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State Prescription Assistance Discontinued

Department of Human Services News Release

The State Pharmacy Assistance Program (SPAP), which subsidizes the co-payment for Medicare prescriptions for low-income seniors, will be discontinued due to a lack of funding, announced the program’s administrator, the Department of Human Services (DHS). This change, effective July 1, 2011, will affect 43,500 eligible Hawaii residents enrolled in the program.

SPAP began in 2007 as a state funded program to subsidize Medicare Part D co-payments for low-income seniors. The state legislature planned to pay for the program through the creation of an SPAP special fund. However, money was never allocated to this fund. The state legislature this session repealed the special fund and SPAP through the passage of Senate Bill 120, which Gov. Neil Abercrombie signed into law. The program cost $1.5 million in state funds in fiscal year 2010 for 21,561 regular users and does not receive any federal funding support.

As Senate Bill 120 moved through the Legislature, DHS presented its potential impacts to lawmakers and the community at several Medicaid forums. The discontinuation of SPAP was then incorporated into overall plans to reduce the DHS Med-QUEST budget.

“After much thought and multiple conversations with community groups, we made the difficult decision to end this program,” said DHS Director Pat McManaman. “We will continue to pursue opportunities to restore medical assistance for low-income residents through all available means including patient centered medical homes, electronic health records, and modernization of our information technology infrastructure.

Ending SPAP will not affect eligibility for Medicare Part D, though many recipients will be now responsible for making co-payments. The average user of the SPAP program had monthly co-payments of approximately $6. Nursing facility patients with stays exceeding 30 days and individuals receiving home and community-based services are not required to make co-payments.
Elderly recipients who qualify for both Medicare and Medicaid are able to enroll in a Medicare Dual Eligible Special Needs Plan (DE-SNP), which may help cover the cost of their monthly co-payments.

DHS Med-QUEST will notify those who qualify by mail and provide additional enrollment information prior to the Medicare open enrollment period this fall. SPAP users with questions about these changes can contact Med-QUEST Customer Service by calling 1-800-316-8005.

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