[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 191 Introduced in Senate (IS)]
108th CONGRESS
1st Session
S. 191
To amend title XVIII of the Social Security Act to provide adequate
coverage for immunosuppressive drugs furnished to beneficiaries under
the medicare program that have received a kidney transplant, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 16, 2003
Mr. DeWine introduced the following bill; which was read twice and
referred to the Committee on Finance
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A BILL
To amend title XVIII of the Social Security Act to provide adequate
coverage for immunosuppressive drugs furnished to beneficiaries under
the medicare program that have received a kidney transplant, and for
other purposes.
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 ``Immunosuppressive Drug Coverage Act
of 2003''.
SEC. 2. PROVISION OF APPROPRIATE COVERAGE OF IMMUNOSUPPRESSIVE DRUGS
UNDER THE MEDICARE PROGRAM.
(a) Continued Entitlement to Immunosuppressive Drugs for Kidney
Transplant Recipients.--
(1) In general.--Section 226A(b)(2) of the Social Security
Act (42 U.S.C. 426-1(b)(2)) is amended by inserting ``(except
for coverage of immunosuppressive drugs under section
1861(s)(2)(J))'' after ``shall end''.
(2) Application.--In the case of an individual whose
eligibility for benefits under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.) has ended except for the
coverage of immunosuppressive drugs by reason of the amendment
made by paragraph (1), the following rules shall apply:
(A) The individual shall be deemed to be enrolled
in part B of the original medicare fee-for-service
program under title XVIII of the Social Security Act
(42 U.S.C. 1395j et seq.) for purposes of receiving
coverage of such drugs.
(B) The individual shall be responsible for the
full part B premium under section 1839 of such Act (42
U.S.C. 1395r) in order to receive such coverage.
(C) The provision of such drugs shall be subject to
the application of--
(i) the part B deductible under section
1833(b) of such Act (42 U.S.C. 1395l(b)); and
(ii) the coinsurance amount applicable for
such drugs (as determined under such part B).
(D) If the individual is an inpatient of a hospital
or other entity, the individual is entitled to receive
coverage of such drugs under such part B.
(3) Establishment of procedures in order to implement
coverage.--The Secretary of Health and Human Services shall
establish procedures for--
(A) identifying beneficiaries that are entitled to
coverage of immunosuppressive drugs by reason of the
amendment made by paragraph (1); and
(B) distinguishing such beneficiaries from
beneficiaries that are enrolled under part B of title
XVIII of the Social Security Act for the complete
package of benefits under such part.
(4) Technical amendment.--Subsection (c) of section 226A
(42 U.S.C. 426-1), as added by section 201(a)(3)(D)(ii) of the
Social Security Independence and Program Improvements Act of
1994 (Public Law 103-296; 108 Stat. 1497), is redesignated as
subsection (d).
(b) Extension of Secondary Payer Requirements for ESRD
Beneficiaries.--Section 1862(b)(1)(C) of the Social Security Act (42
U.S.C. 1395y(b)(1)(C)) is amended by adding at the end the following
new sentence: ``With regard to immunosuppressive drugs furnished on or
after the date of enactment of the Immunosuppressive Drugs Coverage Act
of 2003, this subparagraph shall be applied without regard to any time
limitation.''.
(c) Effective Date.--The amendments made by this section shall
apply to drugs furnished on or after the date of enactment of this Act.
SEC. 3. PLANS REQUIRED TO MAINTAIN COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.
(a) Application to Certain Health Insurance Coverage.--
(1) In General.--Subpart 2 of part A of title XXVII of the
Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is
amended by adding at the end the following:
``SEC. 2707. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.
``A group health plan (and a health insurance issuer offering
health insurance coverage in connection with a group health plan) shall
provide coverage of immunosuppressive drugs that is at least as
comprehensive as the coverage provided by such plan or issuer on the
day before the date of enactment of the Immunosuppressive Drug Coverage
Act of 2003, and such requirement shall be deemed to be incorporated
into this section.''.
(2) Conforming amendment.--Section 2721(b)(2)(A) of the
Public Health Service Act (42 U.S.C. 300gg-21(b)(2)(A)) is
amended by inserting ``(other than section 2707)'' after
``requirements of such subparts''.
(b) Application to Group Health Plans and Group Health Insurance
Coverage Under the Employee Retirement Income Security Act of 1974.--
(1) In general.--Subpart B of part 7 of subtitle B of title
I of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1185 et seq.) is amended by adding at the end the
following new section:
``SEC. 714. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.
``A group health plan (and a health insurance issuer offering
health insurance coverage in connection with a group health plan) shall
provide coverage of immunosuppressive drugs that is at least as
comprehensive as the coverage provided by such plan or issuer on the
day before the date of enactment of the Immunosuppressive Drug Coverage
Act of 2003, and such requirement shall be deemed to be incorporated
into this section.''.
(2) Conforming amendments.--
(A) Section 732(a) of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1185(a)) is
amended by striking ``section 711'' and inserting
``sections 711 and 714''.
(B) The table of contents in section 1 of the
Employee Retirement Income Security Act of 1974 is
amended by inserting after the item relating to section
713 the following new item:
``Sec. 714. Coverage of Immunosuppressive drugs.''.
(c) Application to Group Health Plans Under the Internal Revenue
Code of 1986.--Subchapter B of chapter 100 of the Internal Revenue Code
of 1986 is amended--
(1) in the table of sections, by inserting after the item
relating to section 9812 the following new item:
``Sec. 9813. Coverage of
immunosuppressive drugs.'';
and
(2) by inserting after section 9812 the following:
``SEC. 9813. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.
``A group health plan shall provide coverage of immunosuppressive
drugs that is at least as comprehensive as the coverage provided by
such plan on the day before the date of enactment of the
Immunosuppressive Drug Coverage Act of 2003, and such requirement shall
be deemed to be incorporated into this section.''.
(d) Effective Date.--The amendments made by this section shall
apply to plan years beginning on or after January 1, 2004.
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