[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 299 Reported in House (RH)]






                                                  House Calendar No. 74
108th CONGRESS
  1st Session
H. RES. 299

                          [Report No. 108-181]

 Providing for consideration of the bill (H.R. 1) to amend title XVIII 
   of the Social Security Act to provide for a voluntary program for 
prescription drug coverage under the Medicare Program, to modernize the 
Medicare Program, and for other purposes, and for consideration of the 
bill (H.R. 2596) to amend the Internal Revenue Code of 1986 to allow a 
  deduction to individuals for amounts contributed to health savings 
   security accounts and health savings accounts, to provide for the 
 disposition of unused health benefits in cafeteria plans and flexible 
             spending arrangements, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 25, 2003

    Ms. Pryce, from the Committee on Rules, reported the following 
resolution; which was referred to the House Calendar and ordered to be 
                                printed

_______________________________________________________________________

                               RESOLUTION


 
 Providing for consideration of the bill (H.R. 1) to amend title XVIII 
   of the Social Security Act to provide for a voluntary program for 
prescription drug coverage under the Medicare Program, to modernize the 
Medicare Program, and for other purposes, and for consideration of the 
bill (H.R. 2596) to amend the Internal Revenue Code of 1986 to allow a 
  deduction to individuals for amounts contributed to health savings 
   security accounts and health savings accounts, to provide for the 
 disposition of unused health benefits in cafeteria plans and flexible 
             spending arrangements, and for other purposes.

    Resolved, That upon the adoption of this resolution it shall be in 
order without intervention of any point of order to consider in the 
House the bill (H.R. 1) to amend title XVIII of the Social Security Act 
to provide for a voluntary program for prescription drug coverage under 
the Medicare Program, to modernize the Medicare Program, and for other 
purposes. The bill shall be considered as read for amendment. The 
previous question shall be considered as ordered on the bill and on any 
amendment thereto to final passage without intervening motion except: 
(1) three hours of debate on the bill equally divided among and 
controlled by the chairmen and ranking minority members of the 
Committee on Energy and Commerce and the Committee on Ways and Means; 
(2) the amendment printed in the report of the Committee on Rules 
accompanying this resolution, if offered by Representative Rangel of 
New York or his designee, which shall be in order without intervention 
of any point of order, shall be considered as read, and shall be 
separately debatable for one hour equally divided and controlled by the 
proponent and an opponent; and (3) one motion to recommit with or 
without instructions.
    Sec. 2. Upon the adoption of this resolution it shall be in order 
on the legislative day of June 26 or June 27, 2003, without 
intervention of any point of order to consider in the House the bill 
(H.R. 2596) to amend the Internal Revenue Code of 1986 to allow a 
deduction to individuals for amounts contributed to health savings 
security accounts and health savings accounts, to provide for the 
disposition of unused health benefits in cafeteria plans and flexible 
spending arrangements, and for other purposes. The bill shall be 
considered as read for amendment. The previous question shall be 
considered as ordered on the bill to final passage without intervening 
motion except: (1) one hour of debate on the bill equally divided and 
controlled by the chairman and ranking minority member of the Committee 
on Ways and Means; and (2) one motion to recommit.
    Sec. 3. (a) In the engrossment of H.R. 1, the Clerk shall await the 
disposition of H.R. 2596 under section 2.
    (b) If H.R. 2596 is passed by the House, the Clerk shall--
            (1) add the text of H.R. 2596 as new matter at the end of 
        H.R. 1;
            (2) conform the title of H.R. 1 to reflect the addition of 
        the text of H.R. 2596 of the engrossment;
            (3) assign appropriate designations to provisions within 
        the engrossment; and
            (4) conform provisions for short titles within the 
        engrossment.
    (c) Upon the addition of the text of H.R. 2596 to the engrossment 
of H.R. 1, H.R. 2596 shall be laid on the table.
    Sec. 4. During consideration of H.R. 1 and H.R. 2596 pursuant to 
this resolution, notwithstanding the operation of the previous 
question, the Chair may postpone further consideration of either bill 
to a time designated by the Speaker.
    Sec. 5. Upon the adoption of this resolution it shall be in order, 
any rule of House to the contrary notwithstanding, to consider 
concurrent resolutions providing for adjournment of the House and 
Senate during the month of July.
    Sec. 6. The Committee on Appropriations may have until midnight on 
Thursday, July 3, 2003, to file a report to accompany a bill making 
appropriations for the Department of Defense for the fiscal year ending 
September 30, 2004, and for the other purposes.

