[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1153 Reported in Senate (RS)]






                                                       Calendar No. 817
108th CONGRESS
  2d Session
                                S. 1153

                          [Report No. 108-419]

  To amend title 38, United States Code, to permit medicare-eligible 
veterans to receive an out-patient medication benefit, to provide that 
 certain veterans who receive such benefit are not otherwise eligible 
for medical care and services from the Department of Veterans Affairs, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 23, 2003

  Mr. Specter (for himself, Mr. Bond, Ms. Collins, Mr. Chambliss, Mr. 
    Cochran, Ms. Snowe, Mr. Smith, and Mr. Bennett) introduced the 
 following bill; which was read twice and referred to the Committee on 
                           Veterans' Affairs

                           November 19, 2004

               Reported by Mr. Specter, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
  To amend title 38, United States Code, to permit medicare-eligible 
veterans to receive an out-patient medication benefit, to provide that 
 certain veterans who receive such benefit are not otherwise eligible 
for medical care and services from the Department of Veterans Affairs, 
                        and for other purposes.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Veterans Prescription Drugs 
Assistance Act''.</DELETED>

<DELETED>SEC. 2. ELIGIBILITY OF MEDICARE-ELIGIBLE VETERANS FOR OUT-
              PATIENT MEDICATION BENEFIT.</DELETED>

<DELETED>    (a) Restatement of Current Law on Drugs and Medications 
and Provision of Out-Patient Medication Benefit.--Chapter 17 of title 
38, United States Code, is amended by inserting after section 1710B the 
following new section:</DELETED>
<DELETED>``Sec. 1710C. Drugs and medications; vaccines</DELETED>
<DELETED>    ``(a)(1) The Secretary shall furnish to each veteran who 
is receiving additional compensation or allowance under chapter 11 of 
this title, or increased pension as a veteran of a period of war, by 
reason of being permanently housebound or in need of regular aid and 
attendance, such drugs and medicines as may be ordered on prescription 
of a duly licensed physician as specific therapy in the treatment of 
any illness or injury suffered by such veteran.</DELETED>
<DELETED>    ``(2) The Secretary shall continue to furnish such drugs 
and medicines ordered under paragraph (1) to any such veteran in need 
of regular aid and attendance whose pension payments have been 
discontinued solely because such veteran's annual income is greater 
than the applicable maximum annual income limitation, but only so long 
as such veteran's annual income does not exceed such maximum annual 
income limitation by more than $1,000.</DELETED>
<DELETED>    ``(b)(1) Any medicare-eligible veteran may elect to be 
furnished by the Secretary, on an out-patient basis, such drugs and 
medicines as may be ordered on prescription of a duly licensed 
physician as specific therapy in the treatment of any illness or injury 
suffered by such veteran.</DELETED>
<DELETED>    ``(2) In this subsection, the term `medicare-eligible 
veteran' means any veteran who--</DELETED>
        <DELETED>    ``(A) is entitled to or enrolled in hospital 
        insurance benefits under part A of title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.); or</DELETED>
        <DELETED>    ``(B) is enrolled in the supplementary medical 
        insurance program under part B of such title (42 U.S.C. 1395j 
        et seq.).</DELETED>
<DELETED>    ``(3) The Secretary shall furnish to any veteran who makes 
an election under paragraph (1), on an out-patient basis, such drugs 
and medicines as may be ordered on prescription of a duly licensed 
physician as specific therapy in the treatment of any illness or injury 
suffered by such veteran.</DELETED>
<DELETED>    ``(4)(A) Notwithstanding any other provision of law and 
except as provided in subparagraph (B), a veteran who makes an election 
under paragraph (1) shall not be eligible for care and services under 
this chapter during the year covered by the election.</DELETED>
<DELETED>    ``(B) Subparagraph (A) shall not apply with respect to any 
veteran who has a compensable service-connected disability.</DELETED>
<DELETED>    ``(5) The furnishing of drugs and medicines under this 
subsection shall be subject to the provisions of section 1722A(b) of 
this title.</DELETED>
<DELETED>    ``(6)(A) An election under paragraph (1) shall be for a 
calendar year, and shall be irrevocable for the year covered by such 
election. An election may be renewed.</DELETED>
<DELETED>    ``(B) The Secretary shall prescribe the form, manner, and 
timing of an election.</DELETED>
<DELETED>    ``(7) Before permitting a veteran to make an election 
under paragraph (1), the Secretary shall provide the veteran such 
educational materials and other information on the furnishing and 
receipt of drugs and medicines under this subsection as the Secretary 
considers appropriate to inform the veteran of the benefits and costs 
of being furnished drugs and medicines under this subsection, including 
materials and information on the consequences of making an election 
under paragraph (1) and on the fees, copayments, or other amounts 
required under section 1722A(b) of this title for drugs and medicines 
furnished under this subsection.</DELETED>
<DELETED>    ``(c)(1) In order to assist the Secretary of Health and 
Human Services in carrying out national immunization programs under 
