An Act To Ensure Continuity of Care Related to Implementation of Federal Medicare Drug Benefit
Maine Legislature, Session 122, LD 1325
Committee Amendment CA_A_H686 (House)
Amends: 22 MRSA §254, 22 MRSA §254-D, 22 MRSA §254-A, 22 MRSA §258, 22 MRSA §2681, 22 MRSA §3174-G, 24-A MRSA §5002-B

COMMITTEE AMENDMENT "A" to H.P. 924, 
Act To Ensure Continuity of Care Related to 
Federal Medicare Drug Benefit" 
L.D. 1325, Bill, "An 
Implementation of the 
Amend the bill by striking out everything after the enacting 
clause and before the summary and inserting in its place the 
following: 
. PART A 
Sec. A-t. 22 MRSA §254, as amended by PL 2005, c. 12, Pt. 
KKK, §§l to 3, is repealed. 
Sec. A-2. 22 MRSA §254-D is enacted to read: 
§254-D. 
Elderly low-cost drug program 
The Department of Health and Human Services may conduct the 
elderly low-cost drug program to provide low-cost prescription 
and nonprescription drugs, medication and medical supplies to 
disadvantaged, elderly and disabled individuals. 
I. 
Definitions. 
As 
used 
in this 
section, 
unless 
the 
context 
otherwise 
indicates, 
the 
following 
terms 
have 
the 
following meanings. 
A. "Beneficiary under Medicare Part D" means a person who is 
enrolled in Medicare Part D. 
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COMMITTEE AMENDMENT ,A" to H.P. 924, L.D. 1325 
B. 
"Enrollee" means a person who receives benefits under 
the program. 
C. 
"Household income" means family income as defined by the 
department for the purposes of this section. 
D. 
"MaineCare member" means a person who receives benefits 
under the MaineCare program under chapter 855. 
E. 
"Manufacturer" 
means 
a 
manufacturer 
of prescription 
drugs 
and 
includes 
a 
subsidiary 
or 
affiliate 
of 
the 
manufacturer 
or 
a 
person 
or 
entity 
that 
receives 
prescription drugs from 
a manufacturer or wholesaler and 
repackages those drugs 
for later retail sale and has 
a 
labeler code from the federal Food and Drug Administration 
under 21 Code of Federal Regulations. 207.20 (1999). 
F. 
"Medicare Part D" means the prescription drug benefit 
pro~ram provided 
under 
the 
Medicare 
Prescription 
Drug. 
Improvement. 
and 
Modernization 
Act 
of 
2003. 
Public 
Law 
108-173. 
G. 
"Program" 
means 
the 
elderly 
low-cost 
drug 
program 
authorized in this section. 
H. 
"Wholesale price" means the average price paid by a 
wholesaler to a manufacturer for a product distributed for 
retail sale. 
"Wholesale price" includes a deduction for any 
customary prompt payment discounts. 
2. 
Administration. 
The 
commissioner 
shall 
provide 
sufficient personnel to ensure efficient administration of the 
program. 
The commissioner shall determine the extent and the 
magnitude of the program on the basis of the calculated need of 
the recipient population and the available funds. 
The department 
may not spend more on this program than is available through 
appropriations from the General Fund. dedicated revenue, federal 
or other grants 
and other established and 
committed funding 
sources. 
The 
commissioner 
may 
accept. 
for 
the 
purposes 
of 
carrying out this program. federal funds appropriated under any 
federal law relating to the furnishing of free or low-cost drugs 
to disadvantaged. elderly or disabled individuals and may take 
such action as is necessary for the purposes of carrying out that 
federal law and may accept from any other agency of government. 
individual, grou.p or corporation such funds as may be available 
to 
carry 
out 
this 
chapter. 
The 
department 
may 
establish 
priorities of coverage and cost sharing with available funds. 
Funds 
appropriated 
from 
the 
General 
Fund 
to 
carry out 
the 
purposes of this section may not lapse but must carry from year 
to year. 
