H*3221(Rat #0231, Act #0233 of 2006)  General Bill, By Clemmons, Rice, Simrill, 
Mahaffey, Wilkins, Harrell, Harrison, Cato, J. Brown, Townsend, Edge, Merrill, 
Chellis, Ott, R. Brown, Mack, Barfield, Witherspoon, Duncan, M.A. Pitts, Owens, 
Chalk, Bailey, Ceips, Haley, Viers, Hardwick and Toole
 AN ACT TO AMEND ARTICLE 5, CHAPTER 6, TITLE 44, CODE OF LAWS OF SOUTH
 CAROLINA, 1976, RELATING TO THE SOUTH CAROLINA RETIREES AND INDIVIDUALS
 POOLING TOGETHER FOR SAVINGS ACT (SCRIPTS), SO AS TO CHANGE THE NAME OF THIS
 ACT TO THE GAP ASSISTANCE PHARMACY PROGRAM FOR SENIORS ACT AND TO PROVIDE THAT
 THIS PROGRAM CREATED WITHIN THE SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN
 SERVICES MUST COORDINATE WITH MEDICARE PART D TO PROVIDE TO LOW INCOME SENIOR
 RESIDENTS ASSISTANCE WITH THE COST OF PRESCRIPTION DRUGS DURING THE ANNUAL
 MEDICARE PART D COVERAGE GAP, TO REQUIRE THAT A PARTICIPANT BE ENROLLED IN A
 GAPS PARTICIPATING MEDICARE PART D DRUG PLAN, TO CLARIFY OTHER ELIGIBILITY
 CRITERIA, AND TO SPECIFY THAT AN ENROLLEE IS ENTITLED TO BENEFITS WHEN THE
 ENROLLEE'S ANNUAL OUT-OF-POCKET DRUG EXPENSES REACH THE POINT THAT STANDARD
 MEDICARE PART D BENEFITS ARE NO LONGER AVAILABLE AND THAT BENEFITS TERMINATE
 WHEN THE PARTICIPANT'S ANNUAL OUT-OF-POCKET EXPENSES REACH THE POINT THAT
 CATASTROPHIC MEDICARE PART D BENEFITS BECOME AVAILABLE; AND TO REPEAL CHAPTER
 130, TITLE 44, RELATING TO THE SOUTH CAROLINA SENIORS' PRESCRIPTION DRUG
 PROGRAM ACT. - ratified title

   12/22/04  House  Prefiled
   12/22/04  House  Referred to Committee on Ways and Means
   01/11/05  House  Introduced and read first time HJ-135
   01/11/05  House  Referred to Committee on Ways and Means HJ-135
   01/12/05  House  Member(s) request name added as sponsor: Wilkins,
                     Harrell, Harrison, Cato, J.Brown, Townsend,
                     Edge, Merrill, Chellis, Ott, R.Brown, Mack,
                     Barfield, Witherspoon
   02/01/05  House  Member(s) request name added as sponsor: Duncan,
                     M.A.Pitts, Owens, Chalk, Bailey, Ceips, Haley,
                     Toole, Viers, Hardwick
   05/11/05  House  Committee report: Favorable with amendment Ways
                     and Means HJ-14
   05/12/05         Scrivener's error corrected
   05/17/05  House  Amended HJ-41
   05/17/05  House  Read second time HJ-43
   05/18/05  House  Read third time and sent to Senate HJ-62
   05/18/05  Senate Introduced and read first time SJ-5
   05/18/05  Senate Referred to Committee on Finance SJ-5
   02/01/06  Senate Committee report: Favorable with amendment
                     Finance SJ-44
   02/02/06  Senate Amended SJ-15
   02/02/06  Senate Read second time SJ-15
   02/02/06  Senate Unanimous consent for third reading on next
                     legislative day SJ-15
   02/03/06  Senate Read third time and returned to House with
                     amendments SJ-3
   02/09/06  House  Concurred in Senate amendment and enrolled HJ-27
   02/15/06         Ratified R 231
   02/21/06         Signed By Governor
   02/23/06         Copies available
   02/23/06         Effective date 02/21/06
   02/27/06         Act No. 233

(A233, R231, H3221)

