II
109th CONGRESS
1st Session
S. 239
IN THE SENATE OF THE UNITED STATES
February 1, 2005
Ms. Snowe (for herself, Mr. Wyden, Mr. McCain, Mrs. Feinstein, and Mr. Feingold) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To reduce the costs of prescription drugs for medicare beneficiaries, and for other purposes.
Short title
This Act may be cited as the
Medicare Enhancements for Needed Drugs
Act of 2005
.
GAO studies and reports on prices of prescription drugs
Review and reports on retail prices of prescription drugs
Initial review
The Comptroller General of the United States shall conduct a review of the retail cost of prescription drugs in the United States during 2000 through 2003, with an emphasis on the prescription drugs most utilized for individuals age 65 or older.
Subsequent review
After conducting the review under paragraph (1), the Comptroller General shall continuously review the retail cost of such drugs through April 1, 2006, to determine the changes in such costs.
Reports
Initial review
Not later than September 1, 2005, the Comptroller General shall submit to Congress a report on the initial review conducted under paragraph (1).
Subsequent review
Not later than July 1, 2006, January 1, 2007, and July 1, 2007, the Comptroller General shall submit to Congress a report on the subsequent review conducted under paragraph (2).
Annual GAO study and report on retail and acquisition prices of certain prescription drugs
Ongoing study
The Comptroller General of the United States shall conduct an ongoing study that compares the average retail cost in the United States for each of the 20 most utilized prescription drugs for individuals age 65 or older with—
the average price at which private health plans acquire each such drug;
the average price at which the Department of Defense under the Defense Health Program acquires each such drug;
the average price at which the Department of Veterans Affairs under the laws administered by the Secretary of Veterans Affairs acquires each such drug; and
the average negotiated price for each such drug that eligible beneficiaries enrolled in a prescription drug plan under part D of title XVIII of the Social Security Act, as added by section 101 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173), that provides only basic prescription drug coverage have access to under such plans.
Annual report
Not later than December 1, 2007, and annually thereafter, the Comptroller General shall submit to Congress a report on the study conducted under paragraph (1), together with such recommendations as the Comptroller General determines appropriate.
Inclusion of average aggregate beneficiary costs and savings in comparative information for basic medicare prescription drug plans
Section 1860D–1(c)(3) of the Social Security Act (42 U.S.C. 1395w–101(c)(3)) is amended—
in subparagraph (A)—
in the matter preceding
clause (i), by striking subparagraph (B)
and inserting
subparagraphs (B) and (C)
; and
by adding at the end the following new clause:
Average aggregate beneficiary costs and savings
With respect to plan years beginning on or after January 1, 2007, the average aggregate costs, including deductibles and other cost-sharing, that a beneficiary will incur for covered part D drugs in the year under the plan compared to the average aggregate costs that an eligible beneficiary with no prescription drug coverage will incur for covered part D drugs in the year.
; and
by adding at the end the following new subparagraph:
Average aggregate beneficiary costs and savings information only for basic prescription drug plans
The Secretary shall not provide comparative information under subparagraph (A)(vi) with respect to—
a prescription drug plan that provides supplemental prescription drug coverage; or
a Medicare Advantage plan.
.
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:
Authority To negotiate prices with manufacturers
In general
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.
Mandatory responsibilities
The Secretary shall be required to—
negotiate contracts with manufacturers of covered part D drugs for each fallback prescription drug plan under subsection (g); and
participate in negotiation of contracts of any covered part D drug upon request of an approved prescription drug plan or MA–PD plan.
Rule of construction
Nothing in paragraph (2) shall be construed to limit the authority of the Secretary under paragraph (1) to the mandatory responsibilities under paragraph (2).
.
Effective date
The amendment made by this section shall take effect as if included in the enactment of section 101 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173).
NAIC review and report on changes in medigap policies that provide coverage of prescription drugs contained in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
In general
The Secretary of Health and Human Services shall request the National Association of Insurance Commissioners to conduct a review of the changes to the rules relating to medicare supplemental policies that provide prescription drug coverage contained in subsection (v) of section 1882 of the Social Security Act (42 U.S.C. 1395ss), as added by section 104(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173).
Impact on medicare beneficiaries
The review conducted pursuant to subsection (a) should focus on the impact the changes described in such subsection will have on medicare beneficiaries.
Report
The Secretary shall request the National Association of Insurance Commissioners to submit to Congress, by not later than January 1, 2006, a report on the review conducted pursuant to subsection (a), together with such recommendations as the National Association of Insurance Commissioners determines appropriate.