PART
XIII.Ā  RX PLUS PROGRAM



 



Note



 



Ā  Part heading amended by L 2004, c 47, Ā§11.



Ā  L Sp 2005, c 4, Ā§3 provides:



Ā  "SECTION 3.Ā  The department of human services shall not
take any action to remove pharmaceutical benefits management from managed care
plans that provide health care coverage for Hawaii medicaid
beneficiaries."



Ā  I-SaveRx prescription drug program (repealed June 30, 2012).
L 2008, c 59.



 



Ā§346-311Ā  Definitions.Ā  As used in this
part:



"Administrator" means the director of
human services.



"Department" means the department of
human services.



"Discount" means the amount by which
the price of a drug sold by a pharmacy is reduced as determined by the
department of human services.



"Initial discounted price" as it
pertains to a drug means the price that the department pays medicaid
participatingĀ  pharmacies to purchase the drug for its medicaid members.



"Manufacturer" means anyone who is
engaged in manufacturing, preparing, propagating, compounding, processing,
packaging, repackaging, or labeling a prescription drug.



"Participating pharmacy" or
"retail pharmacy" means a retail pharmacy located in this State, or
another business licensed to dispense prescription drugs in this State, that
elects to participate in the program.



"Pharmacy and therapeutic committee"
means the committee established by the department that advises the state
medicaid director on the Rx plus preferred drug list and may be the same entity
as the committee established in the medicaid program pursuant to section
346-14.



"Preferred drug" includes but is not
limited to:



(1)Ā  A drug listed on the State's medicaid preferred
drug list;



(2)Ā  An antipsychotic drug;



(3)Ā  An antidepressant drug;



(4)Ā  A chemotherapy drug;



(5)Ā  An antiretroviral drug;



(6)Ā  An immunosuppressive drug; and



(7)Ā  Any other drug listed on the Rx plus preferred
drug list pursuant to this part.



"Program" means the Rx plus program
except as otherwise provided.



"Qualified resident" means a resident
of the State who:



(1)Ā  Has a family income equal to or less than three
hundred fifty per cent of the federal poverty level;



(2)Ā  Lacks prescription drug coverage or has
exceeded the extent of the resident's prescription drug benefits; and



(3)Ā  Is enrolled in the program.



"Secondary discounted price" as it
pertains to a drug means the initial discounted price less any further
discounts paid out of the Rx plus special fund. [L 2002, c 76, pt of Ā§1; am L
2004, c 47, Ā§2]