CHAPTER 319ff
CONNECTICUT PHARMACEUTICAL ASSISTANCE CONTRACT
TO THE ELDERLY AND THE DISABLED PROGRAM

      Sec. 17b-490. (Formerly Sec. 17a-340). Definitions. As used in sections 17b-490 to 17b-498, inclusive:

      (a) "Pharmacy" means a pharmacy licensed under section 20-594 or a pharmacy located in a health care institution, as defined in subsection (a) of section 19a-490, which elects to participate in the program;

      (b) "Prescription drugs" means (1) legend drugs, as defined in section 20-571, (2) any other drugs which by state law or regulation require the prescription of a licensed practitioner for dispensing, except: (A) Products prescribed for cosmetic purposes as specified in regulations adopted pursuant to section 17b-494; (B) on and after September 15, 1991, diet pills, smoking cessation gum, contraceptives, multivitamin combinations, cough preparations and antihistamines; (C) drugs for the treatment of erectile dysfunction, unless such drug is prescribed to treat a condition other than sexual or erectile dysfunction, for which the drug has been approved by the Food and Drug Administration; and (D) drugs for the treatment of erectile dysfunction for persons who have been convicted of a sexual offense who are required to register with the Commissioner of Public Safety pursuant to chapter 969, and (3) insulin and insulin syringes;

      (c) "Reasonable cost" means the cost of the prescription drug determined in accordance with the formula adopted by the Commissioner of Social Services in regulations for medical assistance purposes plus a dispensing fee equal to the fee determined by said commissioner for medical assistance purposes;

      (d) "Resident" means a person legally domiciled within the state for a period of not less than one hundred eighty-three days immediately preceding the date of application for inclusion in the program. Mere seasonal or temporary residences within the state, of whatever duration, shall not constitute domicile;

      (e) "Disabled" means a person over eighteen years of age who is receiving disability payments pursuant to either Title 2 or Title 16 of the Social Security Act of 1935, as amended;

      (f) "Commissioner" means the Commissioner of Social Services;

      (g) "Income" means adjusted gross income as determined for purposes of the federal income tax plus any other income of such person not included in such adjusted gross income minus Medicare Part B premium payments. The amount of any Medicaid payments made on behalf of such person or the spouse of such person shall not constitute income;

      (h) "Program" means the Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled Program otherwise known as ConnPACE;

      (i) "Pharmaceutical manufacturer" means any entity holding legal title to or possession of a national drug code number issued by the federal Food and Drug Administration;

      (j) "Average manufacturer price" means the average price paid by a wholesaler to a pharmaceutical manufacturer, after the deduction of any customary prompt payment discounts, for a product distributed for retail sale;

      (k) "Assets" means a person's resources, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003;

      (l) "Low income subsidy" means a premium and cost-sharing subsidy for low-income individuals, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003;

      (m) "Medicare Part D covered prescription drugs" means drugs that are included in Medicare Part D plan's formulary or are treated as being included in a Medicare Part D plan's formulary, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement and Modernization Act of 2003;

      (n) "Medicare Part D plan" means a Medicare Part D plan, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003;

      (o) "Gap in standard Medicare Part D coverage" means a drug obtained after a Medicare Part D beneficiary's initial coverage limit has been exceeded but before the beneficiary's annual out-of-pocket threshold has been met, as defined by Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

      (P.A. 85-573, S. 3, 18; P.A. 87-3, S. 1, 9; 87-12, S. 1, 2; 87-267, S. 3; 87-589, S. 11, 87; P.A. 90-89, S. 1; June Sp. Sess. P.A. 91-8, S. 45, 63; P.A. 92-196, S. 1, 4; P.A. 93-262, S. 1, 87; May Sp. Sess. P.A. 94-5, S. 1, 30; P.A. 05-280, S. 14, 20; P.A. 06-188, S. 11.)

      History: P.A. 85-573, S. 3 effective July 10, 1985, and applicable in any municipality to the assessment year commencing October 1, 1985, and each assessment year thereafter; P.A. 87-3 redefined "pharmacy" to include pharmacies located in health care institutions, redefined "reasonable cost" to be the cost as determined by a formula adopted in regulations for medical assistance plus a dispensing fee, added Subdiv. (e) which defined "disabled", and redefined "program" to include the disabled; P.A. 87-12 redefined "prescription drugs" to include any drugs which require a prescription of a licensed practitioner for dispensing; P.A. 87-267 amended Subsec. (g) by adding the provision on Medicaid payments; P.A. 87-589 revised definition of "disabled"; P.A. 90-89 redefined "prescription drugs" to exclude products prescribed for cosmetic purposes as specified in regulations; Sec. 17-510 transferred to Sec. 17a-340 in 1991; June Sp. Sess. P.A. 91-8 redefined "prescription drugs" to exclude diet pills, smoking cessation gum, contraceptives, multivitamins, cough preparations and antihistamines, redefined "reasonable cost" by deleting the reference to generic drugs and added Subsecs. (i) and (j) defining "pharmaceutical manufacturer" and "wholesale price"; P.A. 92-196 amended Subsec. (j) by substituting "average manufacturer price" for "wholesale price"; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department of income maintenance and commissioner and department on aging, effective July 1, 1993; May Sp. Sess. P.A. 94-5 amended Subsec. (g) to specifically subtract Medicare Part B premiums payments from consideration as adjusted gross income, effective July 1, 1994; Sec. 17a-340 transferred to Sec. 17b-490 in 1995; P.A. 05-280 amended Subsec. (b)(2) by designating existing exceptions as Subparas. (A) and (B) and adding Subpara. (C) excluding drugs for the treatment of erectile dysfunction for persons convicted of a sexual offense who are required to register with the Commissioner of Public Safety pursuant to chapter 969 from definition of "prescription drugs", amended Subsec. (b)(3) by deleting "insulin needles" from said definition, amended Subsec. (h) by making a technical change and added Subsecs. (k) to (o) defining "assets", "low income subsidy", "Medicare Part D covered prescription drugs", "Medicare Part D plan" and "gap in standard Medicare Part D coverage", effective July 1, 2005; P.A. 06-188 amended Subsec. (b)(2) by redefining "prescription drugs" to exclude drugs for the treatment of erectile dysfunction unless such drug is prescribed to treat a condition other than sexual or erectile dysfunction and has been approved by the Food and Drug Administration, effective July 1, 2006.

