[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1291 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 1291
To amend the Public Health Service Act to include State high risk pool
insurance programs in the list of covered entities that receive
reductions in the prices charged for prescription drugs under the
prescription drug pricing agreements under section 340B of that Act.
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IN THE HOUSE OF REPRESENTATIVES
March 13, 2003
Mr. Udall of Colorado introduced the following bill; which was referred
to the Committee on Energy and Commerce
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A BILL
To amend the Public Health Service Act to include State high risk pool
insurance programs in the list of covered entities that receive
reductions in the prices charged for prescription drugs under the
prescription drug pricing agreements under section 340B of that Act.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``State High Risk Pool Drug Assistance
Program Act of 2003''.
SEC. 2. INCLUSION OF STATE HIGH RISK POOL INSURANCE PROGRAMS AS A 340B
COVERED ENTITY.
Section 340B(a)(4) of the Public Health Service Act (42 U.S.C.
256b(a)(4)) is amended by adding at the end the following:
``(M) A State-operated qualified high risk pool
that provides for premium rates and covered benefits
for such coverage consistent with standards included in
the National Association of Insurance Commissioners
Model Health Plan for Uninsurable Individuals, subject
to such conditions as the Secretary may establish by
regulation, which shall include the following:
``(i) The pool establishes criteria for
individuals eligible to obtain benefits through
the pool.
``(ii) Eligible individuals are given a
card identifying them as high risk pool
members.
``(iii) Pharmacies that fill prescriptions
for eligible individuals may bill the
administrator or pharmacy benefit manager of
the pool.
``(iv) The pool has a direct relationship
to the eligible individual that includes--
``(I) maintaining records of the
individual's health care claims; and
``(II) the receipt by the
individuals of health care services
from contracted network providers.
``(v) The pool serves at least individuals
who would be eligible under the provisions of
any of subparagraphs (A) through (L) but for
level of income.
In the case of such a pool, nothing in clause (v) shall be
construed as limiting the application of the agreement under
this section to individuals described in such clause.''.
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