HOUSE BILL No. 5932


     April 18, 2002, Introduced by Reps. Shackleton, Neumann and Ruth Johnson and referred to the Committee on Health Policy.


        A bill to amend 2000 PA 499, entitled

   "Elder prescription insurance coverage act,"

   by amending section 3 (MCL 550.2003).

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1
             Sec. 3.  (1) The EPIC program shall provide prescription

 2
        drug coverage, including related supplies as determined by the

 3
        department in consultation with the advisory committee estab-

 4
        lished in section 7, to each person to whom all of the following

 5
        apply:

 6
             (a) The person is a noninstitutionalized Michigan resident

 7
        65 years of age or older.

 8
             (b) The person has a household income at or below 200% of

 9
        the federal poverty guidelines.

10
             (c) The person is not currently a medicaid recipient.




   06617'02                                                 LTB                                   2

 1
             (d) Excluding medicare supplemental insurance or a federal

 2
        program described in section 9(2), the person is not covered by

 3
        other insurance that provides prescription drug coverage.

 4
             (2) The department shall give initial enrollment priority to

 5
        applicants who in the 12 months preceding  the effective date of

 6
        this act  OCTOBER 1, 2001, participated in the MEPPS.  A second

 7
        enrollment priority will be afforded to applicants with annual

 8
        household incomes up to 150% of the federal poverty guidelines

 9
        who received a senior prescription tax credit in former section

10
        273 of the income tax act of 1967, 1967 PA 281.  Enrollment in

11
        the EPIC program for eligible applicants who formerly partici-

12
        pated in the MEPPS program shall take effect not later than

13
        October 1, 2001.  Enrollment in the EPIC program for eligible

14
        applicants who formerly received a senior prescription tax credit

15
        shall take effect not later than December 1, 2001.  Other appli-

16
        cants with incomes up to 200% of the federal poverty guidelines

17
        will be enrolled contingent upon available money.

18
             (3) An individual or married couple meeting the basic eligi-

19
        bility criteria established in subsection (1) may apply for

20
        enrollment in the EPIC program as follows:

21
             (a) Submit an annual application to the department, or the

22
        department's designee, that, at a minimum, attests to the age,

23
        residence, and household income of the individual applicant or

24
        couple, if married.  A  nonrefundable  REFUNDABLE administrative

25
        fee must be included with the application AND SHALL BE RETURNED

26
        TO AN APPLICANT WHO THE DEPARTMENT DETERMINES IS NOT ELIGIBLE FOR

27
        THE EPIC PROGRAM.  The administrative fee is $25.00.



   06617'02                                   3

 1
             (b) Upon notification of eligibility, the enrollee may

 2
        access the EPIC program by meeting the cost-sharing obligation

 3
        through a copayment on each prescription that does not exceed 20%

 4
        of the cost of the prescription being purchased, with a maximum

 5
        monthly copayment amount calculated based on 1 of the following:

 6
             (i) If the applicant's household income is at or below 100%

 7
        of the federal poverty guidelines, the monthly copayment is 1/12

 8
        of 1% of household income as established during the annual appli-

 9
        cation process.

10
             (ii) If the applicant's household income is at or below 125%

11
        but greater than 100% of the federal poverty guidelines, the

12
        monthly copayment is 1/12 of 2% of household income as estab-

13
        lished during the annual application process.

14
             (iii) If the applicant's household income is at or below

15
        150% but greater than 125% of the federal poverty guidelines, the

16
        monthly copayment is 1/12 of 3% of household income as estab-

17
        lished during the annual application process.

18
             (iv) If the applicant's household income is at or below 175%

19
        but greater than 150% of the federal poverty guidelines, the

20
        monthly copayment is 1/12 of 4% of household income as estab-

21
        lished during the annual application process.

22
             (v) If the applicant's household income is at or below 200%

23
        but greater than 175% of the federal poverty guidelines, the

24
        monthly copayment is 1/12 of 5% of household income as estab-

25
        lished during the annual application process.

26
             (4) Subsequent to enrollment in the EPIC program, an

27
        applicant who has a household income at or below 100% of the



   06617'02                                   4

 1
        federal poverty guidelines shall be referred to the local family

 2
        independence agency for assessment of eligibility for medicaid.

 3
        Nothing in this subsection shall be construed as mandating that

 4
        an applicant found eligible for medicaid must enroll in that pro-

 5
        gram in lieu of enrollment in the EPIC program.














































   06617'02          Final page.                            LTB