| Home > 106th Congressional Bills > S. 2343 (rs) To amend the National Historic Preservation Act for purposes of establishing a national historic lighthouse preservation program. [Reported in Senate] ...
S. 2343 (rs) To amend the National Historic Preservation Act for purposes of establishing a national historic lighthouse preservation program. [Reported in Senate] ...
108th CONGRESS 2d Session S. 2343 To amend title XVIII of the Social Security Act to improve the medicare program, and for other purposes. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES April 22, 2004 Mr. Conrad (for himself and Mrs. Lincoln) introduced the following bill; which was read twice and referred to the Committee on Finance _______________________________________________________________________ A BILL To amend title XVIII of the Social Security Act to improve the medicare program, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE; AMENDMENTS TO THE SOCIAL SECURITY ACT; REFERENCES TO MMA AND SECRETARY; TABLE OF CONTENTS. (a) Short Title.--This Act may be cited as the ``Medicare Modernization Improvement Act of 2004''. (b) Amendments to Social Security Act.--Except as otherwise specifically provided, whenever an amendment is expressed in terms of an amendment to or repeal of a section or other provision, the reference shall be considered to be made to that section or other provision of the Social Security Act. (c) References to MMA and Secretary.--In this Act: (1) MMA.--The term ``MMA'' means the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (117 Stat. 2066 et seq.). (2) Secretary.--The term ``Secretary'' means the Secretary of Health and Human Services. (d) Table of Contents.--The table of contents of this Act is as follows: Sec. 1. Short title; amendments to the Social Security Act; references to MMA and Secretary; table of contents. TITLE I--PROVIDING MEDICARE BENEFICIARIES WITH LOWER, NEGOTIATED PRESCRIPTION DRUG PRICES Sec. 101. Negotiating fair prices for medicare prescription drugs. Sec. 102. Importation of prescription drugs. TITLE II--STABILIZING THE MEDICARE PRESCRIPTION DRUG BENEFIT Sec. 201. Requiring two prescription drug plans to avoid Federal fallback. Sec. 202. Improving the stability of the drug benefit. TITLE III--PROVIDING MEDICARE BENEFICIARIES WITH SOURCES OF ADDITIONAL PRESCRIPTION DRUG COVERAGE Sec. 301. Making available wraparound coverage through medigap. TITLE IV--IMPROVED ACCESS TO PHARMACY CARE FOR MEDICARE BENEFICIARIES Sec. 401. Improving access to pharmacy care. TITLE V--REPEAL OF HEALTH SAVINGS ACCOUNTS AND OTHER EMPLOYER RELATED PROVISIONS Sec. 501. Repeal of Health Savings Accounts. TITLE VI--IMPROVEMENT OF CHRONIC CARE MANAGEMENT Sec. 601. Medicare complex clinical care management payment demonstration. TITLE VII--REQUIRING MORE APPROPRIATE PAYMENTS TO PRIVATE PLANS Sec. 701. Elimination of MA regional plan stabilization fund (slush fund). Sec. 702. Requiring private plan payments to reflect appropriate health risk adjustment. Sec. 703. Phase-in private plan payment to 100 percent of fee-for- service rate. TITLE VIII--REPEAL OF PREMIUM SUPPORT PROGRAM Sec. 801. Repeal of premium support program. TITLE IX--PROVIDING BETTER INFORMATION TO MEDICARE BENEFICIARIES Sec. 901. Providing accurate information to beneficiaries. Sec. 902. Providing medicare beneficiaries with better upfront drug coverage information. Sec. 903. Ensuring medicare beneficiaries are informed of formulary changes. TITLE X--FULL FUNDING AND EXPANSION FOR DEMONSTRATION PROJECT FOR COVERAGE OF CERTAIN PRESCRIPTION DRUGS AND BIOLOGICALS Sec. 1001. Full funding and expansion for demonstration project for coverage of certain prescription drugs and biologicals. TITLE I--PROVIDING MEDICARE BENEFICIARIES WITH LOWER, NEGOTIATED PRESCRIPTION DRUG PRICES SEC. 101. NEGOTIATING FAIR PRICES FOR MEDICARE PRESCRIPTION DRUGS. (a) In General.