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10.09.60.00.htm 10.09.60.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 60 Senior Prescription Drug Assistance Program Authority: Health-General Article, §15-1005(b)1) Annotated Code of Maryland
10.09.60.01.htm 10.09.60.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Administrator" means the third party that contracts with the Department to administer the Program.2) "Annual household income" has the meaning stated in Regulation .02B of this chapter.. 3) “Department” means the Maryland Department of Health.. 4) "Eligible individual" means an individual who meets the criteria set forth in Regulation .02A of this chapter:
10.09.60.02.htm 10.09.60.02. 02 Eligibility, Enrollment, and Disenrollment.. A. To be eligible for enrollment in the Program, an individual shall:. 1) Be a resident of Maryland;. 2) Be a Medicare beneficiary enrolled in the Medicare Part D Voluntary Prescription Drug Benefit Program or a Medicare Advantage Plan that provides Part D coverage;3) Have an annual household income, as described in §B of this regulation, at or below 300 percent of the Federal Poverty Guidelines that apply to the
10.09.60.03.htm 10.09.60.03. 03 Outreach Program.. A. The Department shall develop and implement an outreach program targeted at eligible individuals.. B. The Department shall publicize the existence and eligibility requirements of the Program through the following entities:1) The Department of Aging;. 2) Local health departments;. 3) Continuing care retirement communities;. 4) Places of worship;. 5) Civic organizations;. 6) Community pharmacies; and.
10.09.60.04.htm 10.09.60.04. 04 Administrator.. A. Administrator Contract. The Administrator and the Department shall execute an Administrator contract specifying the terms under which the Administrator shall operate the Program, including but not limited to an agreement by the Administrator to:1) Provide the prescription drug benefit subsidies described in Regulation .06 of this chapter;. 2) Submit a detailed quarterly financial accounting of the Program, including the identification of
10.09.60.05.htm 10.09.60.05. 05 Program Description Booklet.. A. The Administrator shall develop a Program description booklet.. B. The Program description booklet is subject to approval by the Department.. C. The Program description booklet shall describe the essential features of the Program including:. 1) Eligibility requirements;. 2) A listing of available prescription drug plans and details of the prescription drug plans;. 3) Termination provisions;. 4) Appeal procedures;.
10.09.60.06.htm 10.09.60.06. 06 Prescription Drug Benefit Subsidy.. A. The Program shall:. 1) Provide a prescription drug benefit subsidy, as determined by the Department, that may pay all or some of the deductibles, coinsurance payments, premiums, and copayments under the federal Medicare Part D Pharmaceutical Assistance Program for enrollees of the Program; and2) Provide the subsidy to the maximum number of individuals eligible for enrollment in the Program, subject to the money available in the Program Fund.
10.09.60.07.htm 10.09.60.07. 07 Contracts with Prescription Drug Plan Sponsors.. A. The Department may enter into contracts with prescription drug plan sponsors who have been approved by the Centers for Medicare and Medicaid Services to offer Medicare Part D plans in the State.B. A prescription drug plan sponsor that enters into a contract with the Department shall agree to perform its obligations in a manner that complies w1) Medicare Part D and any federal regulations adopted to implement Medicare Part D;.
10.09.60.08.htm 10.09.60.08. 08 Program Fund.. A. The Program Fund shall include:. 1) Interest and investment income attributable to the Program Fund; and. 2) Money deposited to the account by a nonprofit health service plan in accordance with §C of this regulation.B. On or before April 1, 2003 and quarterly thereafter, the nonprofit health service plan required to subsidize the Program under Insurance Article, §14-106(d) Annotated Code of Maryland, shall deposit to the Program Fund the amount that is necessary
10.09.60.9999.htm 10.09.60.9999. Administrative History Effective date:. Chapter recodified from 31.17.04 Senior Prescription Drug Assistance Program, to 10.09.60 Senior Prescription Drug Program effective July 1, 2016Regulation .01B amended effective February 13, 2017 (44:3 Md. R. 188). Regulation .02D amended effective February 13, 2017 (44:3 Md. R. 188). Regulation .03 amended effective February 13, 2017 (44:3 Md. R. 188). Regulation .04A, B amended effective February 13, 2017 (44:3 Md. R. 188).
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