[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4722 Introduced in House (IH)]







109th CONGRESS
  2d Session
                                H. R. 4722

   To amend title XVIII of the Social Security Act to eliminate cost-
   sharing under part D of such title for certain full-benefit dual 
                         eligible individuals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            February 8, 2006

Mr. Engel (for himself, Mr. Brown of Ohio, Mr. Waxman, Mr. Boucher, Mr. 
Towns, Mr. Pallone, Mr. Rush, Mr. Stupak, Mr. Strickland, Ms. DeGette, 
Mrs. Capps, Mr. Allen, Ms. Schakowsky, Mr. McNulty, Mr. Jefferson, Mr. 
  Emanuel, and Mr. Kennedy of Rhode Island) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
  in addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to eliminate cost-
   sharing under part D of such title for certain full-benefit dual 
                         eligible individuals.

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

SECTION 1. ELIMINATION OF PART D COST-SHARING FOR CERTAIN FULL-BENEFIT 
              DUAL ELIGIBLE INDIVIDUALS.

    (a) In General.--Section 1860D-14(a)(1)(D)(i) of the Social 
Security Act (42 U.S.C. 1395w-114(a)(1)(D)(i)) is amended--
            (1) in the heading, by striking ``Institutionalized 
        individuals.--In'' and inserting ``Elimination of cost-sharing 
        for certain full-benefit dual eligible individuals.--''
                                    ``(I) Institutionalized 
                                individuals.--In''; and
            (2) by adding at the end the following new subclauses:
                                    ``(II) Certain other individuals.--
                                In the case of an individual who is a 
                                full-benefit dual eligible individual 
                                and who receives services from a 
                                facility or program described in 
                                subclause (III), the elimination of any 
                                beneficiary coinsurance described in 
                                section 1860D-2(b)(2) (for all amounts 
                                through the total amount of 
                                expenditures at which benefits are 
                                available under section 1860D-2(b)(4)).
                                    ``(III) Facility described.--For 
                                purposes of subclause (II), a facility 
                                or program described in this subclause 
                                is a board and care facility, a 
                                custodial care facility, a group home, 
                                or an assisted living facility (as such 
                                terms are defined by the Secretary), or 
                                any other facility or program that the 
                                Secretary determines provides services 
                                without which the individual would 
                                require long-term care in a medical 
                                institution or nursing facility.''.
    (b) Effective Date.--
            (1) In general.--The amendments made by subsection (a) 
        shall take effect as if included in the enactment of section 
        101 of the Medicare Prescription Drug, Improvement, and 
        Modernization Act of 2003 (Public Law 108-173).
            (2) Reimbursement of cost-sharing payments.--The Secretary 
        shall provide for reimbursement of any beneficiary coinsurance 
        described in section 1860D-2(b)(2) of the Social Security Act 
        (42 U.S.C. 1395w-102(b)(2)) paid by or on behalf of an 
        individual described in section 1860D-14(a)(1)(D)(i)(II) of 
        such Act, as added by subsection (a), during the period 
        beginning on January 1, 2006, and ending on the date of 
        enactment of this Act.
                                 <all>