§ 42-66.2-6. Responsibilities of office of healthy aging. (a) Determination of eligibility. The department shall adopt regulations relating to the determination of eligibility of prospective consumers and the determination and elimination of program abuse. The department has the power to declare ineligible any consumer who abuses or misuses the established prescription plan. The department has the power to investigate cases of suspected provider or consumer fraud.

(b) Program criteria. The program includes the following criteria:

(1) Senior citizens participating in the program are required to maintain records of each transaction as specified by the director in accordance with subsection 42-66.2-4(c);

(2) Prescription benefits for any single prescription may be dispensed in the amounts authorized by the physician, and agreed to by the consumer, up to a maximum of a one hundred (100) day supply or two hundred (200) doses, whichever is less and/or a one hundred (100) day supply or one quart of liquid, whichever is less; provided, however, that disposable insulin syringes are dispersed in a quantity of one hundred (100);

(3) Experimental drugs are excluded from the program;

(4) A system of mail order delivery for prescriptions is allowed under this program; and

(5) Eligible and additional drugs must be dispensed within one year of the original prescription order.

(c) The director shall provide a mechanism, within the department, to handle all public inquiries concerning the program.

(d) The director shall establish a process, in accordance with the Administrative Procedures Act, chapter 35 of this title, to provide an appeals hearing on the determination of eligibility.

(e) The director shall forward to the contractor a list of all eligible consumers.

(f) Expenditures for multiple sclerosis drugs shall not exceed thirty thousand dollars ($30,000).

(g) Generic drug substitution is mandatory when there is an available generic drug equivalent.

History of Section. (P.L. 1985, ch. 343, § 1; P.L. 1986, ch. 361, § 1; P.L. 1992, ch. 133, art. 52, § 1; P.L. 2000, ch. 101, § 1; P.L. 2002, ch. 65, art. 37, § 1; P.L. 2004, ch. 595, art. 41, § 1; P.L. 2006, ch. 246, art. 9, § 1; P.L. 2008, ch. 100, art. 8, § 2; P.L. 2011, ch. 151, art. 23, § 4.)