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H.R. 3029House116th Congress (2019-2021)In Committee

Improving Low-Income Access to Prescription Drugs Act of 2019

Sponsored by Pete OlsonRep. Pete Olson (R-TX)
Introduced May 28, 2019

AI-Generated Summary

Updated April 14, 2026 at 5:45 AM UTC

The Improving Low‑Income Access to Prescription Drugs Act of 2019 changes the Social Security Act so that low‑income Medicare beneficiaries who qualify for a drug subsidy but haven’t yet enrolled in a Medicare Part D plan can get immediate drug coverage. It also lets certain dual‑eligible or SSI recipients receive retroactive reimbursement for drugs bought before they enroll. The bill mainly helps people with limited incomes who are new to Medicare drug coverage.

Key Provisions

  • Creates a “Limited Income Newly Eligible Transition (LI NET) Program” that provides temporary Part D drug coverage for subsidy‑eligible individuals who have not yet enrolled in a prescription‑drug or Medicare Advantage‑PD plan.
  • Defines a LI NET eligible individual as someone who qualifies for a low‑income subsidy and either has not enrolled in a drug plan or whose enrollment has not yet taken effect.
  • Provides immediate access to covered drugs at the point of sale from the day the person is identified as subsidy‑eligible until a drug plan becomes active.
  • For full‑benefit dual‑eligible or SSI recipients, the program offers retroactive coverage—reimbursing drug costs for purchases made from the later of the first subsidy eligibility date or up to 36 months before enrollment, ending when the plan takes effect.
  • Mandates that the program be run through a single contract administrator and that it cover all drugs on an open formulary, allow all qualified pharmacies, and meet safety and dispensing standards.
  • Allows the Secretary to waive certain existing Part D requirements (information dissemination, formulary rules, therapy‑management rules) to make the program work.

Legislative Activity

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3 earlier actions
HouseCommittee Latest Action

Subcommittee Hearings Held.

Health Subcommittee

June 4, 2019

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HouseIntro Referral

Introduced in House

May 28, 2019

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Energy and Commerce Committee

May 28, 2019

HouseCommittee

Referred to the Subcommittee on Health.

Health Subcommittee

May 29, 2019

HouseCommittee

Subcommittee Hearings Held.

Health Subcommittee

June 4, 2019

Bill Text

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Introduced in HouseIssued May 28, 2019

I

116th CONGRESS

1st Session

H. R. 3029

IN THE HOUSE OF REPRESENTATIVES

May 28, 2019

Mr. Olson (for himself, Ms. Barragán, Mr. Marchant, and Mr. Lewis) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to provide transitional coverage and retroactive Medicare part D coverage for certain low-income beneficiaries.

1.

Short title

This Act may be cited as the Improving Low-Income Access to Prescription Drugs Act of 2019.

2.

Transitional coverage and retroactive Medicare part D coverage for certain low-income beneficiaries

Section 1860D–14 of the Social Security Act (42 U.S.C. 1395w–114) is amended—

(1)

by redesignating subsection (e) as subsection (f); and

(2)

by adding after subsection (d) the following new subsection:

(e)

Limited income newly eligible transition program

(1)

In general

The Secretary shall carry out a program to provide transitional coverage for covered part D drugs for LI NET eligible individuals in accordance with this subsection.

(2)

LI net eligible individual defined

For purposes of this subsection, the term LI NET eligible individual means a part D eligible individual who—

(A)

is a subsidy eligible individual; and

(B)

has not yet enrolled in a prescription drug plan or an MA–PD plan, or, who has so enrolled, but with respect to whom coverage under such plan has not yet taken effect.

(3)

Transitional coverage

For purposes of this subsection, the term transitional coverage means with respect to an LI NET eligible individual—

(A)

immediate access to covered part D drugs at the point of sale during the period that begins on the first day of the month such individual is determined to be a subsidy eligible individual and ends on the date that coverage under a prescription drug plan or MA–PD plan takes effect with respect to such individual; and

(B)

in the case of an LI NET eligible individual who is a full-benefit dual eligible individual (as defined in section 1935(c)(6)) or a recipient of supplemental security income benefits under title XVI, retroactive coverage (in the form of reimbursement of the amounts that would have been paid under this part had such individual been enrolled in a prescription drug plan or MA–PD plan) of covered part D drugs purchased by such individual during the period that begins on the date that is the later of—

(i)

the date that such individual was first eligible for a low-income subsidy under this part; or

(ii)

the date that is 36 months prior to the date such individual enrolls in a prescription drug plan or MA–PD plan,

and ends on the date that coverage under such plan takes effect.
(4)

Program administration

(A)

Single point of contact

The Secretary shall, to the extent feasible, administer the program under this subsection through a contract with a single program administrator.

(B)

Benefit design

The Secretary shall ensure that the transitional coverage provided to LI NET eligible individuals under this subsection—

(i)

provides access to all covered part D drugs under an open formulary;

(ii)

permits all pharmacies determined by the Secretary to be in good standing to process claims under the program;

(iii)

is consistent with such requirements as the Secretary considers necessary to improve patient safety and ensure appropriate dispensing of medication; and

(iv)

meets such other requirements as the Secretary may establish.

(5)

Relationship to other provisions of this title; waiver authority

(A)

In general

The following provisions shall not apply with respect to the program under this subsection:

(i)

Paragraphs (1) and (3)(B) of section 1860D–4(a) (relating to dissemination of general information; availability of information on changes in formulary through the internet).

(ii)

Subparagraphs (A) and (B) of section 1860D–4(b)(3) (relating to requirements on development and application of formularies; formulary development).

(iii)

Paragraphs (1)(C) and (2) of section 1860D–4(c) (relating to medication therapy management program).

(B)

Waiver authority

The Secretary may waive such other requirements of titles XI and this title as may be necessary to carry out the purposes of the program established under this subsection.

.