other provisions of law, the Secretary may authorize the administration 
of immunizations to eligible veterans who voluntarily request such 
immunizations in connection with the provision of care for a disability 
under this chapter in any Department health care facility.</DELETED>
<DELETED>    ``(2) Any immunization under paragraph (1) shall be made 
using vaccine furnished by the Secretary of Health and Human Services 
at no cost to the Department. For such purpose, notwithstanding any 
other provision of law, the Secretary of Health and Human Services may 
provide such vaccine to the Department at no cost.</DELETED>
<DELETED>    ``(3) Section 7316 of this title shall apply to claims 
alleging negligence or malpractice on the part of Department personnel 
granted immunity under such section.''.</DELETED>
<DELETED>    (b) Copayment Requirements.--</DELETED>
        <DELETED>    (1) In general.--Section 1722A of such title is 
        amended--</DELETED>
                <DELETED>    (A) in subsection (a)(1), by inserting 
                ``(other than a veteran covered by subsection (b))'' 
                after ``require a veteran'';</DELETED>
                <DELETED>    (B) by redesignating subsections (b), (c), 
                and (d), as subsections (c), (d), and (e), 
                respectively;</DELETED>
                <DELETED>    (C) by inserting after subsection (a) the 
                following new subsection (b):</DELETED>
<DELETED>    ``(b)(1) In the case of a veteran who is furnished 
medications on an out-patient basis under section 1710C(b) of this 
title, the Secretary shall require the veteran to pay, at the election 
of the Secretary, one or more of the following:</DELETED>
        <DELETED>    ``(A) An annual enrollment fee in an amount 
        determined appropriate by the Secretary.</DELETED>
        <DELETED>    ``(B) A copayment for each 30-day supply of such 
        medications in an amount determined appropriate by the 
        Secretary.</DELETED>
        <DELETED>    ``(C) An amount equal to the cost to the Secretary 
        of such medications, as determined by the Secretary.</DELETED>
<DELETED>    ``(2)(A) In determining the amounts to be paid by a 
veteran under paragraph (1), and the basis of payment under one or more 
subparagraphs of that paragraph, the Secretary shall ensure that the 
total amount paid by veterans for medications under that paragraph in a 
year is not less than the costs of the Department in furnishing 
medications to veterans under section 1710C(b) of this title during 
that year, including the cost of purchasing and furnishing medications, 
and other costs of administering that section.</DELETED>
<DELETED>    ``(B) The Secretary shall take appropriate actions to 
ensure, to the maximum extent practicable, that amounts paid by 
veterans under paragraph (1) in a year are equal to the costs of the 
Department referred to in subparagraph (A) in that year.</DELETED>
<DELETED>    ``(3) In determining amounts under paragraph (1), the 
Secretary may take into account the following:</DELETED>
        <DELETED>    ``(A) Whether or not the medications furnished are 
        generic medications or brand name medications.</DELETED>
        <DELETED>    ``(B) Whether or not the medications are furnished 
        by mail.</DELETED>
        <DELETED>    ``(C) Whether or not the medications furnished are 
        listed on the National Prescription Drug Formulary of the 
        Department.</DELETED>
        <DELETED>    ``(D) Any other matters the Secretary considers 
        appropriate.</DELETED>
<DELETED>    ``(4) The Secretary may from time to time adjust any 
amount determined by the Secretary under paragraph (1), as previously 
adjusted under this paragraph, in order to meet the purpose specified 
in paragraph (2).''; and</DELETED>
                <DELETED>    (D) in subsection (d), as so 
                redesignated--</DELETED>
                        <DELETED>    (i) by striking ``subsection (a)'' 
                        and inserting ``subsections (a) and (b)''; 
                        and</DELETED>
                        <DELETED>    (ii) by striking ``subsection 
                        (b)'' and inserting ``subsection 
                        (c)''.</DELETED>
        <DELETED>    (2) Deposit of collections in medical care 
        collections fund.--Paragraph (4) of section 1729A(b) of such 
        title is amended to read as follows:</DELETED>
        <DELETED>    ``(4) Subsection (a) or (b) of section 1722A of 
        this title.''.</DELETED>
<DELETED>    (c) Conforming Amendments.--(1) Section 1707 of such title 
is amended by adding at the end the following new subsection:</DELETED>
<DELETED>    ``(c) Notwithstanding any other provision of law, a 
veteran who makes an election authorized by section 1710C(b) of this 
title (other than a veteran covered by paragraph (4)(B) of that 
section) shall not, for the period of such election, be eligible for 
care and services under this chapter, except as provided in that 
section.''.</DELETED>
<DELETED>    (2) Section 1712 of such title is amended by striking 
subsections (d) and (e).</DELETED>
<DELETED>    (d) Clerical Amendments.--(1) The heading for section 1712 
of such title is amended to read as follows:</DELETED>
<DELETED>``Sec. 1712. Dental care''.</DELETED>
<DELETED>    (2) The table of sections at the beginning of chapter 17 
of such title is amended--</DELETED>
        <DELETED>    (A) by inserting after the item relating to 
        section 1710B the following new item:</DELETED>