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3. 
ApplicatioDs. 
The 
commissioner 
shall 
make 
available 
suitable 
applications 
for 
benefits 
under 
the 
program 
with 
instructions for applicants. 
Indiyiduals who are eligible for 
benefits under both MaineCare and Medicare Part D may be deemed 
eligible for the program without the need for application. 
4. 
CODduct of program. 
This subsection governs the conduct 
of 
the 
program. 
including 
the 
basic, 
supplemental 
and 
catastrophic components, by the department. 
A. 
Prescription and nonprescription drugs, medications and 
medical supplies of manufacturers that enter into rebate 
agreements pursuant to paragraph H may be available under 
the program. 
The department may create and implement 
a 
preferred drug list. 
Drugs may be made available through 
the operation of the basic and supplemental components of 
the program as follows. 
(1) 
The basic component of the program must provide 
drugs and medications for cardiac conditions and high 
blood pressure, diabetes, arthritis, anticoagulation, 
hyperlipidemia, 
osteoporosis, 
chronic 
obstructive 
pulmonary disease 
and 
asthma, 
incontinence, 
thyroid 
diseases, 
glaucoma, 
parkinson's 
disease, 
multiple 
sclerosis and amyotrophic lateral sclerosis. 
The basic 
component 
must 
also 
provide 
over-the-counter 
medications 
that 
are 
prescribed by 
a 
health 
care 
provider 
and 
approved 
as 
cost-effective 
by 
the 
department. 
( 2) 
The supplemental component of the program must 
provide 
all 
prescription 
drugs 
and 
medications 
of 
manufacturers 
that 
enter 
into 
rebate 
agreements 
pursuant to paragraph H other than those prescription 
drugs and medications provided under subparagraph (1). 
B. 
An 
individual is eligible for 
the program if that 
individual: 
(1) 
Is a legal resident of the State; 
(2) 
Meets the income eligibility criteria set forth in 
this section or is eligible for both MaineCare and 
Medicare Part D; 
(3) 
Does not receive full MaineCare pharmaceutical 
benefits; and 
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(4) 
Is at least 62 years of age, or is 19 years of age 
or older and determined to be disabled by the standards 
of the federal social security program. 
A person who 
was eligible for the program at any time from August 1, 
1998 
to July 
31, 
1999 
and 
who 
does 
not meet 
the 
requirements 
of 
this 
subparagraph 
at 
the 
time 
of 
application or 
renewal 
retains eligibility for 
the 
program if that person is a member of a household of an 
eligible person. 
C. 
The department may require that an enrollee or applicant 
for the program who is otherwise eligible for Medicare Part 
D become a beneficiary under Medicare Part D unless the 
department determines that good cause exists for the person 
not to participate in Medicare Part D. 
D. 
Income eligibility of individuals must be determined by 
this paragraph and 
by reference to the federal poverty 
guidelines for the 48 contiguous states and the District of 
Columbia, as defined by the federal Office of Management and 
Budget and revised annually in accordance with the United 
States Omnibus Budget Reconciliation Act of 1981, Section 
673, Subsection 2, Public Law 97 35, reauthorized by Public 
Law 105-285, Section 201 (1998). 
If the household income is 
not 
more 
than 
185% 
of 
the 
federal 
poverty 
guideline 
applicable to the household, the individual is eligible for 
the basic program and the supplemental program. 
Individuals 
are also eligible for the basic and the supplemental program 
if the household spends at least 40% 
of its income 
on 
unreimbursed direct medical expenses for prescription drugs 
and medications and the household income is not more than 
25% higher than the levels specified in this paragraph. 
For 
the purposes of this paragraph, the cost of drugs provided 
to 
a 
household under this section is considered a 
cost 
incurred 
by 
the 
household 
for 
eligibility determination 
purposes. 
E. 
Specifications for the administration and management of 
the program may include, but are not 
limited to, program 
objectives, accounting and handling practices, supervisory 
authority and evaluation methodology. 
