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Effective – 28 Aug 2014, 2 histories

208.780. Definitions. — As used in sections 208.780 to 208.798, the following terms shall mean:

(1) “Asset test”, the asset limits as defined by the Medicare Prescription Drug Improvement and Modernization Act, P.L. 108-173;

(2) “Contractor”, the person, partnership, or corporate entity which has an approved contract with the department to administer the pharmaceutical assistance program established under sections 208.780 to 208.798 and this chapter;

(3) “Department”, the department of social services;

(4) “Division”, the MO HealthNet division of the department of social services;

(5) “Enrollee”, a resident of this state who meets the conditions specified in sections 208.780 to 208.798 and in department regulations relating to eligibility for participation in the Missouri Rx plan and whose application for enrollment in the Missouri Rx plan has been approved by the department;

(6) “Federal poverty guidelines”, the federal poverty guidelines updated annually in the Federal Register by the United States Department of Health and Human Services under the authority of 42 U.S.C. Section 9902(2);

(7) “Liquid assets”, assets used in the eligibility determination process as defined by the Medicare Modernization Act;

(8) “Medicaid dual eligible” or “dual eligible”, a person who is eligible for both Medicare and Medicaid as defined by the Medicare Modernization Act;

(9) “Medicare Modernization Act” or “MMA”, the Medicare Prescription Drug, Improvement and Modernization Act of 2003, P.L. 108-173;

(10) “Medicare Part D prescription drug benefit”, the prescription benefit provided under the Medicare Modernization Act, as it may vary from one prescription drug plan to another;

(11) “Missouri resident”, a person who has or intends to have a fixed place of residence in Missouri, with the present intent of maintaining a permanent home in Missouri for the indefinite future;

(12) “Missouri Rx plan”, the state pharmacy assistance program created in section 208.782, or the combination of state and federal programs providing services to the population described in section 208.784;

(13) “Participating pharmacy”, a pharmacy that elects to participate as a pharmaceutical provider and enters into a participating network agreement with the department or contractor;

(14) “Prescription drug plan” or “PDP”, nongovernmental drug plans under contract with the Center for Medicare and Medicaid Services to provide prescription benefits under the Medicare Modernization Act;

(15) “Prescription drugs”, outpatient prescription drugs that have been approved as safe and effective by the United States Food and Drug Administration. Prescription drugs do not include experimental drugs or over-the-counter pharmaceutical products;

(16) “Program”, the Missouri Rx plan created under sections 208.780 to 208.798.

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(L. 2005 S.B. 539, A.L. 2014 H.B. 1299 Revision)

Terminates 8-28-29