<DELETED>``1710C. Drugs and medications; vaccines.'';
        <DELETED>and</DELETED>
        <DELETED>    (B) by striking the item relating to section 1712 
        and inserting the following new item:</DELETED>

<DELETED>``1712. Dental care.''.

</DELETED>SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Prescription Drugs 
Assistance Act''.

SEC. 2. ELIGIBILITY OF MEDICARE-ELIGIBLE VETERANS FOR OUT-PATIENT 
              MEDICATION BENEFIT.

    (a) Restatement of Current Law on Drugs and Medications and 
Provision of Out-Patient Medication Benefit.--Chapter 17 of title 38, 
United States Code, is amended by inserting after section 1710B the 
following new section:
``Sec. 1710C. Drugs and medications; vaccines
    ``(a)(1) The Secretary shall furnish to each veteran who is 
receiving additional compensation or allowance under chapter 11 of this 
title, or increased pension as a veteran of a period of war, by reason 
of being permanently housebound or in need of regular aid and 
attendance, such drugs and medicines as may be ordered on prescription 
of a duly licensed physician as specific therapy in the treatment of 
any illness or injury suffered by such veteran.
    ``(2) The Secretary shall continue to furnish such drugs and 
medicines ordered under paragraph (1) to any such veteran in need of 
regular aid and attendance whose pension payments have been 
discontinued solely because such veteran's annual income is greater 
than the applicable maximum annual income limitation, but only so long 
as such veteran's annual income does not exceed such maximum annual 
income limitation by more than $1,000.
    ``(b)(1) Any medicare-eligible veteran may elect to be furnished by 
the Secretary, on an out-patient basis, such drugs and medicines as may 
be ordered on prescription of a duly licensed physician as specific 
therapy in the treatment of any illness or injury suffered by such 
veteran.
    ``(2) In this subsection, the term `medicare-eligible veteran' 
means any veteran who--
            ``(A) is entitled to or enrolled in hospital insurance 
        benefits under part A of title XVIII of the Social Security Act 
        (42 U.S.C. 1395 et seq.); or
            ``(B) is enrolled in the supplementary medical insurance 
        program under part B of such title (42 U.S.C. 1395j et seq.).
    ``(3) The Secretary shall furnish to any veteran who makes an 
election under paragraph (1), on an out-patient basis, such drugs and 
medicines as may be ordered on prescription of a duly licensed 
physician as specific therapy in the treatment of any illness or injury 
suffered by such veteran.
    ``(4)(A) Notwithstanding any other provision of law and except as 
provided in subparagraph (B), a veteran who makes an election under 
paragraph (1) shall not be eligible for care and services under this 
chapter during the year covered by the election.
    ``(B) Subparagraph (A) shall not apply with respect to any veteran 
who has a compensable service-connected disability.
    ``(5) The furnishing of drugs and medicines under this subsection 
shall be subject to the provisions of section 1722A(b) of this title.
    ``(6)(A) An election under paragraph (1) shall be for a calendar 
year, and shall be irrevocable for the year covered by such election. 
An election may be renewed.
    ``(B) The Secretary shall prescribe the form, manner, and timing of 
an election.
    ``(7) Before permitting a veteran to make an election under 
paragraph (1), the Secretary shall provide the veteran such educational 
materials and other information on the furnishing and receipt of drugs 
and medicines under this subsection as the Secretary considers 
appropriate to inform the veteran of the benefits and costs of being 
furnished drugs and medicines under this subsection, including 
materials and information on the consequences of making an election 
under paragraph (1) and on the fees, copayments, or other amounts 
required under section 1722A(b) of this title for drugs and medicines 
furnished under this subsection.
    ``(c)(1) In order to assist the Secretary of Health and Human 
Services in carrying out national immunization programs under other 
provisions of law, the Secretary may authorize the administration of 
immunizations to eligible veterans who voluntarily request such 
immunizations in connection with the provision of care for a disability 
under this chapter in any Department health care facility.
    ``(2) Any immunization under paragraph (1) shall be made using 
vaccine furnished by the Secretary of Health and Human Services at no 
cost to the Department. For such purpose, notwithstanding any other 
