[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3317 Introduced in House (IH)]







107th CONGRESS
  1st Session
                                H. R. 3317

To amend title XVIII of the Social Security Act to provide for coverage 
 under the Medicare Program of self-administered drugs that, when used 
 as a replacement for covered drugs, result in overall cost savings to 
                              the program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 16, 2001

  Ms. Baldwin (for herself, Ms. Woolsey, Mr. Kleczka, Mr. Barrett of 
  Wisconsin, Mr. Matsui, Mr. Frank, Mrs. Mink of Hawaii, Ms. Lee, Ms. 
 Kilpatrick, Ms. Schakowsky, Mr. Hilliard, Mr. Evans, Mrs. McCarthy of 
   New York, and Mr. Allen) 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 for coverage 
 under the Medicare Program of self-administered drugs that, when used 
 as a replacement for covered drugs, result in overall cost savings to 
                              the program.

    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 ``Medicare Drug Cost Savings Act of 
2001''.

SEC. 2. MEDICARE COVERAGE OF COST SAVING SELF-ADMINISTERED DRUGS USED 
              AS A REPLACEMENT FOR COVERED DRUGS.

    (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)), as amended by sections 102(a) and 105(a) of the 
Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act 
of 2000 (114 Stat. 2763A-468, 471), as enacted into law by section 
1(a)(6) of Public Law 106-554, is amended--
            (1) by striking ``and'' at the end of subparagraph (U);
            (2) by striking the period at the end of subparagraph (V) 
        and inserting ``; and''; and
            (3) by inserting after subparagraph (V) the following new 
        subparagraph:
            ``(W) a self-administered drug (which is approved by the 
        Food and Drug Administration) that--
                    ``(i) is a full replacement for a drug or drug 
                therapy which is otherwise covered under this title; 
                and
                    ``(ii) as a full replacement for such drug or drug 
                therapy, results in overall cost savings under this 
                title for the treatment of the condition for which such 
                drug or drug therapy is prescribed (as determined by 
                the Secretary);''.
    (b) Prohibition on Mandated Substitution for Intravenous Drugs.--A 
carrier (under section 1842 of the Social Security Act (42 U.S.C. 
1395u)), or fiscal intermediary (under section 1816 of such Act (42 
U.S.C. 1395h)), may not require the substitution of a self-administered 
drug (under section 1861(s)(2)(W) of the Social Security Act, as added 
by subsection (a)) for an intravenously-administered drug or drug 
therapy if, in the judgment of the physician of the individual 
diagnosed with a condition for which the drug or drug therapy has been 
prescribed, intravenous-administration of the drug or drug therapy is 
more appropriate or effective to treat the individual's condition.
    (c) GAO Study.--
            (1) In general.--The Comptroller General of the United 
        States shall conduct a study on the implementation by the 
        Secretary of Health and Human Services of section 1861(s)(2)(W) 
        of the Social Security Act, as added by subsection (a). Such 
        study shall include the identification or evaluation of the 
        following:
                    (A) The self-administered drugs that the Secretary 
                has determined are appropriate for use as replacement 
                drugs under that section.
                    (B) The replacement self-administered drugs for 
                which the Secretary has made payment under the medicare 
                program under title XVIII of the Social Security Act 
                (42 U.S.C. 1395 et seq.).
                    (C) The amount of savings attributable to the use 
                of such replacement self-administered drugs.
                    (D) Additional self-administered drugs that the 
                Comptroller General determines would be appropriate for 
                use under that section.
                    (E) Any impact on utilization and beneficiary 
                access to self-administered drugs under the medicare 
                program.
            (2) Report to congress.--Not later than one year after the 
        date of the enactment of this Act, the Comptroller General 
        shall submit to Congress a report on the study conducted under 
        paragraph (1), and may include such recommendations as the 
        Comptroller General determines appropriate.
    (d) Effective Date.--The amendments made by subsection (a) apply to 
drugs furnished on or after the date that is 90 days after the date of 
the enactment of this Act.
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