HAR §17-1722-116. General provisions

(a) This subchapter describes the eligibility requirements for participation in the state pharmacy assistance program. This program may pay all, or some of, the required co-payments or co-insurance for prescriptions under Medicare Part D to certain elderly and disabled individuals and facilitate the enrollment and coordination of benefits between the state pharmacy assistance program and the Medicare Part D Prescription Drug Benefit Program provided by the Federal MMA. (b) The department shall work with any CMS approved benchmark prescription drug plan to provide UNOFFICIAL 1722-29 the coordination of benefits between the state pharmacy assistance program and the Medicare Part D Prescription Drug Benefit Program. (c) The program shall conduct ongoing quality assurance activities determined by the department (d) The provisions of chapter 1702 addressing confidentiality shall apply to this program. (e) The provisions of chapter 1703 addressing administrative appeals shall apply to this program. However, in applying chapter 1703 to this program, the terms “eligibility branch,” “eligibility branch administrator,” “med-QUEST eligibility office,” and “eligibility worker” in chapter 1703 shall be replaced by the term “med-QUEST division staff or their designee.” (f) The provisions of chapter 1704 addressing fraud shall apply to this program. However, in applying chapter 1704 to this program, the terms “medical assistance” and “Medicaid” in chapter 1704 shall be replaced by the term “state pharmacy assistance program.” (g) The provisions of subchapter 7 of chapter 1705 addressing recipient recovery shall apply to this program. However, in applying subchapter 7 to this program, the term “medical assistance” in subchapter 7 of chapter 1705 shall be replaced by the term “state pharmacy assistance program.” (h) This program shall be administered by the med-QUEST division and contractors identified by the department of human services for the purposes of this program. [Eff 12/29/05; am 02/18/08 ] (Auth: SLH 2005, Act 209; SLH 2006, Act 264) (Imp: SLH 2005, Act 209; SLH 2006, Act 264)