F. 
The method of prescribing or ordering the drugs under 
paragraph A may include, but is not limited to, the use of 
standard or 
larger prescription refill sizes 
so 
as 
to 
minimize operational costs and to maximize economy. 
Unless 
the 
prescribing 
physician 
indicates 
otherwise 
or 
the 
department determines that it would not be cost effective, 
the 
use 
of 
generic 
or 
chemically 
equivalent 
drugs 
is 
required, as long as these drugs are of the same quality and 
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COMMITTEE AMENDMENT 'A" to H.P. 924, L.D. 1325 
have the same mode of delivery as is provided to the general 
public, consistent with good pharmaceutical practice. 
G. 
The commissioner may establish the amount of payment to 
be made by the program and by enrollees toward the cost of 
drugs and medications furnished under the program, including 
covered prescription and nonprescription drugs, medications 
and medical supplies, under the following terms. 
(1) 
For the basic component of the program, the total 
cost to an enrollee for the purchase of any covered 
drug or medication may not exceed the sum of $2 plus 
20% of the price allowed for that drug or medication 
under program rules. 
(2) 
For the supplemental component of the program, the 
total cost to 
an enrollee for 
the purchase of any 
covered drug or medication may not exceed: 
(a) 
For a brand name drug or medication, the cost 
to the program for that drug or medication minus 
the $2 paid by the program: and 
(b) 
For a generic drug or medication, the Sum of 
$2 plus 20% of the price allowed for that drug or 
medication under program rules. 
(3) 
For the catastrophic component of the program, the 
commissioner shall establish annual limits on the costs 
incurred by enrollees for drugs and medications covered 
under the program on or prior to May 31. 2001. 
After 
the limit is reached, the program must pay 80'"0 of the 
cost 
of 
each 
drug 
and 
medication 
covered 
by 
the 
supplemental component of the program on May 31, 2001 
minus 
$2. 
Any 
rema~n~ng amount 
is 
paid 
by 
the 
enrollee. 
The limits must be set by the commissioner 
by rule as necessary to operate the program within the 
program budget. 
H. 
Payment must be denied for drugs from manufacturers that 
do not enter into a rebate agreement with the department. 
(1) 
Each agreement must provide that the manufacturer 
make 
rebate 
payments 
for 
both 
the 
basic 
and 
supplemental 
components 
of 
the 
program 
to 
the 
department according to the following schedule. 
(a) 
From October 1, 1992 to October 1, 1998, the 
rebate 
percentage 
is 
egual 
to 
the 
percentage 
recommended by the federal Center for Medicare and 
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Medicaid Services of the manufacturer's wholesale 
price for the total number of dosage units of each 
form and strength of a prescription drug that the 
department reports as reimbursed to providers of 
prescription drugs. provided p~ents are not due 
until 30 days following the manufacturer's receipt 
of utilization data supplied by the department, 
including the number of dosage units reimbursed to 
providers of prescription drugs during the period 
for which payments are due. 
(b) 
Beginning October I. 
1998. 
the department 
shall seek to achieve an aggregate rebate amount 
from all rebate agreements that is 6 percentage 
points higher than that required by subdivision 
(a). 
provided 
such 
rebates 
result 
in 
a 
net 
increase in the rebate revenue available to the 
elderly low-cost drug program. 
(2) 
Upon receipt of data from the department. 
the 
manufacturer shall calculate the guarterly payment. 
(al 
If 
a 
discrepancy 
is 
discovered. 
the 
department may. at its expense. hire a mutually 
agreed-upon 
independent 
auditor 
to 
verify 
the 
manufacturer's calculation. 
(b) 
If 
a 
discrepancy 
is 
still 
found. 
the 
manufacturer shall justify its calculation or make 
payment 
to 
the 
department 
for 
any 
additional 
amount due. 
(d The manufacturer may. at its expense. hire a 
mutually agreed upon independent auditor to verify 
the accuracy of the utilization data provided by 
the department. 
