A bill to amend title XVIII of the Social Security Act to provide a prescription drug benefit for the aged and disabled under the medicare program, to enhance the preventative benefits covered under such program, and for other purposes.
(Sec. 101) Directs the Secretary of Health and Human Services to study and report on the feasibility and advisability of establishing an annual open enrollment period under the new part D program.
(Sec. 102) Amends SSA title XIX (Medicaid) to: (1) provide for coverage for certain low-income individuals of part D premiums; (2) require State Medicaid plans to provide that in the case of any individual whose eligibility for medical assistance is not limited to Medicare or Medicare drug cost-sharing, and for whom the State elects to pay monthly premiums under part D, the State will purchase all prescription drugs, without regard to whether the benefit limit for such individual has been reached; (3) require Government payment of Medicare drug cost-sharing for qualified Medicare beneficiaries and for Medicare-eligible individuals with incomes between 100 and 150 percent of the Federal poverty line; and (4) make provisions on payment for covered outpatient drugs inapplicable to prescription drugs purchased under part D pursuant to an agreement with the Secretary under the special eligibility, enrollment, and copayment rules below for low-income individuals.
Amends SSA title XVIII part D to outline special eligibility, enrollment, and copayment rules for low-income individuals, which include options for continuation of Medicaid coverage or enrollment under such part.
Amends SSA title XIX to remove the sunset date for cost-sharing in Medicare part B premiums for certain qualifying individuals.
Repeals provisions on State coverage of Medicare cost-sharing for additional low-income Medicare beneficiaries.
(Sec. 103) Directs the Secretary to submit to Congress recommendations on structuring a catastrophic drug benefit for Medicare beneficiaries. Establishes the Catastrophic Prescription Drug Coverage Reserve Fund and makes appropriations to it.
(Sec. 104) Amends SSA title XVIII to provide for comprehensive immunosuppressive drug Medicare coverage for organ transplant patients.
(Sec. 105) Directs the Comptroller General to study and report to Congress on the prescription drug benefit program under part D.
(Sec. 106) Directs the Medicare Payment Advisory Commission (MEDPAC) to take similar action, including an analysis of such program's impact on the pharmaceutical market, franchise, independent, and rural pharmacies, and beneficiary access to prescription drugs.
Title II: Enhanced Medicare Prevention Program - Amends SSA title XVIII to direct MEDPAC to report annually to Congress on the actuarial equivalence of Medicare and private sector benefit packages.
(Sec. 202) Requires the Director of the National Institute on Aging to conduct studies on improving the quality of life for the elderly, developing better ways to prevent or delay the onset of age-related functional decline and disease among the elderly, and developing means of assessing the long-term development of cost-effective and cost-saving benefits for health promotion and disease among the elderly. Authorizes appropriations.
(Sec. 203) Requires the Secretary to contract with the Institute of Medicine to study and report to the President along with appropriate legislative recommendations for Congress with respect to current literature and best practices in the field of health promotion and disease prevention among Medicare beneficiaries. Provides for fast-track consideration by Congress of such presidential report and accompanying recommendations.
Introduced in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 609.
Introduced in Senate
Sponsor introductory remarks on measure. (CR S3839-3840)
Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S3840-3848)
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