BILL NUMBER: S3005B
SPONSOR: CLEARE
 
TITLE OF BILL:
An act to amend the elder law, in relation to establishing the expanded
pharmaceutical insurance coverage panel
 
PURPOSE:
This bill will establish the expanded pharmaceutical insurance coverage
panel to restore oversight and transparency to the function of the
program and allow for future decisions to be made in an accountable
fashion.
 
SUMMARY OF SPECIFIC PROVISIONS:
This Bill Restores the EPIC panel and the advisory committee, 60% of the
later being composed of consumers, and requires an annual report.
 
JUSTIFICATION:
THE EPIC program has made numerous changes administratively that have
negatively impacted enrollees without a public process to review
proposed changes. These changes include: òa change in the application
starting in 2020, that* requires enrollees to determine if they must
disclose asset, not otherwise a program requirement, if they fall into
the income category that would allow them to apply for the federal Low
Income Subsidy (LIS.) In prior years, an EPIC applicant was enrolled in
without an asset test and if the EPIC staff found that the self-reported
income could qualify for LIS (150% FPL,) the enrollee would be contacted
for additional information on assets so that an application to LIS was
completed on behalf of the enrollee. Additionally, while the current
statute includes a role for'EPIC staff to assist enrollees who are
eligible for the Medicare Savings Program (MSP, 135% FPL,) which without
an asset test, will also qualify an enrollee for LIS, the EPIC program
does not assist with MSP enrollment or make a referral to an agency that
will.
* a change implemented in October 2019 that eliminated the previous
benefit to include payment of any Medicare Part D late enrollment penal-
ty for certain enrollees.
* a change in January 2020 that eliminates past records of EPIC partic-
ipation for any enrollee that failed to pay their quarterly dues on
time. Their EPIC number and all income information on their records is
now eradicated, and upon late payment of the dues an enrollee must reap-
ply for the program as if they were never a member. In addition to
making corrections to restore and improve program operations, the chang-
es noted above are addressed in this bill. Further, in order to improve
transparency and accountability, the EPIC panel and advisory committee
are re-convened, along with a requirement for an annual report to the
Legislature.
 
FISCAL IMPLICATIONS:
To be determined, but has been made difficult without publicly available
annual reports on the program. In part, costs associated with prograth
expansion to a lower age limit will be offset by rejecting the proposed
program savings of $16.5m proposed for SFY 2020-21.
 
EFFECTIVE DATE:
This act shall take effect immediately.

Statutes affected:
S3005: 240 elder law, 250 elder law, 250(3) elder law
S3005A: 240 elder law, 250 elder law, 250(3) elder law