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Budget Summary FY2016

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91101455 - Prescription Advantage
Data Current as of:  8/19/2015





Account Description FY2015
Spending
FY2016
GAA
9110-1455 Prescription Advantage
For the costs of the drug insurance program authorized in section 39 of chapter 19A of the General Laws; provided, that amounts received by the executive office of elder affairs' vendor as premium revenue for this program may be retained and expended by the vendor for the purposes of the program; provided further, that funds shall be expended for the operation of the pharmacy outreach program established in section 4C of said chapter 19A; provided further, that notwithstanding any general or special law to the contrary, unless otherwise prohibited by state or federal law, prescription drug coverage or benefits payable by the executive office of elder affairs and the entities with which it has contracted for administration of the subsidized catastrophic drug insurance program pursuant to said section 39 of said chapter 19A, shall be the payer of last resort for this program for eligible persons with regard to any other third-party prescription coverage or benefits available to such eligible persons; provided further, that the executive office shall notify the house and senate committees on ways and means not less than 90 days in advance of any action to limit or cap the number of enrollees in the program; provided further, that this program shall be subject to appropriation; provided further, that notification shall be given to the house and senate committees on ways and means at least 30 days prior to any coverage or benefits expansions; provided further, that the executive office shall seek to obtain maximum federal funding for discounts on prescription drugs available to the executive office and to prescription advantage enrollees; provided further, that the executive office shall take steps for the coordination of benefits with the Medicare prescription drug benefit, created pursuant to the federal Medicare Prescription Drug, Improvement and Modernization Act of 2003, Public Law 108-173, to ensure that residents of the commonwealth take advantage of this benefit; provided further, that a person shall also be eligible to enroll in the program at any time within a year after reaching age 65; provided further, that the executive office shall allow those who meet the program eligibility criteria to enroll in the program at any time during the year; provided further, that $90,000 shall be expended for the serving the health insurance needs of everyone (SHINE) program; provided further, that these funds shall be used to assist seniors in choosing the Medicare plan that best fits their budgets while meeting their health care needs; and provided further, that the department shall report to the house and senate committees on ways and means not later than March 1, 2016 on the number of seniors served by the SHINE program and their average annualized premium savings
18,442,178 18,668,169