If a discrepancy is discovered. 
the department shall justify its data or refund 
any excess payment to the manufacturer. 
(d) If the dispute over the rebate amount is not 
resolved. a request for a hearing with supporting 
documentation 
must 
be 
submitted 
to 
the 
department's 
office of 
administrative hearings. 
Failure to resolve the dispute may be cause for 
terminating the drug rebate agreement and denying 
payment to the manufacturer for any drugs. 
(3) 
A prescription drug of a manufacturer that does 
not enter into an agreement pursuant to this paragraph 
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C~ITTEE AMENDMENT ,A" to H,P, 924, L.D. 1325 
is reimbursable only if the department determines the 
prescription drug is essential. 
(4) 
All prescription drugs of 
a 
manufacturer that 
enters into an agreement pursuant to this paragraph 
that appear on the list of approved drugs under the 
program must be immediately available and the cost of 
the drugs must be reimbursed except as provided in this 
paragraph. 
The 
commissioner 
may 
impose 
prior 
authorization requirements on drugs under the program. 
If the commissioner establishes maximum retail prices 
for prescription drugs pursuant to section 2693. the 
department shall adopt rules for the program requiring 
the use of a drug formulary and prior authorization for 
the dispensing of certain drugs to be listed on a 
formulary. 
(5) 
The names of manufacturers who do and do not enter 
into rebate agreements pursuant to this paragraph are 
public information. 
The department shall release this 
information to health care providers and the public on 
a regular basis and shall publicize participation by 
manufacturers that is of particular benefit to the 
public. 
I. 
The eligibility determination made by the department is 
final. 
subject to 
appeal 
in accordance with the appeal 
process established in the MaineCare program. 
5. 
Relationship to federal Medicare program. 
To the extent 
permitted by federal 
law 
and 
to 
the extent that 
funds 
are 
available. the department may: 
A. 
Serve as the authorized representative for enrollees for 
the purpose of enrollment in a Medicare Part D plan; 
B. 
Apply for Medicare Part D benefits and subsidies on 
behalf of enrollees; 
C. 
Establish rules by which enrollees may opt out of the 
procedures under paragraphs A and B; 
D. 
At 
its 
discretion. 
file 
exceptions 
and 
appeals 
pertaining to Medicare Part D eligibility or benefits on 
behalf of enrollees who 
are beneficiaries under Medicare 
Part D. 
The department may identify a designee for this 
function; 
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COMMITTEE AMENDMENT ·A " to H.P. 924, L.D. 1325 
E. 
Identify objective criteria for evaluating Medicare Part 
D plans for the purposes of assisting or enrolling persons 
in those plansj 
F. 
Deem eligible for and enroll in the program without the 
need for application individuals who are eligible for both 
MaineCare and Medicare Part Dj 
G. 
For 
enrollees 
who 
are 
also beneficiaries 
under 
or 
eligible for Medicare Part D: 
(1) 
Provide coverage of drugs to the Same extent that 
coverage is available to enrollees who are not eligible 
for Medicare Part D; and 
(2) 
Provide 
assistance 
with 
premiums 
and 
other 
cost-sharing reguirements of Medicare Part D; and 
H. 
For enrollees who are MaineCare members and who are also 
beneficiaries under or eligible for Medicare Part D: 
(1) 
Provide coverage of drugs to the Same extent that 
coverage is available to enrollees who are MaineCare 
members who are not eligible for Medicare Part D; and 
(2) Provide assistance with the cost of prescription 
drugs and premiums and other cost-sharing reguirements 
of Medicare Part D. 
6. 
Education, outreach and 
materials to increase access. 
The department shall provide education and outreach services to 
applicants and enrollees in the program. MaineCare members and 
beneficiaries under Medicare Part D to increase access to needed 
prescription 
and 
nonprescription 
drugs 
and 
fully 
use 
other 
private. state and federal programs. The department shall provide 
materials. which must cover the availability of benefits and the 
application 
process. 
must 
include 
brochures. 
posters 
for 
pharmacies 
and 
flyers 
for 
pharmacists 
to 
distribute 
with 
prescription drug purchases. 
