S.Amdt. 2382
What it does: Rewrites page 123, line 1 through page 124, line 10
Sen. Max Baucus (D-MT)What it changes
1 change to S. 1932
Rewrites page 123, line 1 through page 124, line 10
ReplacesPrinted pageRemoves page 123, line 1 through page 124, line 10 of the printed bill. See that page
Inserted: (A) January 1, 2009; or
Inserted: (B) the date that is 6 months after the close of the first regular session of the State legislature that begins after the date of enactment of this Act.
Inserted: (c) Interim Upper Payment Limit.--
Inserted: (1) In general.--With respect to a State program under title XIX of the Social Security Act, during the period that begins on January 1, 2006, and ends on the effective date applicable to such State under subsection (b)(3), the Secretary shall--
Inserted: (A) apply the Federal upper payment limit established under section 447.332(b) of title 42, Code of Federal Regulations to the State by substituting "125 percent" for "150 percent";
Inserted: (B) in the case of covered outpatient drugs under title XIX of such Act that are marketed as of July 1, 2005, and are subject to Federal upper payment limits that apply under section 447.332 of title 42, Code of Federal Regulations, use average wholesale prices, direct prices, and wholesale acquisition costs for such drugs that do not exceed such prices and costs as of such date to determine the Federal upper payment limits that apply under section 447.332 of title 42, Code of Federal Regulations to such drugs during such period; and
Inserted: (C) analyze and report to Congress not later than July 1, 2008, on the impact of applying the pharmacy reimbursement limits for multiple source drugs under section 1927(e) of the Social Security Act (as amended by subsection (b) and taking into account the amendments made by subsection (a)), particularly with respect to whether such limits are consistent with acquisition costs for rural and urban pharmacies.
Inserted: (2) Application to new drugs.--Paragraph (1)(A) shall apply to a covered outpatient drug under title XIX of the Social Security Act that is first marketed after July 1, 2005, but before January 1, 2007, and is subject to the Federal upper payment limit established under section 447.332(b) of title 42, Code of Federal Regulations.
Inserted: (d) Extension of Prescription Drug Discounts to Enrollees of Medicaid Managed Care Organizations.--
Inserted: (1) In general.--Section 1903(m)(2)(A) (42 U.S.C. 1396b(m)(2)(A)) is amended--
Inserted: (A) in clause (xi), by striking "and" at the end;
Inserted: (B) in clause (xii), by striking the period at the end and inserting "; and"; and
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Inserted: (C) by adding at the end the following:
Inserted: "(xiii) such contract provides that payment for covered outpatient drugs dispensed to individuals eligible for medical assistance who are enrolled with the entity shall be subject to the same rebate agreement entered into under section 1927 as the State is subject to and that the State shall have the option of collecting rebates for the dispensing of such drugs by the entity directly from manufacturers or allowing the entity to collect such rebates from manufacturers in exchange for a reduction in the prepaid payments made to the entity for the enrollment of such individuals.".
Inserted: (2) Conforming amendment.--Section 1927(j)(1) (42 U.S.C. 1396r-8(j)91)) is amended by inserting "other than for purposes of collection of rebates for the dispensing of such drugs in accordance with the provisions of a contract under section 1903(m) that meets the requirements of paragraph (2)(A)(xiii) of that section" before the period.
Inserted: (3) Effective date.--The amendments made by this subsection take effect on the date of enactment of this Act and apply to rebate agreements entered into or renewed under section 1927 of the Social Security Act (42 U.S.C. 1396r-8) on or after such date.
Original wording
Beginning on page 123, strike line 1 and all that follows through page 124, line 10, and insert the following:
Read automatically from the Congressional Record. Check the original before relying on it.
As printed
SA 2382. Mr. BAUCUS submitted an amendment intended to be proposed by him to the bill S. 1932, to provide for reconciliation pursuant to section 202(a) of the concurrent resolution on the budget for fiscal year 2006 (H. Con. Res. 95); which was ordered to lie on the table; as follows:
Beginning on page 123, strike line 1 and all that follows through page 124, line 10, and insert the following:
(A) January 1, 2009; or
(B) the date that is 6 months after the close of the first regular session of the State legislature that begins after the date of enactment of this Act.
(c) Interim Upper Payment Limit.--
(1) In general.--With respect to a State program under title XIX of the Social Security Act, during the period that begins on January 1, 2006, and ends on the effective date applicable to such State under subsection (b)(3), the Secretary shall--
(A) apply the Federal upper payment limit established under section 447.332(b) of title 42, Code of Federal Regulations to the State by substituting “125 percent” for “150 percent”;
(B) in the case of covered outpatient drugs under title XIX of such Act that are marketed as of July 1, 2005, and are subject to Federal upper payment limits that apply under section 447.332 of title 42, Code of Federal Regulations, use average wholesale prices, direct prices, and wholesale acquisition costs for such drugs that do not exceed such prices and costs as of such date to determine the Federal upper payment limits that apply under section 447.332 of title 42, Code of Federal Regulations to such drugs during such period; and
(C) analyze and report to Congress not later than July 1, 2008, on the impact of applying the pharmacy reimbursement limits for multiple source drugs under section 1927(e) of the Social Security Act (as amended by subsection (b) and taking into account the amendments made by subsection (a)), particularly with respect to whether such limits are consistent with acquisition costs for rural and urban pharmacies.
(2) Application to new drugs.--Paragraph (1)(A) shall apply to a covered outpatient drug under title XIX of the Social Security Act that is first marketed after July 1, 2005, but before January 1, 2007, and is subject to the Federal upper payment limit established under section 447.332(b) of title 42, Code of Federal Regulations.
(d) Extension of Prescription Drug Discounts to Enrollees of Medicaid Managed Care Organizations.--
(1) In general.--Section 1903(m)(2)(A) (42 U.S.C. 1396b(m)(2)(A)) is amended--
(A) in clause (xi), by striking “and” at the end;
(B) in clause (xii), by striking the period at the end and inserting “; and”; and
(C) by adding at the end the following:
“(xiii) such contract provides that payment for covered outpatient drugs dispensed to individuals eligible for medical assistance who are enrolled with the entity shall be subject to the same rebate agreement entered into under section 1927 as the State is subject to and that the State shall have the option of collecting rebates for the dispensing of such drugs by the entity directly from manufacturers or allowing the entity to collect such rebates from manufacturers in exchange for a reduction in the prepaid payments made to the entity for the enrollment of such individuals.”.
(2) Conforming amendment.--Section 1927(j)(1) (42 U.S.C. 1396r-8(j)91)) is amended by inserting “other than for purposes of collection of rebates for the dispensing of such drugs in accordance with the provisions of a contract under section 1903(m) that meets the requirements of paragraph (2)(A)(xiii) of that section” before the period.
(3) Effective date.--The amendments made by this subsection take effect on the date of enactment of this Act and apply to rebate agreements entered into or renewed under section 1927 of the Social Security Act (42 U.S.C. 1396r-8) on or after such date.
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Senate amendment submitted
November 2, 2005