Code of the District of Columbia

§ 48–831.23. Payment for drugs by low-income elderly.

(a) The Director shall establish the amount of payment to be made by eligible low-income elderly individuals toward the cost of prescription or nonprescription drugs, medications, and medical supplies furnished under AccessRx for low-income elderly; provided, that:

(1) The total cost paid by the low-income elderly individual for any covered purchase of a prescription or nonprescription drug or medication provided under the basic component of AccessRx does not exceed 20% of the price allowed for that prescription under AccessRx rules, or $2, whichever is greater; and

(2) For the supplemental component of AccessRx, except as otherwise provided in this section, the total cost paid by the low-income elderly individual for any covered purchase of a prescription drug or medication shall not exceed 50% of the price allowed for that prescription under AccessRx.

(b) Prior to January 1, 2006, the Director shall establish annual limits on the costs incurred by eligible household members for prescription or nonprescription drugs or medications covered under AccessRx for low-income elderly. After the annual limits have been established, beginning on January 1, 2007, AccessRx for low-income elderly shall pay 80% of the cost of all prescription or nonprescription drugs or medications covered by the supplemental component of AccessRx. The limits shall be set by the Director by regulation as necessary to operate the program within the AccessRx for low-income elderly budget.