      Sec. 17b-491. (Formerly Sec. 17a-342). Pharmaceutical Assistance Program. Copayments. Reimbursement of prescriptions based on price paid by pharmacy and actual package size. Application by pharmaceutical manufacturers to participate in program. Rebates and utilization review required for participating pharmaceutical manufacturers. (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 copayment for each prescription shall not exceed sixteen dollars and twenty-five cents.

      (b) On January 1, 2002, and annually thereafter, the commissioner shall increase the income limits established in subsection (a) of this section that set the appropriate participant copayment by the increase in the annual inflation adjustment in Social Security income, if any. Each such adjustment shall be determined to the nearest one hundred dollars.

      (c) Notwithstanding the provisions of subsection (a), effective September 15, 1991, payment by the state to a pharmacy under the program may be based on the price paid directly by a pharmacy to a pharmaceutical manufacturer for drugs dispensed under the program minus the copayment charge, plus the dispensing fee, if the direct price paid by the pharmacy is lower than the reasonable cost of such drugs.

      (d) Effective September 15, 1991, reimbursement to a pharmacy for prescription drugs dispensed under the program shall be based upon actual package size costs of drugs purchased by the pharmacy in units larger than or smaller than one hundred.

      (e) The commissioner shall establish an application form whereby a pharmaceutical manufacturer may apply to participate in the program. Upon receipt of a completed application, the department shall issue a certificate of participation to the manufacturer. Participation by a pharmaceutical manufacturer shall require that the department shall receive a rebate from the pharmaceutical manufacturer. Rebate amounts for brand name prescription drugs shall be equal to those under the Medicaid program. Rebate amounts for generic prescription drugs shall be established by the commissioner, provided such amounts may not be less than those under the Medicaid program. A participating pharmaceutical manufacturer shall make quarterly rebate payments to the department for the total number of dosage units of each form and strength of a prescription drug which the department reports as reimbursed to providers of prescription drugs, provided such payments shall not be due until thirty days following the manufacturer's receipt of utilization data from the department including the number of dosage units reimbursed to providers of prescription drugs during the quarter for which payment is due.

      (f) All prescription drugs of a pharmaceutical manufacturer that participates in the program pursuant to subsection (e) of this section shall be subject to prospective drug utilization review. Any prescription drug of a manufacturer that does not participate in the program shall not be reimbursable, unless the department determines the prescription drug is essential to program participants.

      (P.A. 85-573, S. 6, 18; P.A. 87-3, S. 3, 9; S.A. 90-18, S. 18, 32; June Sp. Sess. P.A. 91-8, S. 46, 63; P.A. 92-196, S. 2, 4; P.A. 93-80, S. 51, 67; 93-262, S. 1, 87; 93-418, S. 36, 41; P.A. 95-351, S. 19, 30; June 18 Sp. Sess. P.A. 97-2, S. 132, 165; June Sp. Sess. P.A. 00-2, S. 40, 44, 53; May 9 Sp. Sess. P.A. 02-7, S. 15; P.A. 03-2, S. 14; P.A. 04-16, S. 17; 04-104, S. 1; P.A. 05-280, S. 21.)

      History: P.A. 87-3 deleted reference to "pilot", expanded the program to include the disabled and restated the payments to pharmacies to be the reasonable cost of prescription drugs minus a four-dollar copayment charge; S.A. 90-18 raised copayment charge from four to six dollars and added provisions re calculation of annual increases in charged amount on and after July 1, 1991; Sec. 17-513 transferred to Sec. 17a-342 in 1991; June Sp. Sess. P.A. 91-8 raised copayment and prescription charges from six dollars to ten dollars, deleted the language re the commissioner's authority to increase the copayment charges, and added Subsecs. (b) to (f), inclusive, basing payment made by the state to a pharmacy on the price paid by a pharmacy to the pharmaceutical manufacturer, basing reimbursement to the pharmacy on the actual package size of the prescription and detailing implementation and review of a prescription drug rebate agreement program; P.A. 92-196 amended Subsec. (d) by deleting provisions requiring the commissioner to enter into rebate agreements with manufacturers and adding provisions re application process for manufacturers to participate in program and amended Subsec. (f) for consistency; P.A. 93-80 amended Subsec. (a) to increase copayment charge from ten to fifteen dollars, and amended Subsec. (d) to change rebate paid to department by participating pharmaceutical manufacturer from eleven per cent of the average manufacturer price to the basic rebate supplied by the manufacturer under Section 1927 of Title XIX of the Social Security Act, effective July 1, 1993; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department on aging, effective July 1, 1993; P.A. 93-418 reduced the copayment charge from fifteen to twelve dollars for each prescription, effective July 1, 1993; Sec. 17a-342 transferred to Sec. 17b-491 in 1995; P.A. 95-351 required the department to receive a rebate from a pharmaceutical manufacturer in an amount equal to the Medicaid rebate, deleting former Subsec. (e) re quarterly payments, payment discrepancies and independent audits and relettering Subsec. (f) as (e), effective July 1, 1995; June 18 Sp. Sess. P.A. 97-2 amended Subsec. (e) by deleting provision requiring that all prescription drugs of a pharmaceutical manufacturer participating in the program pursuant to Subsec. (d) be immediately available, the cost of such drug reimbursed and not be subject to any restrictions and added provision requiring that such drugs be subject to prospective drug utilization review, effective July 1, 1997; June Sp. Sess. P.A. 00-2 amended Subsec. (d) by deleting references to the rebate supplied under the Social Security Act and by adding language re rebate amounts for brand name drugs equaling those under the Medicaid program and provision allowing the commissioner to establish rebate amounts for generic drugs, and amended Subsec. (e) by deleting provisions exempting prescription drugs of participating manufacturers from prior authorization, effective July 1, 2000; May 9 Sp. Sess. P.A. 02-7 amended Subsec. (a) by deleting provision re twelve dollar copayment charge and adding Subdivs. (1) to (3) re copayment requirements for individuals determined eligible for program on or after September 1, 2002, added new Subsecs. (b) and (c) re copayment rates for individuals determined eligible for program prior to September 1, 2002, and re increased income limits, respectively, and redesignated existing Subsecs. (b) to (e) as Subsecs. (d) to (g), effective September 1, 2002; P.A. 03-2 amended Subsec. (a) by deleting "For an individual who is determined eligible to participate in the program on or after September 1, 2002, said" re copayment rates, by changing copayment rate from twelve dollars to sixteen dollars and twenty-five cents, changing income threshold for unmarried participants from fifteen thousand nine hundred dollars to twenty thousand three hundred dollars and changing income threshold for married participants, with combined spousal income, from twenty-one thousand five hundred dollars to twenty-seven thousand five hundred dollars in Subdiv. (1), by deleting former Subdiv.(2) re middle tier of copayment rates, and by redesignating existing Subdiv. (3) as new Subdiv. (2), amending said Subdiv. to increase income thresholds from twenty thousand dollars to twenty thousand three hundred dollars in Subpara. (A) and from twenty-seven thousand one hundred dollars to twenty-seven thousand five hundred dollars in Subpara. (3) and adding "equals or" in both Subparas., deleted former Subsec. (b) re differing copayments for those determined eligible for the program prior to September 1, 2002, redesignated existing Subsecs. (c) to (g), inclusive, as Subsecs. (b) to (f), inclusive, and changed internal references contained therein, effective February 28, 2003; P.A. 04-16 made a technical change in Subsec. (a)(1); P.A. 04-104 amended Subsec. (a) to add "Except for a replacement prescription dispensed pursuant to section 17b-492" re required copayments, effective July 1, 2004; P.A. 05-280 amended Subsec. (a) by deleting former Subdivs. (1) and (2) re copayments under program and substituting provision that such copayments shall not exceed sixteen dollars and twenty-five cents and by deleting provision that excepted replacement prescriptions dispensed pursuant to Sec. 17b-492 from copayment requirement, effective July 1, 2005.

