Waiver application

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Any waiver application submitted by the Department of Human Services shall include provisions for the department to:

  1. (1)

    1. (A) Establish an income eligibility standard not to exceed:

      1. (i) Eighty percent (80%) of the federal poverty guideline for the period July 1, 2001, through June 30, 2002;

      2. (ii) Ninety percent (90%) of the federal poverty guideline for the period July 1, 2002, through June 30, 2003; and

      3. (iii) One hundred percent (100%) of the federal poverty guideline after June 30, 2003.

    2. (B) Postpone or abolish any increases to the income eligibility standards if program costs exceed projections or if adequate funding is unavailable;

  2. (2) Require qualified residents to pay an annual enrollment fee of twenty-five dollars ($25.00) during the biennium beginning July 1, 2001;

  3. (3) Have the authority to amend the qualified resident enrollment fee by rule beginning July 1, 2003, provided that qualified resident enrollment fee increases may not exceed fifteen percent (15%) during any state fiscal year;

  4. (4) Establish copayments of ten dollars ($10.00) for generic drugs and twenty dollars ($20.00) for name-brand drugs;

  5. (5) Determine eligibility for limited prescription drug benefits under the waiver;

  6. (6) Limit prescription drug benefits under the waiver to two (2) prescriptions per person per month; and

  7. (7) Provide limited prescription drug benefits only in accordance with an approved waiver from the Centers for Medicare & Medicaid Services.


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