New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 167 - PHARMACEUTICAL ASSISTANCE TO THE AGED AND DISABLED ELIGIBILITY MANUAL
Subchapter 4 - SCOPE OF SERVICE
Section 10:167-4.5 - Medicare Part D Prescription Drug Plan premium payments
Universal Citation: NJ Admin Code 10:167-4.5
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The Department shall pay Medicare Part D premiums to the PDP on behalf of PAAD beneficiaries in accordance with the Fiscal Year 2016 Appropriations Act, P.L. 2015, c. 63, approved June 26, 2015, as amended and supplemented by subsequent State appropriations acts.
1. If the PDP is a Medicare-authorized prescription
drug plan associated with a Medicare-managed care plan (MA-PD), the PAAD program shall pay an amount towards
the prescription portion of the premium up to and including the benchmark amount set for New Jersey by CMS
for the current benefit year pursuant to
42 CFR
423.780(b)(2), as amended and supplemented, which is
incorporated herein by reference.
2. If the PDP is an MA-PD and
the premium cost is above the benchmark amount set for New Jersey by CMS, the PAAD beneficiary shall be
responsible for any premium costs that are above the benchmark amount.
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