7. 
Rulemaking. 
The 
commissioner 
may 
adopt 
rules 
to 
implement the program. Rules adopted pursuant to this subsection 
are routine technical rules as defined in Title 5. chapter 375 , 
subchapter 2-A. 
Sec. A-3. Emergency rules. 
Because of concerns regarding the 
anticipated scope of benefits and other factors that might limit 
access to medically necessary drugs provided under the federal 
Medicare Prescription Drug, Improvement, and Modernization Act of 
2003 
and 
the 
challenge 
of 
coordination 
of 
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COMMITTEE AMENDMENT "A" to H.P. 924, L.D. 1325 
benefits under federal and state laws, the Department of Health 
and Human Services and the Governor shall convene a group of 
stakeholders of not more 
than 
persons, 
appointed by 
the 
Commissioner of Health and Human Services, to advise and report 
to 
the 
department. 
After 
receiving 
the 
report 
of 
the 
stakeholders group 
and 
no 
later 
than January 
1, 
2006, 
the 
department shall adopt emergency rules for the elderly low-cost 
drug program under the Maine Revised Statutes, Title 22, section 
254-D and the MaineCare program 
to implement the provisions of 
this Part. Rules adopted pursuant to this section are routine 
technical rules as defined in Title 5, chapter 375, subchapter 
2-A. 
PARTB 
Sec. B·l. 22 MRSA §§3174·HH and 3174-ll are enacted to read: 
§3l74-BB. 
Coordination of services 
For the purposes of maximizing coverage for prescription 
drugs for members who are enrolled in the MaineCare program, the 
department may provide Prescription drug services for MaineCare 
members through the elderly low-cost drug program established 
under section 254-D. 
§3l74-II. 
Relationship to federal Medicare program 
1. 
Authorization. 
To the extent permitted by federal law, 
with regard to the Medicare Part D benefit established in the 
federal 
Medicare 
Prescription 
Drug, 
Improvement, 
and 
Modernization Act of 2003, Public Law 108-173, the department may: 
A. 
Serve as 
an authorized representative for MaineCare 
members for the purpose of enrollment into a Medicare Part D 
~ 
B. 
Apply for Medicare Part D benefits and subsidies on 
behalf of MaineCare members; 
C. 
Establish rules by which MaineCare members may opt out 
of the procedures under paragraphs A and Bj 
D. 
At its discretion, file exceptions and appeals on behalf 
of MaineCare members who are beneficiaries under Medicare 
Part D. 
The department may identify a designee for this 
functionj and 
E. 
Identify objective criteria for evaluating Medicare Part 
D plans for the purposes of assisting or enrolling MaineCare 
members in Medicare Part D plans. 
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COMMITTEE AMENDMENT A" to H.P. 924, L.D. 1325 
PARTC 
Sec. C-l. 22 MRSA §254-A, as amended by PL 2001, c. 691, §2 
and affected by §6, is repealed. 
Sec. C-2. 22 MRSA §258, sub-§l, 1JA, as enacted by PL 2001, c. 
293, §5, is amended to read: 
A. 
"Elderly 
low-cost 
drug 
program" 
means 
established 
as 
part 
of 
the 
Healthy 
Maine 
Program pursuant to section 694 254-0. 
the 
program 
Prescription 
Sec. C-3. 22 MRSA §2681, sub-§3, as enacted by PL 1999, c. 
786, Pt. A, §3, is amended to read: 
3. 
Rebate agreement. 
A drug manufacturer or labeler that 
sells 
prescription drugs 
in this State 
through 
the elderly 
low-cost drug program 
under 
section 
6&4 ~ 
or 
any other 
publicly supported pharmaceutical assistance program shall enter 
into a 
rebate agreement with the department for this program. 
