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Ch. 153
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2002 LAWS OF MARYLAND
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(3) IS NOT ENROLLED IN A MEDICARE PLUS CHOICE MANAGED CARE
PROGRAM OR OTHER INSURANCE PROGRAM THAT PROVIDES PRESCRIPTION DRUG
BENEFITS AT THE TIME THAT THE INDIVIDUAL APPLIES FOR ENROLLMENT IN THE
PLAN;
(4) HAS AN ANNUAL HOUSEHOLD INCOME AT OR BELOW 300% OF THE
FEDERAL POVERTY GUIDELINES; AND
(5) PAYS THE PREMIUM AND COPAYMENTS FOR THE PLAN.
(C) "ENROLLEE" MEANS AN INDIVIDUAL ENROLLED IN THE PLAN.
(D) "PROGRAM" MEANS THE SENIOR PRESCRIPTION DRUG PROGRAM
ESTABLISHED UNDER PART II OF THIS SUBTITLE.
14-511.
(A) THERE IS A SENIOR PRESCRIPTION DRUG PROGRAM.
(B) THE PURPOSE OF THE PROGRAM IS TO PROVIDE MEDICARE
BENEFICIARIES, WHO LACK PRESCRIPTION DRUG COVERAGE, WITH ACCESS TO
AFFORDABLE, MEDICALLY NECESSARY PRESCRIPTION DRUGS UNTIL SUCH TIME AS
AN OUTPATIENT PRESCRIPTION DRUG BENEFIT IS PROVIDED THROUGH THE
FEDERAL MEDICARE PROGRAM.
(C) THE PROGRAM SHALL BE ADMINISTERED BY A CARRIER AS PROVIDED
UNDER § 14-106(E) OF THIS TITLE.
(D) THE CARRIER THAT ADMINISTERS THE PROGRAM SHALL:
(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 NOT MORE
THAN 30,000 ENROLLEES AT ANY ONE TIME THE MAXIMUM NUMBER OF INDIVIDUALS
ELIGIBLE FOR ENROLLMENT IN THE PROGRAM;
(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;
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- 1550 -
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