1998 Minnesota Statutes

     256.9364 Post-kidney transplant drug program. 

    Subdivision 1.    Establishment.  The commissioner of 
 human services shall establish and administer a program to pay 
 for costs of drugs prescribed exclusively for post-kidney 
 transplant maintenance when those costs are not otherwise 
 reimbursed by a third-party payer.  The commissioner may 
 contract with a nonprofit entity to administer this program.  

    Subd. 2.    Eligibility requirements.  To be eligible 
 for the program, an applicant must satisfy the following 
 requirements:  

    (1) the applicant's family gross income must not exceed 275 
 percent of the federal poverty level; and 

    (2) the applicant must be a Minnesota resident who has 
 resided in Minnesota for at least 12 months.  

 An applicant shall not be excluded because the applicant 
 received the transplant outside the state of Minnesota, so long 
 as the other requirements are met. 

    Subd. 3.    Payment amounts.  (a) The amount of the 
 payments made for each eligible recipient shall be based on the 
 following: 

    (1) available funds; and 

    (2) the cost of the post-kidney transplant maintenance 
 drugs.  

    (b) The payment rate under this program must be no greater 
 than the medical assistance reimbursement rate for the 
 prescribed drug. 

    (c) Payments shall be made to or on behalf of an eligible 
 recipient for the cost of the post-kidney transplant maintenance 
 drugs that is not covered, reimbursed, or eligible for 
 reimbursement by any other third party or government entity, 
 including, but not limited to, private or group health 
 insurance, medical assistance, Medicare, the Veterans 
 Administration, the senior citizen drug program established 
 under section 256.955, or under any waiver arrangement received 
 by the state to provide a prescription drug benefit for 
 qualified Medicare beneficiaries or service-limited Medicare 
 beneficiaries.  

    (d) The commissioner may restrict or categorize payments to 
 meet the appropriation allocated for this program. 

    (e) Any cost of the post-kidney transplant maintenance 
 drugs that is not reimbursed under this program is the 
 responsibility of the program recipient. 

    Subd. 4.    Drug formulary.  The commissioner shall 
 maintain a drug formulary that includes all drugs eligible for 
 reimbursement by the program.  The commissioner may use the drug 
 formulary established under section 256B.0625, subdivision 13.  
 The commissioner shall establish an internal review procedure 
 for updating the formulary that allows for the addition and 
 deletion of drugs to the formulary.  The drug formulary must be 
 reviewed at least quarterly per fiscal year. 

    Subd. 5.    Private donations.  The commissioner may 
 accept funding from other public or private sources. 

    Subd. 6.    Sunset.  This program expires on July 1, 
 2000. 

    HIST: 1998 c 407 art 4 s 6