Senate Bill No. 459–Committee on Human
Resources and Facilities

 

CHAPTER..........

 

AN ACT relating to the Fund for a Healthy Nevada; revising the amount of the limit on the income of a senior citizen to qualify for a subsidy for the provision of prescription drugs and pharmaceutical services from money in the Fund for a Healthy Nevada; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

    Section 1. NRS 439.665 is hereby amended to read as follows:

    439.665  1.  The Department [shall] may enter into contracts

with private insurers who transact health insurance in this state to

arrange for the availability, at a reasonable cost, of policies of health

insurance that provide coverage to senior citizens for prescription

drugs and pharmaceutical services.

    2.  Within the limits of the money available for this purpose in

the Fund for a Healthy Nevada, a senior citizen who is not eligible

for Medicaid and who [purchases] is eligible for a policy of health

insurance that is made available pursuant to subsection 1 is entitled

to an annual grant from the [Trust] Fund to subsidize the cost of that

insurance, including premiums and deductibles, if he has been

domiciled in this state for at least 1 year immediately preceding the

date of his application and :

    (a) If the senior citizen is single, his [household] income is not

over $21,500[.] ; or

    (b) If the senior citizen is married, his household income is not

over $28,660.

The monetary amounts set forth in this subsection must be

adjusted for each fiscal year by adding to each amount the product

of the amount shown multiplied by the percentage increase in the

Consumer Price Index from December 2002 to the December

preceding the fiscal year for which the adjustment is calculated.

    3.  The subsidy granted pursuant to this section must not exceed

the annual cost of insurance that provides coverage for prescription

drugs and pharmaceutical services, including premiums and

deductibles.

    4.  A policy of health insurance that is made available pursuant

to subsection 1 must provide for:

    (a) A copayment of not more than $10 per prescription drug or

pharmaceutical service that is generic as set forth in the formulary of

the insurer; and

    (b) A copayment of not more than $25 per prescription drug or

pharmaceutical service that is preferred as set forth in the formulary

of the insurer.

    5.  The Department may waive the eligibility requirement set

forth in subsection 2 regarding household income upon written

request of the applicant [if the circumstances of the applicant’s

household have changed as a result of:] or enrollee based on one or

more of the following circumstances:

    (a) Illness;

    (b) Disability; or

    (c) Extreme financial hardship , [based on a significant

reduction of income,] when considering the [applicant’s] current

financial circumstances[.] of the applicant or enrollee.

An applicant or enrollee who requests such a waiver shall include

with that request all medical and financial documents that support

his request.

    6.  If the Federal Government provides any coverage of

prescription drugs and pharmaceutical services for senior citizens

who are eligible for a subsidy pursuant to subsections 1 to 5,

inclusive, the Department may, upon approval of the Legislature, or

the Interim Finance Committee if the Legislature is not in session,

change any program established pursuant to NRS 439.635 to

439.690, inclusive, and otherwise provide assistance with

prescription drugs and pharmaceutical services for senior citizens

within the limits of the money available for this purpose in the Fund

for a Healthy Nevada.

    7.  The provisions of subsections 1 to 5,inclusive, do not apply

if the Department provides assistance with prescription drugs and

pharmaceutical services for senior citizens pursuant to subsection 6.

    Sec. 2.  This act becomes effective on July 1, 2003.

 

²⁰~~~~~⁰³