53-6-1004. State pharmacy access program. (1) The department shall administer a pharmacy access prescription drug benefit program that contributes to the cost of the premium and, optionally, to the cost of the deductible for the Part D medicare prescription drug benefit as established in Title I of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Terms Used In Montana Code 53-6-1004

  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Department: means the department of public health and human services provided for in Title 2, chapter 15, part 22. See Montana Code 53-6-1001
  • Program: means the prescription drug plus discount program provided for in 53-6-1002. See Montana Code 53-6-1001

(2)An individual is eligible for the pharmacy access program if the individual:

(a)has a family income, as adopted by rule, of up to 200% of the federal poverty guidelines set annually by the U.S. department of health and human services and is not eligible for federal low-income assistance under Part D;

(b)submits proof of enrollment in a prescription drug plan for the Part D medicare benefit.

(3)The department shall establish by rule eligibility based upon the applicant’s family income within the range provided in subsection (2). The department may adopt rules defining income. In establishing eligibility based upon income, the department shall take into account the amount of funding available for the program.

(4)The department shall set an amount of benefit for the premium and may optionally set a portion of the deductible by rule based on the numbers enrolled and the appropriation.

(5)The department shall open the enrollment of the pharmacy access program at the same time as enrollment commences for the medicare Part D program.

(6)If the department determines that there are excess funds for the pharmacy access program, it may use the funds for the program provided for in 53-6-1002.