S.Amdt. 1008
What it does: Inserts new text on page 134, between lines 9 and 10
Sen. Rick Santorum (R-PA)What it changes
1 change to S. 1
Inserts new text on page 134, between lines 9 and 10
InsertsPrinted pageInserted: (d) Zero Premium Stop-Loss Protection and Access to Negotiated Prices For Certain Eligible Beneficiaries Enrolled in the Original Medicare Fee-For-Service Program After 2013.--
Inserted: (1) In general.--Notwithstanding the preceding provisions of this part, the following rules shall apply with respect to an applicable eligible beneficiary enrolled in a Medicare Prescription Drug plan or under a contract under section 1860D-13(e):
Inserted: (A) No premium.--Notwithstanding sections 1860D-13(e)(2) and 1860D-17, the monthly beneficiary obligation for enrollment in the Medicare Prescription Drug plan or under a contract under section 1860D-13(e) shall be zero.
Inserted: (B) Beneficiary receives access to negotiated prices and stop-loss protection for no additional premium.--Notwithstanding section 1860D-6, qualified prescription drug coverage shall include coverage of covered drugs that meets the following requirements:
Inserted: (i) The coverage has cost-sharing (for costs up to the annual out-of-pocket limit under subsection (c)(4) of such section) that is equal to 100 percent.
Inserted: (ii) The coverage provides the limitation on out-of-pocket expenditures under such subsection (c)(4).
Inserted: (ii) The coverage provides access to negotiated prices under subsection (e) of such section during the entire year.
Inserted: (C) Application of low-income subsidies.--Notwithstanding section 1860D-19, the Administrator shall not apply the following provisions of subsection (a) of such section:
Inserted: (i) Subparagraphs (A), (B), (C), and (D) of paragraph (1).
Inserted: (ii) Subparagraphs (A), (B), (C), and (D) of paragraph (2).
Inserted: (iii) Clauses (i), (ii), (iii), and (iv) of paragraph (3)(A).
Inserted: (2) Applicable eligible beneficiary.--For purposes of this subsection, the term 'applicable eligible beneficiary' means an eligible beneficiary who--
Show 4 more inserted paragraphsShow less
Inserted: (A) is enrolled under this part; and
Inserted: (B) became an eligible beneficiary for the first time on or after January 1, 2014.
Inserted: (3) Procedures.--The Administrator shall establish procedures to carry out this subsection. Under such procedures, the Administrator may waive or modify any of the preceding provisions of this part to the extent necessary to carry out this subsection.
Inserted: (4) No effect on beneficiaries enrolled in a medicareadvantage plan that provides qualified prescription drug coverage.--This subsection shall have no effect on eligible beneficiaries enrolled in this part and under a MedicareAdvantage plan that provides qualified prescription drug coverage.
Original wording
On page 134, between lines 9 and 10, insert the following:
Read automatically from the Congressional Record. Check the original before relying on it.
As printed
SA 1008. Mr. SANTORUM submitted an amendment intended to be proposed by him to the bill S. 1, to amend title XVIII of the Social Security Act to make improvements in the medicare program, to provide prescription drug coverage under the medicare program, and for other purposes; which was ordered to lie on the table; as follows:
On page 134, between lines 9 and 10, insert the following:
“(d) Zero Premium Stop-Loss Protection and Access to Negotiated Prices For Certain Eligible Beneficiaries Enrolled in the Original Medicare Fee-For-Service Program After 2013.--
“(1) In general.--Notwithstanding the preceding provisions of this part, the following rules shall apply with respect to an applicable eligible beneficiary enrolled in a Medicare Prescription Drug plan or under a contract under section 1860D-13(e):
“(A) No premium.--Notwithstanding sections 1860D-13(e)(2) and 1860D-17, the monthly beneficiary obligation for enrollment in the Medicare Prescription Drug plan or under a contract under section 1860D-13(e) shall be zero.
“(B) Beneficiary receives access to negotiated prices and stop-loss protection for no additional premium.--Notwithstanding section 1860D-6, qualified prescription drug coverage shall include coverage of covered drugs that meets the following requirements:
“(i) The coverage has cost-sharing (for costs up to the annual out-of-pocket limit under subsection (c)(4) of such section) that is equal to 100 percent.
“(ii) The coverage provides the limitation on out-of-pocket expenditures under such subsection (c)(4).
“(ii) The coverage provides access to negotiated prices under subsection (e) of such section during the entire year.
“(C) Application of low-income subsidies.--Notwithstanding section 1860D-19, the Administrator shall not apply the following provisions of subsection (a) of such section:
“(i) Subparagraphs (A), (B), (C), and (D) of paragraph (1).
“(ii) Subparagraphs (A), (B), (C), and (D) of paragraph (2).
“(iii) Clauses (i), (ii), (iii), and (iv) of paragraph (3)(A).
“(2) Applicable eligible beneficiary.--For purposes of this subsection, the term ‘applicable eligible beneficiary' means an eligible beneficiary who--
“(A) is enrolled under this part; and
“(B) became an eligible beneficiary for the first time on or after January 1, 2014.
“(3) Procedures.--The Administrator shall establish procedures to carry out this subsection. Under such procedures, the Administrator may waive or modify any of the preceding provisions of this part to the extent necessary to carry out this subsection.
“(4) No effect on beneficiaries enrolled in a medicareadvantage plan that provides qualified prescription drug coverage.--This subsection shall have no effect on eligible beneficiaries enrolled in this part and under a MedicareAdvantage plan that provides qualified prescription drug coverage.”.
Legislative Activity
Stay on top of the latest movement without scrolling through every action
Senate amendment submitted
June 24, 2003