January 2011 Special Session
2011 - 2012 LEGISLATURE
ASSEMBLY AMENDMENT 14,
TO ASSEMBLY BILL 11
February 22, 2011 - Offered by Representatives Staskunas, Sinicki, Toles, Zepnick,
Turner, Steinbrink, Bernard Schaber, Seidel, Vruwink, Roys, Hebl, Barca,
Pasch, D. Cullen, Ringhand, Krusick, Mason, Young, Pope-Roberts,
Zamarripa, Hulsey and
20.435 (4) (j) of the statutes is repealed.
(y) Prescription drug assistance for elderly trust fund.
From the 7
prescription drug assistance for elderly trust fund, a sum sufficient for the 8
prescription drug assistance program under s. 49.688.".
25.776 of the statutes is created to read:
1125.776 Prescription drug assistance for elderly trust fund.
There is 12
created a separate nonlapsible trust fund designated as the prescription drug 13
assistance for elderly trust fund, consisting of all of the following:
All moneys collected as fees under s. 49.688 (3).
All moneys collected as rebates under s. 49.688 (6).
All federal moneys received that are related to the program under s. 49.688.
All gifts, grants, bequests, or other contributions made to the fund.".
49.688 (6) (a) of the statutes is amended to read:
(a) That, except as provided in sub. (7) (b), the manufacturer shall 8
make rebate payments for each prescription drug of the manufacturer that is 9
prescribed for and purchased by persons who meet criteria under sub. (2) (a) and 10
persons who meet criteria under sub. (2) (b) and have paid the deductible under sub. 11
(3) (b) 2. a., to the secretary of administration to be credited to the appropriation 12
account under s. 20.435 (4) (j) (y)
, each calendar quarter or according to a schedule 13
established by the department.
(a) Except as provided in par. (b), from the appropriation accounts 16
under s. 20.435 (4) (bv), (j),
and (pg) (y)
, beginning on September 1, 2002, the 17
department shall, under a schedule that is identical to that used by the department 18
for payment of pharmacy provider claims under medical assistance, provide to 19
pharmacies and pharmacists payments for prescription drugs sold by the 20
pharmacies or pharmacists to persons eligible under sub. (2) who have paid the 21
deductible specified under sub. (3) (b) 1. or 2. or who, under sub. (3) (b) 1., are not 22
required to pay a deductible. The payment for each prescription drug under this 23
paragraph shall be at the program payment rate, minus any copayment paid by the 24
person under sub. (5) (a) 2. or 4., and plus, if applicable, incentive payments that are
similar to those provided under s. 49.45 (8v). The department shall devise and 2
distribute a claim form for use by pharmacies and pharmacists under this paragraph 3
and may limit payment under this paragraph to those prescription drugs for which 4
payment claims are submitted by pharmacists or pharmacies directly to the 5
department. The department may apply to the program under this section the same 6
utilization and cost control procedures that apply under rules promulgated by the 7
department to medical assistance under subch. IV of ch. 49.
(b) During any period in which funding under s. 20.435 (4) (bv) and
is completely expended for the payments specified in par. (a), the requirements 11
of par. (a) and subs. (3) (c), (5), and (6) (a) and (b) do not apply to drugs purchased 12
during that period, but the department shall continue to accept applications and 13
determine eligibility under sub. (4) and shall indicate to applicants that the 14
eligibility of program participants to purchase prescription drugs as specified in sub. 15
(3), under the requirements of sub. (5), is conditioned on the availability of funding 16
under s. 20.435 (4) (bv) and (pg)