      Sec. 17b-491a. Prior authorization requirements for prescription drugs. Designation of specific suppliers. Schedule for dispensing of maximum quantities of oral dosage units. Submission of plans and revisions thereto to General Assembly. (a) The Commissioner of Social Services may require prior authorization of any prescription for a drug covered under the Medicaid, state-administered general assistance, or ConnPACE program, including (1) any early refill of a prescription drug covered under any of said programs; and (2) brand name drug products when a chemically equivalent generic drug product substitution is available. The authorization for a brand name drug product shall be valid for one year from the date the prescription is first filled. The Commissioner of Social Services shall establish a procedure by which prior authorization under this subsection shall be obtained from an independent pharmacy consultant acting on behalf of the Department of Social Services, under an administrative services only contract. If prior authorization is not granted or denied within two hours of receipt by the commissioner of the request for prior authorization, it shall be deemed granted.

      (b) The Commissioner of Social Services, to increase cost-efficiency or enhance access to a particular prescription drug, may designate specific suppliers of a prescription drug from which a dispensing pharmacy shall order the prescription to be delivered to the pharmacy and billed by the supplier to the department. For each prescription dispensed through designated suppliers, the department shall pay the dispensing pharmacy a handling fee not to exceed four hundred per cent of the dispensing fee established pursuant to section 17b-280. In no event shall the provisions of this subsection be construed to allow the commissioner to purchase all prescription drugs covered under the Medicaid, state-administered general assistance, and ConnPACE programs under one contract.

      (c) Notwithstanding the provisions of section 17b-262 and any regulation adopted thereunder, on or after July 1, 2000, the Commissioner of Social Services may establish a schedule of maximum quantities of oral dosage units permitted to be dispensed at one time for prescriptions covered under the Medicaid and state-administered general assistance programs based on a review of utilization patterns.

      (d) A plan or schedule established pursuant to subsection (a), (b) or (c) of this section and on and after July 1, 2005, any revisions thereto shall be submitted to the joint standing committees of the General Assembly having cognizance of matters relating to public health, human services and appropriations and the budgets of state agencies. Within sixty days of receipt of such a plan or schedule or revisions thereto, said joint standing committees of the General Assembly shall approve or deny the plan or schedule or any revisions thereto and advise the commissioner of their approval or denial of the plan or schedule or any revisions thereto. The plan or schedule or any revisions thereto shall be deemed approved unless all committees vote to reject such plan or schedule or revisions thereto within sixty days of receipt of such plan or schedule or revisions thereto.

      (June Sp. Sess. P.A. 00-2, S. 36, 53; P.A. 04-76, S. 21; P.A. 05-280, S. 17.)

      History: June Sp. Sess. P.A. 00-2 effective July 1, 2000; P.A. 04-76 amended Subsecs. (a) to (c), inclusive, by deleting references to "general assistance"; P.A. 05-280 amended Subsec. (a) by replacing "establish a plan for the" with "require" re prior authorization, removing former Subdiv. (1) designator, "initial" and "that costs five hundred dollars or more for a thirty day supply or", redesignating existing Subdiv. (2) as Subdiv. (1), adding new Subdiv. (2) re prior authorization requirement for brand name drugs when a chemically equivalent generic drug product substitution is available, and providing that authorization for brand name drug shall be valid for one year from the date the initial prescription is first filled, amended Subsec. (b) by deleting provision that required commissioner to establish a plan for designating certain suppliers of prescription drugs to be used by pharmacies when ordering prescription drugs and amended Subsec. (d) by adding "on and after July 1, 2005," re submission of plan revisions to General Assembly, effective July 13, 2005.

      Sec. 17b-491b. Reimbursement formula for drugs used to treat hemophilia A. The maximum allowable cost paid for Factor VIII pharmaceuticals under the Medicaid, state-administered general assistance, and ConnPACE programs shall be the actual acquisition cost plus eight per cent. The Commissioner of Social Services may designate specific suppliers of Factor VIII pharmaceuticals from which a dispensing pharmacy shall order the prescription to be delivered to the pharmacy and billed by the supplier to the Department of Social Services. If the commissioner so designates specific suppliers of Factor VIII pharmaceuticals, the department shall pay the dispensing pharmacy a handling fee equal to eight per cent of the actual acquisition cost for such prescription.

      (June Sp. Sess. P.A. 00-2, S. 35, 53; P.A. 04-76, S. 22.)

      History: June Sp. Sess. P.A. 00-2 effective July 1, 2000; P.A. 04-76 deleted reference to "general assistance".

