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Substitute House Bill No. 5008

Public Act No. 04-104

AN ACT CONCERNING REPLACEMENT OF LOST OR STOLEN PRESCRIPTION DRUGS UNDER THE CONNPACE PROGRAM.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (a) of section 17b-491 of the general statutes, as amended by section 14 of public act 03-2, is repealed and the following is substituted in lieu thereof (Effective July 1, 2004):

(a) There shall be a "Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled Program" which shall be within the Department of Social Services. The program shall consist of payments by the state to pharmacies for the reasonable cost of prescription drugs dispensed to eligible persons minus a copayment charge. The pharmacy shall collect the copayment charge from the eligible person at the time of each purchase of prescription drugs, and shall not waive, discount or rebate in whole or in part such amount. [The] Except for a replacement prescription dispensed pursuant to section 17b-492, as amended by this act, the copayment for each prescription shall be as follows:

(1) Sixteen dollars and twenty-five cents if the participant is (A) not married and has an annual income of less than twenty thousand three hundred dollars, or (B) is married and has an annual income that, when combined with the participant's spouse, is less than twenty-seven thousand five hundred dollars.

(2) Upon the granting of a federal waiver to expand the program in accordance with section 17b-492, as amended, the copayment shall be twenty dollars for a participant who is (A) not married and has an annual income that equals or exceeds twenty thousand three hundred dollars, or (B) married and has an annual income that, when combined with the participant's spouse, equals or exceeds twenty-seven thousand five hundred dollars.

Sec. 2. Subsection (b) of section 17b-492 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2004):

(b) (1) Payment for a prescription under the program shall be made only if no other plan of insurance or assistance is available to an eligible person for such prescription at the time of dispensing. The pharmacy shall make reasonable efforts to ascertain the existence of other insurance or assistance.

(2) Payment for a replacement prescription under the program shall be made only if the eligible person signs a statement, on such form as the commissioner prescribes and subject to penalty under section 17b-497, as amended by this act, that the prescription drug is lost or was stolen or destroyed and the person has made a good faith effort to recover the prescription drug, except that payment for a replacement prescription shall not be made on behalf of a person more than twice in a calendar year. No copayment shall be required for such replacement prescription.

Sec. 3. Section 17b-497 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2004):

(a) Any person acting for a pharmacy who submits a false or fraudulent claim under sections 17b-490 to 17b-498, inclusive, as amended, or the regulations adopted pursuant to section 17b-494, or who aids or abets another in the submission of a false or fraudulent claim, or otherwise violates any provision of sections 17b-490 to 17b-498, inclusive, as amended, or said regulations, shall be subject to a fine of not less than one thousand dollars or imprisonment for a term of not more than one year, or both.

(b) Any person who wilfully misrepresents any fact in connection with obtaining a replacement prescription pursuant to section 17b-492, as amended by this act, or in connection with obtaining an identification number or card, or who misuses such identification number or card to obtain prescription drugs shall be subject to suspension of eligibility for a period of not more than one year for a first offense and a permanent revocation of eligibility for a second offense.

(c) Any pharmacy found guilty of a violation under subsection (a) shall be immediately terminated from participation in the program, and shall be liable to the state for five times the value of any material gain received.

(d) Any person found guilty of a violation under subsection (b) of this section shall be liable to the state for five times the value of any material gain received.

Approved May 21, 2004