                   summary of amendment made in order

        Rangel/Dingell: Amendment in the Nature of a Substitute. Title 
I--Medicare Prescription Medicine Benefit. Adds new Part D in Medicare 
that provides voluntary prescription drug coverage for all Medicare 
beneficiaries beginning in 2006. Provides a $25 a month premium, a $100 
a year deductible, a co-insurance of 20/40 (Beneficiaries/Medicare), 
and a $2,000 out-of-pocket limit per beneficiary per year. 
Beneficiaries with incomes between 150 percent of poverty pay no 
premium or cost sharing. Beneficiaries with incomes between 150 percent 
and 175 percent of poverty pay no cost-sharing and receive assistance 
with the Part D premium on a sliding scale. Medicare contractors will 
obtain guaranteed reductions in prices, and the Secretary of Health and 
Human Services will have the authority to use the collective purchasing 
power of Medicare's 40 million beneficiaries to negotiate lower drug 
prices, taking into account prices paid in other countries and by other 
payers in the U.S. The Secretary could also implement measures that 
will further reduce costs and improve quality for beneficiaries, such 
as: encouraging use of generic drugs, lowering co-insurance for 
preferred drugs, disease management, and beneficiary and provider 
education. Medicare would also require contractors to put in place 
safeguards to check for adverse drug interactions and proper use of 
medications. Title II--Medicare+Choice. Includes a two-year payment 
enhancement for Medicare+Choice plans (2004 and 2005) as well as 
provisions pertaining to specialized plans for special needs 
beneficiaries and the extension of Medicare cost-contracts. Title III--
Combating Waste, Fraud, and Abuse. Improves payments for oncology 
providers to administer cancer drugs and also directs the Centers for 
Medicare and Medicaid Services to pay for drug administration services, 
chemotherapy support services, therapy management services and related 
services. Reimburses for the cost of oncology drugs by not involving a 
new bureaucracy and middle-man and paying 105 percent of the average 
sales price of medicines. Protects beneficiaries from undue 
consequences of competitive bidding for durable medical equipment (DME) 
by delaying the start of DME competitive bidding until 2009 and phasing 
it in over three years. Title IV--Rural Health Care Improvements. 
Includes all of the provisions from the Ways and Means reported bill 
pertaining to rural providers. In addition, it: eliminates the 10 
percent cap on disproportionate share hospital payments to rural 
hospitals; adds a provision providing up to 25 percent increase in low-
volume adjustment for small hospitals; increases rural home health 
payments by 10 percent (rather than 5 percent); allows lab payments on 
reasonable costs for sole community hospitals; increases the floors for 
physician work in rural areas to 1.0; eliminates the 35-mile rule for 
critical access hospital ambulance services; increases the ground 
ambulance payment rate; and increases the critical access hospital bed 
limit to 25. Title V--Provisions Relating to Medicare Part A. Includes 
all the provisions from Ways and Means reported bill pertaining to Part 
A (hospitals) except it eliminate the 3-year cut in hospital inpatient 
reimbursement and adds a boost for indirect medical education (IME) to 
6.5 percent for two years. It also replaces the MedPac study on 
specialty hospitals with the Senate provision that limits physician 
self-referral to these facilities. Title VI--Provisions Relating to 
Medicare Part B. Includes all of the provisions from the Ways and Means 
and Energy and Commerce reported bills except it does not increase the 
deductible that seniors must pay in order to receive Part B (primarily 
physicians) services. Title VII--Provisions Relating to Medicare Parts 
A and B. Includes all of the provisions from the Ways and Means and 
Energy and Commerce reported bills except it does not include a co-
payment for home health care and does not continue the cap on payments 
for direct graduate medical education for facilities above 140 percent. 
Title VIII--Medicaid. Includes Whitfield-DeGette Medicaid DSH 
legislation that includes full restoration of funding for DSH and 
improvements for low-DSH States. Title IX--Regulatory Reduction and 
Contracting Reform. Includes the Energy and Commerce reported provision 
on Medicare contractor and regulatory reform. Title X--Importation of 
Prescription Drugs. Incorporates reimportation amendments adopted on 
the Senate Floor on June 19, 2003, which will allow access to low-cost 
Canadian Drugs if the Secretary of the Department of Health and Human 
Services certifies that they are safe. Title XI--Access to Affordable 
Pharmaceuticals. Incorporates text of S. 1225 as adopted by the Senate, 
which will make lower cost generic drugs available more quickly.




                                                  House Calendar No. 74

108th CONGRESS

  1st Session

                              H. RES. 299

                          [Report No. 108-181]

_______________________________________________________________________

                               RESOLUTION

 Providing for consideration of the bill (H.R. 1) to amend title XVIII 
   of the Social Security Act to provide for a voluntary program for 
prescription drug coverage under the Medicare Program, to modernize the 
Medicare Program, and for other purposes, and for consideration of the 
bill (H.R. 2596) to amend the Internal Revenue Code of 1986 to allow a 
  deduction to individuals for amounts contributed to health savings 
   security accounts and health savings accounts, to provide for the 
 disposition of unused health benefits in cafeteria plans and flexible 
             spending arrangements, and for other purposes.

_______________________________________________________________________

                             June 25, 2003

        Referred to the House Calendar and ordered to be printed