1976 South Carolina Code of Laws
Updated through the end of the 2001 Session
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Title 44 - Health
THE SOUTH CAROLINA SENIORS' PRESCRIPTION DRUG PROGRAM ACT
SECTION 44-130-10. Short title.
This chapter may be cited as the "South Carolina Seniors' Prescription Drug Program Act".
SECTION 44-130-20. Definitions.
For purposes of this chapter:
(1) "Prescription drugs" means outpatient prescription drugs, that have been approved as safe and effective by the United States Food and Drug Administration including insulin syringes, insulin needles, and insulin. "Prescription drugs" do not include experimental drugs and over the counter pharmaceutical products.
(2) "Program" means the South Carolina Seniors Prescription Drug Program created pursuant to Section 44-130-30.
SECTION 44-130-30. Prescription drug program created.
There is created within the Office of Insurance Services of the State Budget and Control Board the South Carolina Seniors' Prescription Drug Program. Beginning January 1, 2001, this program must provide financial assistance for purchasing prescription drugs to senior citizens who are ineligible for or do not have insurance coverage or other assistance through federal, state, or private programs for these purchases.
SECTION 44-130-40. Administration of program; what program may include; information from other agencies.
This program must be administered by the State Budget and Control Board through its Office of Insurance Services. The office may designate or enter into contracts with other entities to assist in this administration. The program may include:
(1) co-payments and deductibles based on income;
(2) incentives for the use of generic drugs; and
(3) prospective and retrospective utilization review, clinical management, and other administrative techniques used in the management of the State Health Insurance Plan in order to reduce drug interactions, overutilizations, therapeutic duplications, or early refills.
When requested by the office, other state agencies shall provide assistance or information necessary in the administration of this program.
SECTION 44-130-50. Eligibility requirements.
A person eligible to participate for this program must:
(1) be a South Carolina resident who has attained the age of sixty-five years;
(2) have resided in South Carolina at least six consecutive months before participation in the program;
(3) be ineligible for Medicaid prescription benefits;
(4) not have any pharmacy benefits or coverage from any governmental or private insurance program providing such benefits;
(5) have an annual income that does not exceed one hundred fifty percent of the federal poverty level.
Priority must be given to applicants without Medicare supplements or other third party benefits or coverage during the six months before application.
SECTION 44-130-60. Maintenance of data to evaluate cost effectiveness; semiannual reports.
The Office of Insurance Services shall maintain data to allow evaluation of the cost effectiveness of the program and submit semiannual reports to the Governor and General Assembly summarizing beneficiary demographics, utilization, provider dispensing experience, and any other information needed to evaluate the costs and benefits of the prescription drug program.
SECTION 44-130-70. Expansion of program.
(A) Notwithstanding the provisions of Section 44-130-50(5), upon analysis of eligibility and enrollment information compiled as of January 1, 2001, the Office of Insurance Services may expand coverage under this program to seniors whose incomes do not exceed one hundred seventy five percent of poverty.
(B) If seniors served by this program become eligible for substantially the same benefits under a federal program, the Office of Insurance Services may reevaluate the program benefits and funding and may increase the program up to two hundred percent of poverty for senior citizens who otherwise are eligible for the program if program funding will support the expansion.
(C) This program may only be expanded if funds are available through appropriations, interest earned, and other revenue that may have been received including, but not limited to, federal funding.
SECTION 44-130-80. Program funding.
The program must be funded from proceeds received by the State in the settlement agreement and related documents, between the State and leading United States tobacco manufacturers dated November 23, 1998.