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Substitute Senate Bill No. 33

Public Act No. 08-1

AN ACT IMPLEMENTING THE GOVERNOR'S RECOMMENDATIONS WITH RESPECT TO SOCIAL SERVICES PHARMACY PROGRAMS.

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

Section 1. Subsection (e) of section 17b-491 of the 2008 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(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 for prescriptions covered under the program and for prescriptions covered by the department pursuant to subsection (c) of section 17b-265e of the 2008 supplement to the general statutes, as amended by this act. 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.

Sec. 2. Subsection (c) of section 17b-265e of the 2008 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(c) The Department of Social Services shall, in accordance with the provisions of this section, pay claims for prescription drugs for Medicare Part D beneficiaries, who are also either Medicaid or ConnPACE recipients and who are denied coverage by the Medicare Part D plan in which such beneficiary is enrolled because a prescribed drug is not on the formulary utilized by such Medicare Part D plan. Payment shall initially be made by the department for a thirty-day supply, subject to any applicable copayment. Pharmaceutical manufacturers shall pay rebate amounts established pursuant to section 17b-491 of the 2008 supplement to the general statutes, as amended by this act, to the department for prescriptions paid by the department pursuant to this section on or after January 1, 2007. The beneficiary shall appoint the commissioner as such beneficiary'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.

Sec. 3. (NEW) (Effective from passage) Except as provided in subsection (c) of section 17b-265e of the 2008 supplement to the general statutes, as amended by this act, any pharmaceutical manufacturer of a prescription drug covered by the Department of Social Services under any of the state medical assistance programs administered by the department shall provide rebates to the department for prescription drugs paid for by the department on or after February 1, 2008. The amount of rebates and the administration of the program shall be in accordance with subsections (e) and (f) of section 17b-491 of the 2008 supplement to the general statutes, as amended by this act.

Approved April 4, 2008