The rebate agreement must require the manufacturer or labeler to 
make 
rebate payments 
to the State each calendar quarter or 
according to a schedule established by the department. 
Sec. C-4. 22 MRSA §2681, sub-§9, as amended by PL 2003, c. 
494, §8, is further amended to read: 
9. 
Dedicated fund. 
The 
Maine 
Rx 
Plus Dedicated Fund, 
referred to in this section as the "fund," is established to 
receive revenue from manufacturers and labelers who pay rebates 
as provided in subsection 4 and any appropriations or allocations 
designated for 
the 
fund. 
The 
purposes 
of the 
fund 
are to 
reimburse retail pharmacies for discounted prices provided to 
qualified residents pursuant to subsection 5; to reimburse the 
department 
for 
contracted services 
including 
pharmacy 
claims 
processing fees, administrative and associated computer costs and 
other 
reasonable 
program costs; 
and 
to benefit the elderly 
low-cost drug program under section 6&4 254-0. 
The fund is a 
nonlapsing dedicated fund. 
Interest on fund balances accrues to 
the fund. 
Surplus funds in the fund must be used for the benefit 
of the program. 
Notwithstanding Title 5, section 1585, surplus 
funds 
may also be transferred to 
the elderly low-cost drug 
program established under section 694 254-0. 
Sec. C-5. 22 MRSA §3174-G, sub-§l-B, as amended by PL 2001, c. 
650, §2, is further amended to read: 
l-B. 
Funding. 
State 
funds 
necessary 
to 
implement 
subsection l-C must include General Fund appropriations and Other 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT A" to H.P. 924, L.D. 1325 
Special Revenue allocations from the Fund for a Healthy Maine to 
the elderly low-cost drug program operated pursuant to section 
6§4 
254-0, 
including rebates 
received 
in that program 
from 
pharmaceutical manufacturers, that are no longer needed in that 
program as a result of the Medicaid waiver obtained pursuant to 
subsection I-C. 
Sec. C-6. 22 MRSA §3174-G, sub-§l-C, as enacted by PL 200l, 
c. 650, §3, is amended to read: 
1-C. 
Prescription drug waiver program. 
Except as provided 
in paragraph G, the department shall apply to the federal Centers 
for Medicare and Medicaid Services for 
a waiver or 
amend 
a 
pending or current waiver under the Medicaid program authorizing 
the department to use federal matching dollars to enhance the 
prescription drug benefits available to persons who qualify for 
the elderly low-cost drug program established under section 694 
~. The 
program created pursuant 
to 
the 
waiver 
is the 
prescription drug waiver program, referred to in this subsection 
as the "program." 
A. 
As 
funds permit, the department has the authority to 
establish income eligibility levels for the program up to 
and including 200'l-o of the federal nonfarm income official 
poverty level, except that for individuals in households 
that spend at least 40'l-o of income on unreimbursed direct 
medical expenses for prescription medications, 
the income 
eligibility level is increased by 25~. 
B. 
To the extent reasonably achievable under the federal 
waiver process, the program must include the full range of 
prescription drugs provided under the Medicaid program on 
the 
effective 
date 
of 
this 
subsection 
and 
must 
limit 
copayrnents 
and 
cost 
sharing for participants. 
If cost 
sharing above the nominal cost sharing for the Medicaid 
program is determined to be necessary, the department may 
use a sliding scale to 
m~n~m~ze the financial burden on 
lower-income participants. 
C. 
Coverage under the program may not be less beneficial to 
persons who meet the qualifications of former section 254 
than the coverage available under that section on September 
30, 2001. 
D. 
In determining enrollee benefits under the program, to 
the extent possible, 
the department shall give equitable 
treatment 
to 
coverage 
of 
prescription 
medications 
for 
cancer, Alzheimer'S disease and behavioral health. 
Page ll-LR1609(2) 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT A" to H.P. 924, L.D. 1325 
E. 