      Sec. 17b-492. (Formerly Sec. 17a-343). Eligibility. Registration fee. ConnPACE program requirements related to the establishment of the Medicare Part D program. Payment for original and replacement prescriptions. Application prior to exhausting coverage. Regulations. (a) Eligibility for participation in the program shall be limited to any resident (1) who is sixty-five years of age or older or who is disabled, (2) whose current annual income at the time of application or redetermination, if unmarried, is less than twenty thousand eight hundred dollars or whose annual income, if married, when combined with that of the resident's spouse is less than twenty-eight thousand one hundred dollars, (3) who is not insured under a policy which provides full or partial coverage for prescription drugs once a deductible is met, except for a Medicare prescription drug discount card endorsed by the Secretary of Health and Human Services in accordance with Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, or coverage under Medicare Part D pursuant to said act, and (4) on and after September 15, 1991, who pays an annual thirty-dollar registration fee to the Department of Social Services. On January 1, 1998, and annually thereafter, the commissioner shall increase the income limits established under this subsection over those of the previous fiscal year to reflect the annual inflation adjustment in Social Security income, if any. Each such adjustment shall be determined to the nearest one hundred dollars.

      (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, except for benefits received from an endorsed Medicare prescription drug discount card or benefits provided under Medicare Part D. The pharmacy shall make reasonable efforts to ascertain the existence of other insurance or assistance, including the subsidy provided by an endorsed Medicare prescription drug discount card or benefits provided under Medicare Part D. A Medicare prescription drug discount card beneficiary shall be responsible for the payment of any Medicare prescription drug discount card coinsurance requirements, provided such requirements do not exceed the ConnPACE program copayment requirements. If a Medicare prescription drug discount card beneficiary's coinsurance requirements exceed the ConnPACE copayment requirements, the Department of Social Services shall make payment to the pharmacy to cover costs in excess of the ConnPACE copayment amount. If the cost to such beneficiary exceeds the remaining available Medicare prescription drug discount card subsidy, the beneficiary shall not be responsible for any payment in excess of the amount of the ConnPACE program copayment requirement. In such cases, the Department of Social Services shall make payment to the pharmacy to cover costs in excess of the ConnPACE copayment amount.

      (2) A Medicare Part D beneficiary shall be responsible for the payment of Medicare Part D copayments, coinsurance and deductible requirements for Medicare-Part-D-covered prescription drugs, as defined in Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, to the extent such requirements do not exceed the ConnPACE program copayment requirements. The Department of Social Services shall pay Medicare Part D monthly beneficiary premiums on behalf of the beneficiary. If a Medicare Part D beneficiary's out-of-pocket copayment, coinsurance or deductible requirements exceed the ConnPACE copayment requirements, the department shall make payment to the pharmacy to cover costs in excess of the ConnPACE copayment amount. The department shall be responsible for payment of a Medicare-Part-D-covered prescription drug obtained during the gap in standard Medicare Part D coverage. To the extent permitted under said act, such payment may be made by the department for a prescription at (A) the lower of the price that would be paid under the ConnPACE program or the negotiated price established by the beneficiary's Medicare Part D plan pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, or (B) in consultation with the Secretary of the Office of Policy and Management, at the price that would be paid under the ConnPACE program. Payment shall be made under the ConnPACE program for prescription drugs that are not Medicare Part D drugs, as defined in said act.

      (3) 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, 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.

      (c) Any eligible resident who (1) is insured under a policy, including an endorsed Medicare prescription drug discount card, which provides full or partial coverage for prescription drugs, and (2) expects to exhaust such coverage, may apply to participate in the program prior to the exhaustion of such coverage. Such application shall be valid for the applicable income year. To be included in the program, on or after the date the applicant exhausts such coverage, the applicant or the applicant's designee shall notify the department that such coverage is exhausted and, if required by the department, shall submit evidence of exhaustion of coverage. Not later than ten days after an eligible resident submits such evidence, such resident shall be included in the program. The program shall, except for those beneficiaries with an endorsed Medicare prescription drug discount card, (A) cover prescriptions that are not covered by any other plan of insurance or assistance available to the eligible resident and that meet the requirements of this chapter, and (B) retroactively cover such prescriptions filled after or concurrently with the exhaustion of such coverage. Nothing in this subsection shall be construed to prevent a resident from applying to participate in the program as otherwise permitted by this chapter and regulations adopted pursuant to this chapter.

      (d) (1) As a condition of eligibility for participation in the ConnPACE program, a resident with an income at or below one hundred thirty-five per cent of the federal poverty level, who is Medicare Part A or Part B eligible, shall obtain annually an endorsed Medicare prescription drug discount card designated by the Commissioner of Social Services for use in conjunction with the ConnPACE program. The commissioner shall be the authorized representative of such resident for the purpose of enrolling a resident in the transitional assistance program of Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. As the authorized representative for this purpose, the commissioner may sign required forms and enroll such resident in an endorsed Medicare prescription drug discount card on the resident's behalf. Such resident shall have the opportunity to select an endorsed Medicare prescription drug discount card designated by the commissioner for use in conjunction with the ConnPACE program, and shall be notified of such opportunity by the commissioner. In the event that such resident does not select an endorsed Medicare prescription drug discount card designated by the commissioner for use in conjunction with the ConnPACE program within a reasonable period of time, as determined by the commissioner, the department shall enroll the resident in an endorsed Medicare prescription drug discount card designated by the commissioner. The provisions of this subdivision shall remain in effect until the effective date of the Medicare Part D program pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

      (2) The commissioner may require, as a condition of eligibility for participation in the ConnPACE program, that a resident with an income above one hundred thirty-five per cent of the federal poverty level, who is Medicare Part A or Part B eligible, obtain an endorsed Medicare prescription drug discount card designated by the commissioner for use in conjunction with the ConnPACE program if obtaining such discount card is determined by the commissioner to be cost-effective to the state. In such an event, the commissioner may provide payment for any Medicare prescription drug discount card enrollment fees. The provisions of this subdivision shall remain in effect until the effective date of the Medicare Part D program pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

      (e) On and after the effective date of the Medicare Part D program pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, enrollment in the Medicare Part D program, for individuals eligible for such program in accordance with said act, shall be a condition of eligibility for the ConnPACE program. The ConnPACE program shall cover the financial costs of Medicare Part D participation for ConnPACE recipients enrolled in Medicare Part D in accordance with subsection (b) of this section. Effective July 1, 2005, a ConnPACE recipient shall, as a condition of eligibility, provide information regarding the recipient's assets and income, as defined by said act, and that of the recipient's spouse, provided said spouse resides in the same household, as required by the Department of Social Services in order to determine the extent of benefits for which the recipient is eligible under Medicare Part D.

