[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

_______________________________________________________________________

                                 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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