--Section 1860D-11(i) (42 U.S.C. 1395w-111(i)) is amended to read as follows: ``(i) 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 to negotiate contracts with manufacturers of covered part D drugs as necessary to reduce prices and protect access to needed drugs, consistent with the requirements and in furtherance of the goals of providing quality care and containing costs under this part.''. (b) Effective Date.--The amendment made by this section shall take effect as if included in the enactment of section 101 of MMA (117 Stat. 2071). SEC. 102. IMPORTATION OF PRESCRIPTION DRUGS. (a) In General.--Section 804 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 535) is amended-- (1) by striking subsection (l); and (2) by redesignating subsection (m) as subsection (l). (b) Effective Date.--The amendments made by this section shall take effect as if included in the enactment of section 1121 of MMA (117 Stat. 2464). TITLE II--STABILIZING THE MEDICARE PRESCRIPTION DRUG BENEFIT SEC. 201. REQUIRING TWO PRESCRIPTION DRUG PLANS TO AVOID FEDERAL FALLBACK. Section 1860D-3(a) (42 U.S.C. 1395w-103(a)) is amended-- (1) in paragraph (1)-- (A) by striking ``qualifying plans (as defined in paragraph (3))'' and inserting ``prescription drug plans''; and (B) by striking ``, at least one of which is a prescription drug plan''; (2) in paragraph (2), by striking ``qualifying plans'' and inserting ``prescription drug plans''; and (3) by striking paragraph (3). SEC. 202. IMPROVING THE STABILITY OF THE DRUG BENEFIT. (a) In General.--Section 1860D-3 (42 U.S.C. 1395w-103) is amended by adding at the end the following new subsection: ``(c) Fallback Prescription Drug Plans To Be Available for 2 Years.--Notwithstanding subsection (b)(2), if the Secretary provides for the offering of a fallback prescription drug plan under subsection (a) in an area for a year, the following rules shall apply: ``(1) The fallback prescription drug plan shall be available for not less than a 2-year period. ``(2) The Secretary is not required to make the determination under subsection (a)(1) with respect to the second year in which the fallback prescription drug plan is offered in the area. ``(3) During the second year in which the fallback prescription drug plan is offered in an area, any part D eligible individual residing in the area (regardless of whether such individual was enrolled in the fallback prescription drug plan during the previous year) may elect to receive prescription drug coverage under the fallback prescription drug plan or through any other type of qualified prescription drug coverage available in the area, subject to the requirements of section 1860D-1.''. (b) Effective Date.--The amendment made by this section shall take effect as if included in the enactment of section 101 of MMA (117 Stat. 2071). TITLE III--PROVIDING MEDICARE BENEFICIARIES WITH SOURCES OF ADDITIONAL PRESCRIPTION DRUG COVERAGE SEC. 301. MAKING AVAILABLE WRAPAROUND COVERAGE THROUGH MEDIGAP. (a) In General.--Section 1882(v)(1) (42 U.S.C. 1395ss(v)(1)) is amended-- (1) in subparagraph (A), by inserting ``, other than such a policy that provides wraparound prescription drug coverage included within a range of such coverage approved under subparagraph (D)(ii),'' after ``paragraph (6)(A))''; and (2) by adding at the end the following new subparagraph: ``(D) Wraparound prescription drug coverage.-- ``(i) In general.--Notwithstanding any other provision of this subsection, a medigap Rx policy that provides wraparound prescription drug coverage included within a range of such coverage approved by the Secretary under clause (ii) may be offered to part D enrollees. ``(ii) Development of standards.--The Secretary shall approve a range of wraparound prescription drug coverage that may be offered under this subparagraph to part D enrollees.''. (b) Effective Date.