      (f) The Commissioner of Social Services may be the authorized representative of a ConnPACE applicant or recipient for purposes of enrolling in a Medicare Part D plan or submitting an application to the Social Security Administration to obtain the low income subsidy benefit provided under Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The applicant or recipient shall have the opportunity to select a Medicare Part D plan and shall be notified of such opportunity by the commissioner. The applicant or recipient, prior to selecting a Medicare Part D plan, shall have the opportunity to consult with the commissioner, or the commissioner's designated agent, concerning the selection of a Medicare Part D plan that best meets the prescription drug needs of such applicant or recipient. In the event that such applicant or recipient does not select a Medicare Part D plan within a reasonable period of time, as determined by the commissioner, the commissioner shall enroll the applicant or recipient in a Medicare Part D plan designated by the commissioner in accordance with said act. The applicant or recipient shall appoint the commissioner as such applicant's or recipient's representative for the purpose of appealing any denial of Medicare Part D benefits and for any other purpose allowed under said act and deemed necessary by the commissioner.

      (g) The Commissioner of Social Services may adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of subsection (c) of this section. Such regulations may provide for the electronic transmission of relevant coverage information between a pharmacist and the department or between an insurer and the department in order to expedite applications and notice. The commissioner may implement the policies and procedures necessary to carry out the provisions of this section while in the process of adopting such policies and procedures in regulation form, provided notice of intent to adopt the regulations is published not later than twenty days after the date of implementation. Such policies and procedures shall be valid until the time the final regulations are adopted.

      (P.A. 85-573, S. 7, 18; P.A. 87-3, S. 4, 9; June Sp. Sess. P.A. 91-8, S. 47, 63; P.A. 92-196, S. 3, 4; P.A. 93-262, S. 1, 87; P.A. 95-160, S. 1, 69; P.A. 96-139, S. 12, 13; June 18 Sp. Sess. P.A. 97-2, S. 128, 165; P.A. 98-194, S. 1, 2; June Sp. Sess. P.A. 01-2, S. 22, 69; June Sp. Sess. P.A. 01-9, S. 129, 131; May 9 Sp. Sess. P.A. 02-7, S. 16; P.A. 03-2, S. 15; June 30 Sp. Sess. P.A. 03-3, S. 58; P.A. 04-6, S. 1; 04-101, S. 2; 04-104, S. 2; 04-258, S. 12; P.A. 05-280, S. 22; Nov. 2 Sp. Sess. P.A. 05-2, S. 3, 4; Nov. 2 Sp. Sess. P.A. 05-3, S. 2.)

      History: P.A. 87-3 restated eligibility to include the disabled, changed the income limits to thirteen thousand three hundred dollars for unmarried persons and sixteen thousand for married, provided for annual adjustments and restated Subsec. (b) re ineligibility; Sec. 17-514 transferred to Sec. 17a-343 in 1991; June Sp. Sess. P.A. 91-8 changed the income limits to thirteen thousand eight hundred dollars for unmarried persons and sixteen thousand six hundred dollars for married persons and added a fifteen-dollar registration fee; P.A. 92-196 amended Subsec. (a) by limiting eligibility to those not insured under a policy providing full or partial prescription coverage once a deductible is met; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department on aging, effective July 1, 1993; Sec. 17a-343 transferred to Sec. 17b-492 in 1995; P.A. 95-160 increased the registration fee of fifteen dollars to an annual fee of twenty-five dollars, effective July 1, 1995; P.A. 96-139 changed effective date of P.A. 95-160 but without affecting this section; June 18 Sp. Sess. P.A. 97-2 amended Subsec. (a) to require the commissioner to increase the income limits to reflect any annual inflation adjustment in Social Security income after January 1, 1998, effective July 1, 1997; P.A. 98-194 added Subsecs. (c) and (d), extending program to eligible residents who exhaust prescription drug insurance coverage, effective July 1, 1998; June Sp. Sess. P.A. 01-2 amended Subsec. (a) to make a technical change for purposes of gender neutrality, to change annual income limits applicable after April 1, 2002, or in the case of a federal waiver, after July 1, 2002, and to require the commissioner, effective January 1, 2002, to commence accepting applications from individuals who will become eligible to participate in the program as of April 2, 2002, and amended Subsec. (c) to make technical changes, effective July 1, 2001; June Sp. Sess. P.A. 01-9 revised effective date of June Sp. Sess. P.A. 01-2 but without affecting this section; May 9 Sp. Sess. P.A. 02-7 amended Subsec. (a) by deleting requirement that commissioner adopt regulations re increased eligibility income limits, effective September 1, 2002; P.A. 03-2 amended Subsec. (a)(4) to increase annual registration fee from twenty-five dollars to thirty dollars, effective February 28, 2003; June 30 Sp. Sess. P.A. 03-3 amended Subsec. (a) by adding new Subdiv. (4) limiting program eligibility to unmarried individuals with available assets below one hundred thousand dollars and married individuals with assets below one hundred twenty-five thousand dollars, and providing that asset limit for married individuals be determined by combining value of assets available to both spouses and that for purposes of section "available assets" are those considered available under the Connecticut Home Care Program for the Elderly, and by redesignating existing Subdiv. (4) as Subdiv. (5), effective August 20, 2003; P.A. 04-6 amended Subsec. (a)(2)(A) by deleting Subpara. (A) designator, increasing income eligibility level to twenty thousand eight hundred dollars for unmarried persons and increasing the combined income level for married persons to twenty-eight thousand one hundred dollars, deleted Subsec. (a)(2)(B) re income levels in the event of waiver being granted, amended Subsecs. (a) to (c), inclusive, by adding provisions re use of Medicare prescription drug discount cards by program beneficiaries, added new Subsec. (d) requiring that persons with income at or below one hundred thirty-five per cent of the federal poverty level obtain Medicare prescription drug discount card as a condition of program eligibility, and redesignated existing Subsec. (d) as Subsec. (e) and added provisions authorizing commissioner to implement policies and procedures relative to section while in process of adopting such policies and procedures as regulation, effective March 30, 2004; P.A. 04-101 amended Subsec. (d) to insert Subdiv. (1) and (2) designators and, in Subdiv. (1), inserted "annually" re requirement to obtain a discount card, required that the commissioner be the authorized representative of a resident in enrolling the resident in the transitional assistance program, authorized the commissioner to enroll the resident and allowed the resident to select an endorsed discount card, effective April 28, 2004; P.A. 04-104 amended Subsec. (b) to designate existing provisions as Subdiv. (1) and add Subdiv. (2) re payment for replacement prescriptions, effective July 1, 2004; P.A. 04-258 eliminated former Subsec. (a)(4) re asset limits used in making program eligibility determinations and redesignated existing Subsec. (a)(5) as new Subsec. (a)(4), effective June 1, 2004; P.A. 05-280 amended Subsec. (a) by changing "annual income" to "current annual income at the time of application or redetermination" in Subdiv. (2), repositioning "once a deductible is met" and adding reference to coverage under Medicare Part D in Subdiv. (3) and deleting provision re accepting applications from persons eligible for program, amended Subsec. (b) by adding "or benefits provided under Medicare Part D" in Subdiv. (1), adding new Subdiv. (2) re Medicare Part D, redesignating existing Subdiv. (2) as Subdiv. (3) and amending same by deleting provision re no copayment required for replacement prescription, amended Subsec. (d) by making technical changes and adding language re provisions of Subdivs. (1) and (2) to remain in effect until effective date of the Medicare Part D program, added new Subsecs. (e) and (f) re Medicare Part D and redesignated existing Subsec. (e) as Subsec. (g), effective July 1, 2005; Nov. 2 Sp. Sess. P.A. 05-2 amended Subsec. (b)(2) by deleting former Subpara. (A) re department's authority to pay for a prescription drug at the lowest price established by the Medicare Part D plan for a preferred drug in the same therapeutic class and category, with the client responsible for any cost differential, and by redesignating existing Subparas. (B) and (C) as Subparas. (A) and (B), and amended Subsec. (f) by providing that applicant or recipient, prior to selecting a Medicare Part D plan, shall have the opportunity to consult with commissioner or commissioner's designated agent concerning selection of a plan that best meets the prescription drug needs of such applicant or recipient, effective December 1, 2005; Nov. 2 Sp. Sess. P.A. 05-3 amended Subsec. (f) by changing "shall" to "may" re commissioner's acting as authorized representative of a ConnPACE applicant or recipient, adding provision clarifying commissioner's authority to enroll such applicant or recipient in a Medicare Part D plan, and deleting provision re commissioner's authority to sign required forms on behalf of such applicant or recipient, effective December 1, 2005.

