MINIMIZE THE COST-SHARING BURDEN ON THE INDIVIDUALS.
(D) THE PROGRAM SHALL BE ADMINISTERED AND OPERATED BY THE
DEPARTMENT AS PERMITTED BY FEDERAL LAW OR WAIVER.
(E) (1) THE PROGRAM SHALL BE OPEN TO ANY INDIVIDUAL WHO:
(I) IS A RESIDENT OF THE STATE;
(II) IS A MEDICARE BENEFICIARY;
(III) IS NOT ENROLLED IN A MEDICARE ADVANTAGE PLAN OR
OTHER PUBLIC OR PRIVATE INSURANCE PROGRAM, EXCEPT FOR MEDICAID AND THE
MARYLAND PHARMACY ASSISTANCE PROGRAM, THAT PROVIDES PRESCRIPTION
DRUG BENEFITS AT THE TIME THAT THE INDIVIDUAL APPLIES FOR ENROLLMENT IN
THE PROGRAM;
(IV) HAS AN ANNUAL HOUSEHOLD INCOME BELOW 150 PERCENT OF
THE FEDERAL POVERTY LEVEL; AND
(V) MEETS THE ASSET TEST ESTABLISHED BY THE MEDICARE
MODERNIZATION ACT UNDER MEDICARE PART D.
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- 1461 -
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