The department is authorized to provide funding for the 
program by using funds appropriated or allocated to provide 
prescription drugs under sections ~§4 254-D and 258. 
Sec. C-7. 24-A MRSA §5002-B, sub-§2-A, as enacted by PL 2001, 
c. 410, Pt. B, §7, is amended to read: 
2-A. 
Low-cost drugs for the elderly or disabled program. 
An 
issuer 
that 
offers 
standardized 
plans 
that 
include 
prescription drug benefits shall permit an insured who has a plan 
from 
the 
same 
issuer without 
prescription drug benefits 
to 
purchase 
a 
plan with 
prescription 
drug 
benefits 
under 
the 
following circumstances: 
A. The insured was covered under the low-cost drugs for the 
elderly or disabled program established by Title 22, former 
section 254 or section 254-D; 
B. 
The insured 
coverage within 
low-cost 
drugs 
established by 
254-D; and 
applies for a plan with prescription drug 
days after losing eligibility for the 
for 
the 
elderly 
or 
disabled 
program 
Title 22, 
former section 254 
or section 
c. 
The insured either: 
(1) Had a Medicare supplement plan with prescription 
drug benefits from the same issuer prior to enrolling 
in the low-cost drugs 
for 
the elderly or disabled 
program established by Title 22, former section 254 or 
section 254-D; or 
(2) Is entitled to coritinuity of coverage pursuant to 
subsection 1 and has had prescription drug benefits, 
through either 
a 
Medicare 
supplement 
plan 
or 
the 
low-cost drugs 
for the elderly or disabled program 
established by Title 22, section 
~§4 254-D, since the 
insured's 
open 
enrollment 
period 
with 
no 
gap 
in 
prescription drug coverage in excess of 90 days. 
The purchase of a plan with prescription drug benefits by an 
insured pursuant to this subsection does not affect eligibility 
for coverage under the low-cost drugs for the elderly or disabled 
program established by Title 22, section ~§4 254-D if the insured 
is not covered by a Medicare supplement plan with prescription 
drug benefits at the time of reapplying for coverage under the 
low-cost drugs for the elderly or disabled program established by 
Title 22, section 694 254-D.' 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT A" to H.P. 924, L.D. 1325 
SUMMARY 
This amendment replaces the bill. 
The amendment repeals and 
enacts 
in a 
new statutory section the elderly low-cost drug 
program in order to better organize the statute. 
The amendment 
authorizes the Department of Health and Human Services to provide 
administrative 
services, 
information 
and 
enrollment 
and 
prescription drug services through the elderly low-cost drug 
program and MaineCare program that coordinate with the benefits 
that will be available beginning January 1, 2006 under the new 
Medicare Part D benefit. 
The amendment requires the department 
to 
adopt 
emergency 
rules, 
after 
rece~v~ng 
advice 
from 
a 
stakeholders group, for the elderly low-cost drug program and the 
MaineCare program by JanuaI'y 1, 2006. 
The amendment also makes 
technical changes in Part C to change internal cross-references 
to the newly restructured provision authorizing the program. 
FISCAL '«~Tr HFQURED_ 
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(See anachcd) 
COMMITTEE AMENDMENT 
Approved: 06/11105 ~ac:.. 
LD 1325 
LR 1609(02) 
An Act To Ensure Continuity of Care Related to Implementation of Federal Medicare Drug Benefit 
Fiscal Note for Bill as Amended by Committee Amendment A" 
Committee: Health and Human Services 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Minor cost increase - Fund for a Healthy Maine 
Minor cost increase - Other Special Revenue Funds 
Assumes the bill's re-design of the elderly low-cost drug program can be done within existing budgeted General Fur 
Fund for a Healthy Maine, and Other Special Revenue Funds resources for the existing program. Further assumes any 
additional costs to the Department of Health and Human Services in implementing this bill can be absorbed by the 
department utilizing existing budgetary resources. 
LR1609(2) - Fiscal Note - Page 1 of 1