AN ACT TO AMEND ARTICLE 5, CHAPTER 6, TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE SOUTH CAROLINA RETIREES AND INDIVIDUALS POOLING TOGETHER FOR SAVINGS ACT (SCRIPTS), SO AS TO CHANGE THE NAME OF THIS ACT TO THE GAP ASSISTANCE PHARMACY PROGRAM FOR SENIORS ACT AND TO PROVIDE THAT THIS PROGRAM CREATED WITHIN THE SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES MUST COORDINATE WITH MEDICARE PART D TO PROVIDE TO LOW INCOME SENIOR RESIDENTS ASSISTANCE WITH THE COST OF PRESCRIPTION DRUGS DURING THE ANNUAL MEDICARE PART D COVERAGE GAP, TO REQUIRE THAT A PARTICIPANT BE ENROLLED IN A GAPS PARTICIPATING MEDICARE PART D DRUG PLAN, TO CLARIFY OTHER ELIGIBILITY CRITERIA, AND TO SPECIFY THAT AN ENROLLEE IS ENTITLED TO BENEFITS WHEN THE ENROLLEE'S ANNUAL OUT-OF-POCKET DRUG EXPENSES REACH THE POINT THAT STANDARD MEDICARE PART D BENEFITS ARE NO LONGER AVAILABLE AND THAT BENEFITS TERMINATE WHEN THE PARTICIPANT'S ANNUAL OUT-OF-POCKET EXPENSES REACH THE POINT THAT CATASTROPHIC MEDICARE PART D BENEFITS BECOME AVAILABLE; AND TO REPEAL CHAPTER 130, TITLE 44, RELATING TO THE SOUTH CAROLINA SENIORS' PRESCRIPTION DRUG PROGRAM ACT.

Be it enacted by the General Assembly of the State of South Carolina:

GAP Assistance Pharmacy Program for Seniors Act

SECTION    1.    Article 5, Chapter 6, Title 44 of the 1976 Code is amended to read:

"Article 5

Section 44-6-610.    This article may be cited as the 'Gap Assistance Pharmacy Program for Seniors (GAPS) Act'.

Section 44-6-620.    For purposes of this article:

(1)    'Department' means the South Carolina Department of Health and Human Services.

(2)    'Prescription drugs' means outpatient prescription drugs that have been approved by the United States Food and Drug Administration. 'Prescription drugs' do not include experimental drugs and over-the-counter pharmaceutical products.

(3)    'Program' means the Gap Assistance Pharmacy Program for Seniors (GAPS) created pursuant to this article.

(4)    'Medicare Part D Prescription Drug Plan' means a Prescription Drug Plan that has been approved by the Centers for Medicare and Medicaid Services (CMS) to provide Medicare Part D prescription drugs to Medicare beneficiaries in South Carolina.

(5)    'GAPS Participating Medicare Part D Prescription Drug Plan' means Prescription Drug Plans that have executed a contract with the department to provide prescription drug coverage to eligible individuals during the annual Medicare Part D coverage gap.

Section 44-6-630.    (A)    There is created within the Department of Health and Human Services the Gap Assistance Pharmacy Program for Seniors (GAPS) program. The purpose of this program is to coordinate, beginning January 1, 2006, with Medicare Part D Prescription Drug Plans to provide to low-income seniors in this State assistance with costs for prescription drugs during the annual Medicare Part D coverage gap.

(B)    The program must provide assistance with prescription drugs that:

(1)    have been approved by the United States Food and Drug Administration; and

(2)    are included in the enrollee's selected GAPS participating Medicare Part D Plan formulary.

Section 44-6-640.    (A)    This program must be administered by the Department of Health and Human Services. The department may designate, or enter into contracts with, other entities including, but not limited to, other states, other governmental purchasing pools, and nonprofit organizations to assist in the administration of this program.

(B)    The department may establish an enrollment fee that must be used to fund the administration of this program.

(C)    When requested by the department, other state agencies shall provide assistance or information necessary for the administration of this program.

Section 44-6-650.    (A)    To be eligible to enroll in this program a person must:

(1)    have attained the age of sixty-five years;

(2)    be a resident of this State;

(3)    be enrolled in a GAPS participating Medicare Part D Drug Plan;

(4)    satisfy annual income, resources, and other criteria established by the department;

(5)    pay the enrollment fee, if any, as established by the department.

(B)    An enrollee is entitled to benefits under this program during the coverage gap when the enrollee's annual prescription drug costs have reached the point that standard Medicare Part D benefits are no longer available. The GAPS benefits terminate when the enrollee's annual out-of-pocket prescription drug expenses have reached the point that catastrophic Medicare Part D benefits become available.

Section 44-6-660.    (A)    The department shall maintain data to allow evaluation of the cost effectiveness of the program.

(B)    Beginning with fiscal year 2006-2007, the department shall include in its annual report, a report on the GAPS program."

Repeal

SECTION    2.    Chapter 130, Title 44 of the 1976 Code is repealed.

Time effective

SECTION    3.    This act takes effect upon approval by the Governor.

Ratified the 15th day of February, 2006.

Approved the 21st day of February, 2006.