Golden Bear State Pharmacy Assistance Program
Section § 130400
This law establishes the Golden Bear State Pharmacy Assistance Program, which is related to pharmacies assisting Californians.
Terms defined in this law include the 'Department,' referring to the State Department of Health Services, the 'Fund' referring to the program's Rebate Fund, and 'Medicare beneficiary,' specifically referring to Medicare beneficiaries who are California residents.
Section § 130401
This law allows Medicare beneficiaries to join a prescription drug discount program. Apart from already mentioned programs, they can now access this new division's benefits. The department is responsible for informing Medicare beneficiaries about their rights and how the discount works. It's mandatory for them to register once at a participating pharmacy, pay a set administrative fee, and receive a registration card, with materials for this card provided by the department.
Section § 130401.1
This law allows the department to receive gifts, bequests, or donations specifically aimed at educating Medicare beneficiaries about their rights to join a program. This can include outreach services and materials like brochures and advertisements. Usually, certain approvals are needed for such gifts, but this exemption simplifies the process for these particular items.
Additionally, advertisements received as gifts under this law do not have to follow certain regulations typically required by the government.
Section § 130402
In California, both pharmacies and drug manufacturers can take part in a program that helps provide prescription medications. This program specifically caters to Medicare beneficiaries who aren't living in institutions like nursing homes.
Section § 130403
This law section states that California's health department will try to negotiate rebate deals with drug manufacturers for medications bought by people on Medicare. The agreements will also include a fee for each pharmacy claim handled by the department as per another specific law section.
If the department finds it can't secure enough rebate deals, it can stop working on this program altogether.
Section § 130404
If you're a Medicare beneficiary with a program card, participating pharmacies will charge you no more than the Medi-Cal rate plus a fee for electronic processing for your meds if there's a rebate deal in place. The total price will be further reduced by the negotiated rebate amount. Pharmacies will get the exact price info electronically from the department. This rule doesn't apply to prescriptions covered by insurance.
Section § 130405
When a pharmacy gives someone a prescription drug under Section 130404, it sends a bill to the department for a specific amount. The department is then responsible for paying that bill.
Section § 130406
This law gives the department the authority to collect advance rebates from drug manufacturers to pay pharmacies. If the department pays a rebate regarding a manufacturer's drug, they must inform the manufacturer. If the rebate paid exceeds what the department collected, the manufacturer must refund the excess amount to the department.
Section § 130406.5
This law allows the department to create a program where Medicare beneficiaries can access better prescription drug discounts through drug manufacturer programs compared to the existing program discounts. The Medicare program registration card would work as an access point to these manufacturer discount programs.
The department can negotiate contracts with drug manufacturers for this purpose, and it may hire public or private entities to help with negotiations.
Medicare beneficiaries are not required to join or share personal information for these private discount programs to use the main program. However, they can choose to provide information if needed to join a private discount program.
Section § 130407
This law creates the Golden Bear State Pharmacy Assistance Program Rebate Fund, where certain payments related to pharmacy rebates are deposited.
The money in this fund is automatically allocated for paying out rebates and covering costs related to managing the program without needing annual budget approvals. Additionally, the money cannot be used for any other purpose or transferred to other funds.
Section § 130407.5
This section mandates that a department must pay back a $1,000,000 loan that it initially received from the General Fund to cover startup costs for a specific program.
Section § 130408
California's health department is tasked with creating a program to stop fraud related to the Golden Bear State Pharmacy Assistance Program. If someone or a group breaks the rules of this fraud prevention program, they might be banned from taking part in the assistance program. The department will also set up specific rules on how this exclusion process works.
Section § 130409
This law states that the department can hire staff or use contracts with certain entities to run and manage a healthcare program, including enrolling eligible Medicare beneficiaries and handling payments and rebates. They must ensure services are clearly identified and not seeking federal money. Also, certain contracts can bypass California's usual procurement rules. However, they cannot implement the program until they have all the necessary federal approvals.
Section § 130410
This law states that any contract created under this specific division doesn't have to follow the rules and regulations outlined in Part 2 of Division 2 of the Public Contract Code.