provision of law, the Secretary of Health and Human Services may 
provide such vaccine to the Department at no cost.
    ``(3) Section 7316 of this title shall apply to claims alleging 
negligence or malpractice on the part of Department personnel granted 
immunity under such section.''.
    (b) Copayment Requirements.--Section 1722A of such title is 
amended--
            (1) in subsection (a)(1), by inserting ``(other than a 
        veteran covered by subsection (b))'' after ``require a 
        veteran'';
            (2) by redesignating subsections (b) and (c) as subsections 
        (c) and (d), respectively; and
            (3) by inserting after subsection (a) the following new 
        subsection (b):
    ``(b)(1) In the case of a veteran who is furnished medications on 
an out-patient basis under section 1710C(b) of this title, the 
Secretary shall require the veteran to pay, at the election of the 
Secretary, one or more of the following:
            ``(A) An annual enrollment fee in an amount determined 
        appropriate by the Secretary.
            ``(B) A copayment for each 30-day supply of such 
        medications in an amount determined appropriate by the 
        Secretary.
            ``(C) An amount equal to the cost to the Secretary of such 
        medications, as determined by the Secretary.
    ``(2)(A) In determining the amounts to be paid by a veteran under 
paragraph (1), and the basis of payment under one or more subparagraphs 
of that paragraph, the Secretary shall ensure that the total amount 
paid by veterans for medications under that paragraph in a year is not 
less than the costs of the Department in furnishing medications to 
veterans under section 1710C(b) of this title during that year, 
including the cost of purchasing and furnishing medications, and other 
costs of administering that section.
    ``(B) The Secretary shall take appropriate actions to ensure, to 
the maximum extent practicable, that amounts paid by veterans under 
paragraph (1) in a year are equal to the costs of the Department 
referred to in subparagraph (A) in that year.
    ``(3) In determining amounts under paragraph (1), the Secretary may 
take into account the following:
            ``(A) Whether or not the medications furnished are generic 
        medications or brand name medications.
            ``(B) Whether or not the medications are furnished by mail.
            ``(C) Whether or not the medications furnished are listed 
        on the National Prescription Drug Formulary of the Department.
            ``(D) Any other matters the Secretary considers 
        appropriate.
    ``(4) The Secretary may from time to time adjust any amount 
determined by the Secretary under paragraph (1), as previously adjusted 
under this paragraph, in order to meet the purpose specified in 
paragraph (2).''.
    (c) Conforming Amendments.--(1) Section 1707 of such title is 
amended by adding at the end the following new subsection:
    ``(c) Notwithstanding any other provision of law, a veteran who 
makes an election authorized by section 1710C(b) of this title (other 
than a veteran covered by paragraph (4)(B) of that section) shall not, 
for the period of such election, be eligible for care and services 
under this chapter, except as provided in that section.''.
    (2) Section 1712 of such title is amended by striking subsections 
(d) and (e).
    (d) Clerical Amendments.--(1) The heading of section 1712 of such 
title is amended to read as follows:
``Sec. 1712. Dental care''.
    (2) The table of sections at the beginning of chapter 17 of such 
title is amended--
            (A) by inserting after the item relating to section 1710B 
        the following new item:

``1710C. Drugs and medications; vaccines.'';
        and
            (B) by striking the item relating to section 1712 and 
        inserting the following new item:

``1712. Dental care.''.




                                                       Calendar No. 817

108th CONGRESS

  2d Session

                                S. 1153

                          [Report No. 108-419]

_______________________________________________________________________

                                 A BILL

  To amend title 38, United States Code, to permit medicare-eligible 
veterans to receive an out-patient medication benefit, to provide that 
 certain veterans who receive such benefit are not otherwise eligible 
for medical care and services from the Department of Veterans Affairs, 
                        and for other purposes.

_______________________________________________________________________

                           November 19, 2004

                       Reported with an amendment