--The amendments made by this section shall take effect as if included in the enactment of section 104 of MMA (117 Stat. 2161). TITLE IV--IMPROVED ACCESS TO PHARMACY CARE FOR MEDICARE BENEFICIARIES SEC. 401. IMPROVING ACCESS TO PHARMACY CARE. (a) Application of TriCare Pharmacy Access Standards.--Section 1860D-4(b)(1)(C)(ii) (42 U.S.C. 1395w-104(b)(1)(C)(ii)) is amended-- (1) by striking: ``Application of tricare standards.--The Secretary shall'' and inserting the following: ``Application of tricare standards.-- ``(I) The Secretary shall''; and (2) by adding at the end the following new subclauses: ``(II) In determining whether convenient access has been provided under subclause (I), the Secretary may only consider community retail pharmacies (as defined by the Secretary) that are accessible to the general public. The Secretary may not consider pharmacies located in long- term care facilities, pharmacies located in skilled nursing facilities, pharmacies operated by the Indian Health Service, Indian tribes or tribal organizations, or urban Indian organizations (as defined in section 4 of the Indian Health Care Improvement Act), mail order pharmacies, or pharmacies located in community health centers receiving funds under section 330 of the Public Health Service Act. ``(III) The Secretary shall make a separate determination under subclause (I) with respect to each State within the region served by the prescription drug plan or MA-PD plan.''. (b) Level Playing Field.--Section 1860D-4(b)(1)(D) (42 U.S.C. 1395w-104(b)(1)(D)) is amended to read as follows: ``(D) Level playing field.--Such a sponsor shall permit enrollees to receive the same amount, scope, and duration of drugs and biologicals (which may include a 90-day supply of drugs or biologicals) and medication therapy management services through any pharmacy (other than a mail order pharmacy) as the sponsor permits enrollees to receive through a mail order pharmacy, with any differential in charge paid by such enrollees.''. (c) Provision of Coverage Information by Pharmacies.--Section 1860D-4(a) is amended by adding at the end the following new paragraph: ``(5) Dissemination of information by pharmacists.-- ``(A) Payment to pharmacies.--Subject to subparagraph (C)(ii), beginning on January 1, 2006, and annually thereafter, the Secretary shall make an annual payment to each pharmacy participating in a pharmacy network of a PDP sponsor for providing information to enrollees in prescription drug plans and MA-PD plans offered by that sponsor in an amount determined by the Secretary based on an estimate of the number of enrollees in prescription drug plans and MA-PD plans served by the pharmacy and taking into account the costs of the pharmacy in distributing such information and the availability of funding under subparagraph (C). ``(B) Provision of information to pharmacies.--Each PDP sponsor offering a prescription drug plan or an MA- PD plan shall furnish each pharmacy that participates in its network with the information to be provided under subparagraph (A). ``(C) Funding.-- ``(i) In general.--Subject to clause (ii), the Secretary shall make payments under subparagraph (A) from the Medicare Prescription Drug Account. ``(ii) Limitation.--The Secretary may not make any payments under subparagraph (A) after the date on which a total of $500,000,000 have been expended from such Account as a result of the application of this paragraph.''. (d) Effective Date.--The amendments made by this section shall take effect as if included in the enactment of section 101 of MMA (117 Stat. 2071). TITLE V--REPEAL OF HEALTH SAVINGS ACCOUNTS AND OTHER EMPLOYER RELATED PROVISIONS SEC. 501. REPEAL OF HEALTH SAVINGS ACCOUNTS. Section 1201 of MMA (117 Stat. 2469) is repealed and any provisions of law amended by such section are restored as if such section had not been enacted. TITLE VI--IMPROVEMENT OF CHRONIC CARE MANAGEMENT SEC. 601. MEDICARE COMPLEX CLINICAL CARE MANAGEMENT PAYMENT DEMONSTRATION.
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