[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1291 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 1291

To amend the Public Health Service Act to include State high risk pool 
    insurance programs in the list of covered entities that receive 
   reductions in the prices charged for prescription drugs under the 
  prescription drug pricing agreements under section 340B of that Act.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 13, 2003

Mr. Udall of Colorado introduced the following bill; which was referred 
                to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to include State high risk pool 
    insurance programs in the list of covered entities that receive 
   reductions in the prices charged for prescription drugs under the 
  prescription drug pricing agreements under section 340B of that Act.

    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 ``State High Risk Pool Drug Assistance 
Program Act of 2003''.

SEC. 2. INCLUSION OF STATE HIGH RISK POOL INSURANCE PROGRAMS AS A 340B 
              COVERED ENTITY.

    Section 340B(a)(4) of the Public Health Service Act (42 U.S.C. 
256b(a)(4)) is amended by adding at the end the following:
                    ``(M) A State-operated qualified high risk pool 
                that provides for premium rates and covered benefits 
                for such coverage consistent with standards included in 
                the National Association of Insurance Commissioners 
                Model Health Plan for Uninsurable Individuals, subject 
                to such conditions as the Secretary may establish by 
                regulation, which shall include the following:
                            ``(i) The pool establishes criteria for 
                        individuals eligible to obtain benefits through 
                        the pool.
                            ``(ii) Eligible individuals are given a 
                        card identifying them as high risk pool 
                        members.
                            ``(iii) Pharmacies that fill prescriptions 
                        for eligible individuals may bill the 
                        administrator or pharmacy benefit manager of 
                        the pool.
                            ``(iv) The pool has a direct relationship 
                        to the eligible individual that includes--
                                    ``(I) maintaining records of the 
                                individual's health care claims; and
                                    ``(II) the receipt by the 
                                individuals of health care services 
                                from contracted network providers.
                            ``(v) The pool serves at least individuals 
                        who would be eligible under the provisions of 
                        any of subparagraphs (A) through (L) but for 
                        level of income.
        In the case of such a pool, nothing in clause (v) shall be 
        construed as limiting the application of the agreement under 
        this section to individuals described in such clause.''.
                                 <all>