Section 550.2009 - Program not as entitlement; limitation on benefits; EPIC as payer of last resort; use of automated system; pharmacy dispensing fee. - Michigan Statutes

ELDER PRESCRIPTION INSURANCE COVERAGE ACT (EXCERPT)
Act 499 of 2000

550.2009 Program not as entitlement; limitation on benefits; EPIC as payer of last resort; use of automated system; pharmacy dispensing fee.

Sec. 9.

(1) The program created by this act is not an entitlement. Benefits are limited to the level supported by the money explicitly appropriated in this or other acts for the EPIC program.

(2) Except as allowed in section 3(4), the EPIC program is a payer of last resort. If the federal government establishes a pharmaceutical assistance program that covers EPIC eligible seniors under medicare or another program, the EPIC program shall cover only eligible costs not covered by the federal program. This subsection does not require payment by a local prescription drug discount program or a local emergency prescription drug assistance program for a prescription drug covered under the EPIC program.

(3) The EPIC program shall utilize an automated pharmacy claims adjudication and prospective drug utilization review system. This automated system shall contain those edits necessary to reduce the risk of adverse drug reactions in the enrolled population.

(4) The pharmacy dispensing fee payable under the EPIC program shall be equal to the current medicaid dispensing fee.

History: 2000, Act 499, Eff. Oct. 1, 2001