S.Amdt. 2416

1. Adds SEC. 6005. ELECTRONIC PRESCRIPTION INCENTIVES FOR MEDICAID MANAGED CARE ORGANIZATIONS on page 130, line 25

   Adds a sectionPrinted page

   Inserted: SEC. 6005. ELECTRONIC PRESCRIPTION INCENTIVES FOR MEDICAID MANAGED CARE ORGANIZATIONS.

   Inserted: (a) In General.--Section 1903(m)(2)(A) (42 U.S.C. 1396b(m)(2)(A)) is amended--

   Inserted: (1) in clause (xi), by striking "and" at the end;

   Inserted: (2) in clause (xii), by striking the period at the end and inserting "; and"; and

   Inserted: (3) by adding at the end the following:

   Inserted: "(xiii) notwithstanding clause (x), such contract provides that--

   Inserted: "(I) for each electronic prescription written by a physician during the period beginning on January 1, 2006, and ending on December 31, 2009, the entity shall make a payment of an amount equal to--

   Inserted: "(aa) $1.00, minus

   Inserted: "(bb) an amount equal to the percentage of total claims that consist of electronic prescription drug claims under this title by medicaid managed care organizations (as determined under section 6005(b) of the Deficit Reduction Omnibus Reconciliation Act of 2005, expressed in cents);

   Inserted: "(II) for each non-electronic prescription written by a physician during the period described in subclause (I), the entity shall reduce the dispensing fee otherwise applicable by an amount equal to--

   Inserted: "(aa) $1.00, minus

   Inserted: "(bb) an amount equal to the percentage of total claims under this title by medicaid managed care organizations that consist of non-electronic claims (as so determined and expressed in cents).".

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   Inserted: (b) Data for Determining Electronic Claims.--

   Inserted: (1) In general.--For purposes of section 1903(m)(2)(A)(xiii) of the Social Security Act (as added by subsection (a)), subject to the update required under paragraph (2), in determining the percentage of total claims that consist of electronic prescription drug claims by medicaid managed care organizations under title XIX of the Social Security Act and the percentage of total claims that consist of non-electronic prescription drug claims, the Secretary shall use an estimate of the number of electronic claims and non-electronic claims that will be submitted as of January 1, 2006.

   Inserted: (2) Update.--For each 6 month period beginning after January 1, 2006, the Secretary shall update the estimate of the number of electronic prescription drug claims and non-electronic prescription drug claims used to determine the percentage of total claims that consist of such electronic claims and the percentage of total claims that consist of such non-electronic claims.

   Inserted: (3) Most recent data.--To the extent feasible, the Secretary shall use the most recent data available, including real-time data on drug claims submitted under title XIX pf the Social Security Act with respect to medicaid managed care organizations, to determine the percentage of total claims that consist of electronic claims and the percentage of total claims that consist of non-electronic claims.

   Inserted: (c) Study and Report.--The Comptroller General of the United States shall conduct a study regarding the feasibility of applying electronic prescription incentives similar to the incentives required under section 1903(m)(2)(A)(xiii) of the Social Security Act (as added by subsection (a)) to fee-for-service Medicaid. Not later than January 1, 2007, the Comptroller General shall submit a report to Congress on the results of the study conducted under this subsection.

   Original wording

   On page 130, after line 25, add the following:

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As printed