      Sec. 17b-492a. Participating pharmacy. Requirements. On and after March 30, 2004, only a pharmacy, as defined in subsection (a) of section 17b-490, that accepts all Medicare prescription drug discount cards that are (1) endorsed by the Secretary of Health and Human Services in accordance with Public Law 108-173, the federal Medicare Prescription Drug, Improvement, and Modernization Act of 2003, and (2) designated by the Commissioner of Social Services for use in conjunction with the ConnPACE program, may participate in the ConnPACE program. In addition, the commissioner may require, as a condition for such participation, that a pharmacy accept any endorsed drug discount card, if so required under federal law.

      (P.A. 04-6, S. 2.)

      History: P.A. 04-6 effective March 30, 2004.

      Sec. 17b-492b. Authority of Commissioner of Mental Retardation with respect to the Medicare Part D program. The Commissioner of Mental Retardation, or the commissioner's designee, may be the authorized representative of an applicant or recipient of services provided by the Department of Mental Retardation for the purpose of submitting an application to the Social Security Administration to obtain the low income subsidy benefit provided under Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. As the authorized representative for this purpose, the commissioner, or the commissioner's designee, may also sign required forms and enroll the applicant or recipient in a Medicare Part D plan on the applicant's or recipient's behalf. The applicant or recipient shall have the opportunity to select a Medicare Part D plan and shall be notified of such opportunity by the commissioner. In the event that such applicant or recipient does not select a Medicare Part D plan within a reasonable period of time, as determined by the commissioner, the department shall enroll the applicant or recipient in a Medicare Part D plan designated by the commissioner in accordance with said act. The applicant or recipient shall appoint the commissioner, or the commissioner's designee, as such applicant's or recipient's authorized representative for the purpose of appealing any denial of Medicare Part D benefits and for any other purpose allowed under said act and deemed necessary by the commissioner.

      (P.A. 05-280, S. 28.)

      History: P.A. 05-280 effective July 1, 2005.

      Sec. 17b-492c. Authority of Commissioner of Mental Health and Addiction Services with respect to the Medicare Part D program. The Commissioner of Mental Heath and Addiction Services, or the commissioner's designee, may be the authorized representative of an applicant or recipient of services provided by the Department of Mental Health and Addiction Services for the purpose of submitting an application to the Social Security Administration to obtain the low income subsidy benefit provided under Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. As the authorized representative for this purpose, the commissioner, or the commissioner's designee, may also sign required forms and enroll the applicant or recipient in a Medicare Part D plan on the applicant's or recipient's behalf. The applicant or recipient shall have the opportunity to select a Medicare Part D plan and shall be notified of such opportunity by the commissioner. In the event that such applicant or recipient does not select a Medicare Part D plan within a reasonable period of time, as determined by the commissioner, the department shall enroll the applicant or recipient in a Medicare Part D plan designated by the commissioner in accordance with said act. The applicant or recipient shall appoint the commissioner, or the commissioner's designee, as such applicant's or recipient's authorized representative for the purpose of appealing any denial of Medicare Part D benefits and for any other purpose allowed under said act and deemed necessary by the commissioner.

      (P.A. 05-280, S. 29.)

      History: P.A. 05-280 effective July 1, 2005.

      Sec. 17b-492d. Council to advise on implementation of Medicare Part D program. Duties. Membership. Annual report. (a) There is established a council which shall advise the Commissioner of Social Services on matters relating to the administration and implementation of the Medicare Part D program, established pursuant to Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The council shall advise on matters that include, but are not limited to, (1) the effect of the implementation of the Medicare Part D program on: (A) The administration and operation of the ConnPACE and Medicaid programs, (B) persons in the state who are full benefit dually eligible Medicare Part D beneficiaries, as defined in subsection (a) of section 17b-265d, (C) state pharmacies and pharmacists, (D) physicians and other persons who are authorized to prescribe drugs within the state, and (E) prescription drug coverage, benefits and costs for program beneficiaries, and (2) the administration of the Medicare Part D Supplemental Needs Fund, established pursuant to section 17b-265e. In addition, the council shall provide legislative recommendations to the General Assembly concerning the administration and implementation of the Medicare Part D program by the Department of Social Services, and may provide federal legislative recommendations concerning the Medicare Part D program to members of the state's congressional delegation.

