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Ch. 282 2005 LAWS OF MARYLAND
(1) submit a detailed financial accounting of the Program to the Board as
often as the Board requires;
(2) collect and submit to the Board data regarding the utilization
patterns and costs for Program enrollees; and
(3) develop and implement a marketing plan targeted at eligible
individuals throughout the State.
14-512.
(a) The Program shall:
(1) subject to the moneys available in the segregated account under §
14-504 of this subtitle, provide benefits to the maximum number of individuals
eligible for enrollment in the Program; AND
(2) require a monthly premium charge of $10 per enrollee;
(3) not require a deductible; [and]
(4) limit the copay charged an enrollee to:
(i) $10 for a prescription for a generic drug;
(ii) $20 for a prescription for a preferred brand name drug; and
(iii) $35 for a prescription for a nonpreferred brand name drug; AND
(5) (2) PROVIDE A STATE SUBSIDY FOR A PORTION OF THE COST OF
MEDICARE PART D AND MEDICARE ADVANTAGE PLAN DRUG-RELATED PREMIUMS,
DEDUCTIBLES, AND COINSURANCE PREMIUMS AND DEDUCTIBLES.
(b) The Board may:
(1) limit the total annual benefit to $1,000 per individual; AND
(2) FOR ENROLLEES WITH ANNUAL HOUSEHOLD INCOME AT OR BELOW
150% OF THE FEDERAL POVERTY GUIDELINES, REDUCE PROGRAM COPAYMENTS OR
LIMIT COPAYMENTS TO THE AMOUNTS ESTABLISHED IN FEDERAL LAW FOR THE
MEDICARE PART D BENEFIT.
(e) [Subject to approval by the Board, the carrier that administers the
Program shall develop a prescription drug formulary to be used in the Program] IF
MONEYS AVAILABLE IN THE SEGREGATED ACCOUNT ESTABLISHED UNDER § 14-504
OF THIS SUBTITLE ARE INSUFFICIENT TO COVER THE FULL COST OF MEDICARE PART
D PREMIUMS, DEDUCTIBLES, AND COINSURANCE FOR ENROLLEES, THE PRIORITY
FOR FUNDING SHALL BE:
(1) PREMIUMS;
(2) DEDUCTIBLES; AND
(3) COINSURANCE.
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