II
109th CONGRESS
2d Session
S. 2240
IN THE SENATE OF THE UNITED STATES
February 2, 2006
Mr. Levin (for himself and Ms. Stabenow) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII to reform the Medicare prescription drug program.
Short title
This Act may be cited as
the Medicare Part D Reform Act of
2006
.
Removal of covered part D drugs from the prescription drug plan formulary
Section 1860D–4(b)(3)(E) of the Social Security Act (42 U.S.C. 1395w–104(b)(3)(E)) is amended to read as follows:
Removing drug from formulary or changing preferred or tier status of drug
Limitation on removal or change
Beginning with 2006, the PDP sponsor of a prescription drug plan may not remove a covered part D drug from the plan formulary or change the preferred or tiered cost-sharing status of such a drug other than during the period beginning on September 1 and ending on October 31. Subject to clause (ii), such removal or change shall only be effective beginning on January 1 of the immediately succeeding calendar year.
Notice
Any removal or change under this subparagraph shall not take effect unless appropriate notice is made available (such as under subsection (a)(3)) to the Secretary, affected enrollees, physicians, pharmacies, and pharmacists. Such notice shall ensure that such information is made available prior to the annual, coordinated open election period described in section 1851(e)(3)(B)(iii), as applied under section 1860D–1(b)(1)(B)(iii).
.
Pharmaceutical patient assistance programs
Providing a safe harbor for pharmaceutical patient assistance programs
Section 1128B(b)(3) of the Social Security Act (42 U.S.C. 1320a–7b(b)(3)) is amended—
in subparagraph (G)—
by inserting
or under a patient assistance program (including a pharmaceutical
manufacturer patient assistance program)
after Indian
organizations)
; and
by striking
and
at the end;
in subparagraph (H), as added by section 237(d) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2213)—
by moving such subparagraph 2 ems to the left; and
by striking the
period at the end and inserting ; and
; and
by redesignating subparagraph (H), as added by section 431(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173; 117 Stat. 2287), as subparagraph (I) and moving such subparagraph 2 ems to the left.
Exclusion of expenditures under certain pharmacy assistance programs from TROOP
Section 1860D–2(b)(4)(C)(ii) of such Act (42 U.S.C.
1395w–102(b)(4)(C)(ii)) is amended by inserting under a pharmaceutical
manufacturer patient assistance program,
after a group health
plan,
.
Effective date
The amendments made by this section shall take effect on the date of enactment of this Act.
Protection against cost-sharing for full-benefit dual eligible individuals
In general
Section 1860D–14(a)(1)(D)(ii) of the Social Security Act (42 U.S.C. 1395w–114(a)(1)(D)(ii)) is amended—
in the heading,
by striking Lowest
income
;
by striking
and whose income does not exceed 100 percent of the poverty line
applicable to a family of the size involved
; and
by adding at the
end the following new sentence: In the case of an individual who is
unable to pay the copayment applicable under the preceding sentence, such
copayment shall be waived.
.
Effective Date
The amendments made by this section shall apply to drugs dispensed on or after the date of enactment of this Act.
Negotiating fair prices for medicare prescription drugs
In General
Section 1860D–11 of the Social Security Act (42 U.S.C. 1395w–111) is amended by striking subsection (i) (relating to noninterference) and by inserting the following new subsection:
Authority To Negotiate Prices With Manufacturers
In order to ensure that beneficiaries enrolled under prescription drug plans and MA–PD plans pay the lowest possible price, the Secretary shall have authority similar to that of other Federal entities that purchase prescription drugs in bulk to negotiate contracts with manufacturers of covered part D drugs, consistent with the requirements and in furtherance of the goals of providing quality care and containing costs under this part.
.
Effective Date
The amendment made by this section shall take effect on the date of enactment of this Act.