      (b) The council shall consist of the following members:

      (1) Two appointed by the speaker of the House of Representatives, who shall be pharmacists, licensed pursuant to chapter 400j, employed at pharmacies located in urban areas;

      (2) Two appointed by the president pro tempore of the Senate, who shall be pharmacists, licensed pursuant to chapter 400j, employed at pharmacies located in rural areas;

      (3) One appointed by the majority leader of the House of Representatives, who shall be a physician licensed pursuant to chapter 370;

      (4) One appointed by the majority leader of the Senate, who shall be a psychiatrist licensed pursuant to chapter 370;

      (5) One appointed by the minority leader of the House of Representatives, who shall be a consumer representative;

      (6) One appointed by the minority leader of the Senate, who shall be an attorney with expertise in Medicare advocacy;

      (7) The Commissioners of Social Services and Public Health, or their designees; and

      (8) The chairpersons and ranking members of the joint standing committees of the General Assembly having cognizance of matters relating to human services and public health and the chairpersons and ranking members of the select committee of the General Assembly having cognizance of matters relating to aging.

      (c) All appointments to the council shall be made not later than thirty days after June 6, 2006. Any vacancy shall be filled by the appointing authority.

      (d) The speaker of the House of Representatives and the president pro tempore of the Senate shall select the chairpersons of the council, from among the members of the council. The chairpersons shall schedule the first meeting of the council, which shall be held not later than sixty days after June 6, 2006. Thereafter, the council shall meet quarterly and more often upon the call of the chairpersons or a majority of its members.

      (e) The Joint Committee on Legislative Management shall provide administrative support to the council.

      (f) On or before January 15, 2007, and annually thereafter, the council shall report, in accordance with section 11-4a, on its activities to the joint standing committees of the General Assembly having cognizance of matters relating to human services and public health and to the select committee of the General Assembly having cognizance of matters relating to aging.

      (P.A. 06-170, S. 1.)

      History: P.A. 06-170 effective June 6, 2006.

      Sec. 17b-493. (Formerly Sec. 17a-344). Generic substitution required. A pharmacist shall, except as limited by subsection (c) of section 20-619 and section 17b-274, substitute a therapeutically and chemically equivalent generic drug product for a prescribed drug product when filling a prescription for an eligible person under the program.

      (P.A. 85-573, S. 8, 18; June Sp. Sess. P.A. 91-8, S. 48, 63; P.A. 95-264, S. 69; June Sp. Sess. P.A. 00-2, S. 41, 53.)

      History: Sec. 17-515 transferred to Sec. 17a-344 in 1991; June Sp. Sess. P.A. 91-8 required that a pharmacist provide a generic drug product, eliminating the previous discretionary authority; Sec. 17a-344 transferred to Sec. 17b-493 in 1995; P.A. 95-264 made a technical change; June Sp. Sess. P.A. 00-2 added reference to Sec. 17b-274 as an additional limitation on substitution of generic drug products, effective July 1, 2000.

      Sec. 17b-494. (Formerly Sec. 17a-345). Regulations. The Commissioner of Social Services shall adopt regulations, in accordance with the provisions of chapter 54, to establish (1) a system for determining eligibility and disqualification under the program, including provisions for an identification number and a renewable, nontransferable identification card; (2) requirements for the use of the identification number and card by the pharmacy and the eligible person; (3) a system of payments; (4) limitations on the maximum quantity per prescription which shall not exceed a thirty-day supply or one hundred twenty oral dosage units whichever is greater; (5) requirements as to records to be kept by the pharmacy, including patient profiles; (6) products prescribed for cosmetic and other purposes which shall not be covered under the program; and (7) such other provisions as are necessary to implement the provisions of sections 17b-490 to 17b-495, inclusive.

      (P.A. 85-573, S. 9, 18; P.A. 87-3, S. 5, 9; P.A. 90-89, S. 2; June Sp. Sess. P.A. 91-8, S. 49, 63; P.A. 93-262, S. 1, 87.)

      History: P.A. 87-3 deleted reference to the annual participation fee, restated the quantity limitation to be the greater of a thirty-day supply or one hundred twenty oral dosage units and deleted Subsec. (b) re deposit of the annual participation fee; P.A. 90-89 required the commissioner to adopt regulations establishing products prescribed for cosmetic purposes which shall not be covered under the program; Sec. 17-516 transferred to Sec. 17a-345 in 1991; June Sp. Sess. P.A. 91-8 added reference to Secs. 17a-340 and 17a-342 to 17a-346, inclusive, and made other technical corrections; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department on aging, effective July 1, 1993; Sec. 17a-345 transferred to Sec. 17b-494 in 1995.

      Sec. 17b-495. (Formerly Sec. 17a-346). Contract with fiscal intermediary. Reports. (a) The commissioner may enter into an agreement with a fiscal intermediary which may be an agency of the state, or a person, firm or public or nonprofit corporation, for the administration of the whole or any part of the program. Any such contract shall be subject to the provisions of sections 4a-57 and 4a-59, except that preference shall be given to persons, firms or corporations doing business in the state.

      (b) The contract shall require the fiscal intermediary to submit quarterly reports to the commissioner on the operation of the program, including financial and utilization statistics as to drug use by therapeutic category, actuarial projections, an outline of problems encountered in the administration of the program and suggested solutions to the same and any recommendations to enhance the program.

      (c) The commissioner shall verify the propriety and reasonableness of payments to providers, through field audit examinations and other reasonable means, to the extent possible within available appropriations. The commissioner shall submit an annual report, on or before February first of each year, to the Secretary of the Office of Policy and Management and the chairpersons of the joint standing committee of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies outlining the program for carrying out such verifications and including the results of such verifications.

      (d) The commissioner shall submit biannual reports, in accordance with section 11-4a, to the Governor and the chairpersons of the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies and public health. Each report shall include a copy of the most recent report of the fiscal intermediary, if any, and (1) the number of consumers eligible for the program, (2) the number of consumers utilizing the program, (3) an outline of and a report on the educational outreach program, (4) the number of appeals, (5) an outline of problems encountered in the administration of the program and suggested solutions and any recommendations to enhance the program.

