[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5467 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 5467

  To provide for substantial reductions in the price of prescription 
 drugs for Medicare beneficiaries and for women diagnosed with breast 
                                cancer.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 12, 2000

  Mrs. McCarthy of New York introduced the following bill; which was 
referred to the Committee on 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 provide for substantial reductions in the price of prescription 
 drugs for Medicare beneficiaries and for women diagnosed with breast 
                                cancer.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Breast Cancer Prescription Drug 
Fairness Act''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--The Congress finds the following:
            (1) All women are at risk for breast cancer and that risk 
        increases with age.
            (2) Breast cancer is the most common cancer among women.
            (3) Annually, there are 180,200 new cases of breast cancer 
        in the United States, and 2,000 on Long Island, New York, 
        alone.
            (4) Manufacturers of prescription drugs engage in price 
        discrimination practices that compel many older Americans and 
        women to pay substantially more for prescription drugs than the 
        drug manufacturers' most favored customers, such as health 
        insurers, health maintenance organizations, and the Federal 
        Government.
            (5) On average, older Americans and women who buy their own 
        prescription drugs pay twice as much for prescription drugs as 
        the drug manufacturers' most favored customers. In some cases, 
        older Americans and women pay over 15 times more for 
        prescription drugs than the most favored customers.
            (6) The discriminatory pricing by major drug manufacturers 
        sustains their annual profits of $20,000,000,000, but causes 
        financial hardship and impairs the health and well-being of 
        millions of older Americans and women. More than one in eight 
        older Americans and women are forced to choose between buying 
        their food and buying their medicines.
            (7) Most federally funded health care programs, including 
        Medicaid, the Veterans Health Administration, the Public Health 
        Service, and the Indian Health Service, obtain prescription 
        drugs for their beneficiaries at low prices. Medicare 
        beneficiaries are denied this benefit and cannot obtain their 
        prescription drugs at the favorable prices available to other 
        federally funded health care programs.
            (8) Implementation of the policy set forth in this Act is 
        estimated to reduce prescription drug prices for Medicare 
        beneficiaries by more than 40 percent.
            (9) In addition to substantially lowering the costs of 
        prescription drugs for older Americans and women, 
        implementation of the policy set forth in this Act will 
        significantly improve the health and well-being of older 
        Americans and women and lower the costs to the Federal taxpayer 
        of the Medicare program.
            (10) Older Americans and women who are terminally ill and 
        receiving hospice care services represent some of the most 
        vulnerable individuals in our nation. Making prescription drugs 
        available to Medicare beneficiaries under the care of Medicare-
        certified hospices will assist in extending the benefits of 
        lower prescription drug prices to those most vulnerable and in 
        need.
    (b) Purpose.--The purpose of this Act is to protect women diagnosed 
with breast cancer and Medicare beneficiaries from discriminatory 
pricing by drug manufacturers and to make prescription drugs available 
to Medicare beneficiaries at substantially reduced prices.

SEC. 3. PARTICIPATING MANUFACTURERS.

    (a) In General.--Each participating manufacturer of a covered 
outpatient drug shall make available for purchase by each pharmacy such 
covered outpatient drug in the amount described in subsection (b) at 
the price described in subsection (c).
    (b) Description of Amount of Drugs.--The amount of a covered 
outpatient drug that a participating manufacturer shall make available 
for purchase by a pharmacy is an amount equal to the aggregate amount 
of the covered outpatient drug sold or distributed by the pharmacy to 
Medicare beneficiaries.
    (c) Description of Price.--The price at which a participating 
manufacturer shall make a covered outpatient drug available for 
purchase by a pharmacy is the price equal to the lower of the 
following:
            (1) The lowest price paid for the covered outpatient drug 
        by any agency or department of the United States.
            (2) The manufacturer's best price for the covered 
        outpatient drug, as defined in section 1927(c)(1)(C) of the 
        Social Security Act (42 U.S.C. 1396r-8(c)(1)(C)).

SEC. 4. SPECIAL PROVISION WITH RESPECT TO HOSPICE PROGRAMS.

    For purposes of determining the amount of a covered outpatient drug 
that a participating manufacturer shall make available for purchase by 
a pharmacy under section 3, there shall be included in the calculation 
of such amount the amount of the covered outpatient drug sold or 
distributed by a pharmacy to a hospice program. In calculating such 
amount, only amounts of the covered outpatient drug furnished to a 
Medicare beneficiary enrolled in the hospice program shall be included.

SEC. 5. ADMINISTRATION.

    The Secretary shall issue such regulations as may be necessary to 
implement this Act.

SEC. 6. REPORTS TO CONGRESS REGARDING EFFECTIVENESS OF ACT.

    (a) In General.--Not later than 2 years after the date of the 
enactment of this Act, and annually thereafter, the Secretary shall 
report to the Congress regarding the effectiveness of this Act in--
            (1) protecting Medicare beneficiaries from discriminatory 
        pricing by drug manufacturers, and
            (2) making prescription drugs available to Medicare 
        beneficiaries at substantially reduced prices.
    (b) Consultation.--In preparing such reports, the Secretary shall 
consult with public health experts, affected industries, organizations 
representing consumers and older Americans and women, and other 
interested persons.
    (c) Recommendations.--The Secretary shall include in such reports 
any recommendations they consider appropriate for changes in this Act 
to further reduce the cost of covered outpatient drugs to Medicare 
beneficiaries.

SEC. 7. DEFINITIONS.

    In this Act:
            (1) Participating manufacturer.--The term ``participating 
        manufacturer'' means any manufacturer of drugs or biologicals 
        that, on or after the date of the enactment of this Act, enters 
        into a contract or agreement with the United States for the 
        sale or distribution of covered outpatient drugs to the United 
        States.
            (2) Covered outpatient drug.--The term ``covered outpatient 
        drug'' has the meaning given that term in section 1927(k)(2) of 
        the Social Security Act (42 U.S.C. 1396r-8(k)(2)).
            (3) Medicare beneficiary.--The term ``Medicare 
        beneficiary'' means an individual entitled to benefits under 
        part A of title XVIII of the Social Security Act or enrolled 
        under part B of such title, or both, and includes individuals 
        who are not so entitled or enrolled but who have been diagnosed 
        with breast cancer.
            (4) Hospice program.--The term ``hospice program'' has the 
        meaning given that term under section 1861(dd)(2) of the Social 
        Security Act (42 U.S.C. 1395x(dd)(2)).
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

SEC. 8. EFFECTIVE DATE.

    The Secretary shall implement this Act as expeditiously as 
practicable and in a manner consistent with the obligations of the 
United States.

SEC. 9. STUDY ON LIFE EXPECTANCY OF WOMEN DIAGNOSED WITH BREAST CANCER 
              WHO LACK PRESCRIPTION DRUG COVERAGE.

    (a) Study.--The Secretary of Health and Human Services, acting 
through the Director of the Center for Disease Control and Prevention, 
shall conduct a study on women diagnosed with breast cancer and analyze 
the effect, if any, that the lack of prescription drug coverage has on 
the life expectancy of such women.
    (b) Report.--By not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to Congress a report 
on the study conducted under subsection (a).
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