      (P.A. 85-573, S. 10, 18; 86-403, S. 92, 132; P.A. 87-3, S. 6, 9; P.A. 91-190, S. 2, 9; June Sp. Sess. P.A. 91-8, S. 50, 63; P.A. 03-268, S. 10; P.A. 04-16, S. 13.)

      History: P.A. 86-403 made technical change in Subsec. (b), substituting "commissioner" for "secretary"; P.A. 87-3 inserted new Subsec. (c) re verification of reasonableness of payments and relettered former subsection as (d), adding provision re reporting to the advisory board; Sec. 17-517 transferred to Sec. 17a-346 in 1991; P.A. 91-190 amended Subsecs. (c) and (d) to eliminate requirement that annual and quarterly reports be submitted to chairpersons of pharmaceutical assistance advisory board established pursuant to Sec. 17a-341 to reflect repeal of said section; June Sp. Sess. P.A. 91-8 deleted references to the generic incentive dispensing fee in Subsec. (c); Sec. 17a-346 transferred to Sec. 17b-495 in 1995; P.A. 03-268 amended Subsec. (d) to require that commissioner submit biannual reports rather than quarterly reports and to add reference to Sec. 11-4a; P.A. 04-16 made a technical change in Subsec. (d).

      Sec. 17b-496. (Formerly Sec. 17a-347). Hearing. Any person aggrieved by any action of the commissioner in connection with the administration of the program shall have a right to a hearing before the commissioner in accordance with the provisions of chapter 54.

      (P.A. 85-573, S. 11, 18.)

      History: Sec. 17-518 transferred to Sec. 17a-347 in 1991; Sec. 17a-347 transferred to Sec. 17b-496 in 1995.

      Sec. 17b-497. (Formerly Sec. 17a-348). Penalties. (a) Any person acting for a pharmacy who submits a false or fraudulent claim under sections 17b-490 to 17b-498, inclusive, 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, 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 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.

      (P.A. 85-573, S. 12, 18; P.A. 88-364, S. 78, 123; P.A. 96-169, S. 14; P.A. 04-104, S. 3.)

      History: P.A. 88-364 substituted references to Sec. 17-521 for references to Sec. 17-522; Sec. 17-519 transferred to Sec. 17a-348 in 1991; Sec. 17a-348 transferred to Sec. 17b-497 in 1995; P.A. 96-169 amended Subsec. (a) to increase minimum fine from five hundred dollars to one thousand dollars, amended Subsec. (c) to replace "subject to immediate termination of" with "immediately terminated from" and increased amount of liability to state from "three" to "five" times the value of material gain received in both Subsecs. (c) and (d); P.A. 04-104 amended Subsec. (b) to include a wilful misrepresentation in connection with obtaining a replacement prescription and to make a technical change, effective July 1, 2004.

      Sec. 17b-498. (Formerly Sec. 17a-349). Educational outreach program. The Commissioner of Social Services shall undertake an educational outreach program to make known the provisions of the program to the public, with emphasis on reaching the elderly and the disabled in the state through the various local and state-wide agencies and organizations concerned with the elderly and the disabled, and to all pharmacies in the state.

      (P.A. 85-573, S. 14, 18; P.A. 87-3, S. 7, 9; P.A. 93-262, S. 1, 87.)

      History: P.A. 87-3 added references to the disabled; Sec. 17-521 transferred to Sec. 17a-349 in 1991; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and department on aging, effective July 1, 1993; Sec. 17a-349 transferred to Sec. 17b-498 in 1995.

      Sec. 17b-499. Pharmacy outreach program: Definitions. As used in this section and section 17b-499a:

      (1) "Eligible person" means any person who is a resident of Connecticut at the time such person files an application for prescription medications or nonprescription medications with a participating manufacturer;

      (2) "Department" means the Department of Social Services;

      (3) "Participating manufacturer" means a pharmaceutical manufacturer that offers prescription medications or nonprescription medications at a reduced cost or at no cost to persons pursuant to a voluntary drug assistance program established by such manufacturer;

      (4) "Prescription medications" means prescription drugs that have been approved as safe and effective by the federal Food and Drug Administration or that are otherwise legally marketed and manufactured in the United States and manufactured and offered by pharmaceutical companies.

      (P.A. 05-269, S. 1.)

      History: P.A. 05-269 effective July 13, 2005.

      Sec. 17b-499a. Pharmacy outreach program. Established. Purpose. Duties. Report by Department of Social Services. (a) There is established a pharmacy outreach program, administered by participating manufacturers through a toll-free telephone number, for the purpose of assisting residents of this state in obtaining reduced cost or no cost prescription medications or nonprescription medications from participating manufacturers and educating such residents about all available programs in Connecticut relating to such medications. The department, within available appropriations, shall oversee such program.

      (b) The pharmacy outreach program shall assist eligible persons in procuring free or low cost prescription medications or nonprescription medications by: (1) Evaluating the likelihood that such eligible person will qualify to receive reduced cost or no cost prescription medications or nonprescription medications from a participating manufacturer based upon such participating manufacturer's eligibility requirements for participation in such manufacturer's voluntary drug assistance program; (2) aiding eligible persons who qualify to receive such reduced cost or no cost prescription medications or nonprescription medications in receiving such medications from such participating manufacturers; and (3) assisting any physician licensed in this state with communications to any such participating manufacturer that concern the application of any such eligible person for participation in such participating manufacturer's voluntary drug assistance program.

      (c) The pharmacy outreach program shall: (1) Create and maintain a state-wide toll-free telephone number staffed by individuals who are qualified to advise eligible persons on questions such persons may have about access to reduced cost or no cost prescription drugs or nonprescription drugs; (2) sponsor and organize materials and information, in conjunction with other organizations, concerning issues relating to access to affordable prescription medications; and (3) offer and provide information on prescription medications and nonprescription medications, including, but not limited to, information on drug interactions and drug abuse.

      (d) Not later than January 15, 2006, and annually thereafter, upon the request of the joint standing committees of the General Assembly having cognizance of matters relating to human services and general law, the Department of Social Services shall report, in accordance with section 11-4a, on the number of telephone calls received by the pharmacy outreach program, the number of prescriptions requested and issued through the program and any other information relating to the program that the department deems relevant.

      (P.A. 05-269, S. 2.)

      History: P.A. 05-269 effective July 13, 2005.

      Secs. 17b-500 to 17b-519. Reserved for future use.

      Note: Chapter 319gg is also reserved for future use.