[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 2184 Introduced in Senate (IS)]








109th CONGRESS
  2d Session
                                S. 2184

To amend title XVIII of the Social Security Act to provide residents of 
long-term care facilities with assistance with respect to prescription 
       drug coverage under part D of such title for the resident.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 25, 2006

  Mr. Schumer 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 residents of 
long-term care facilities with assistance with respect to prescription 
       drug coverage under part D of such title for the resident.

    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 ``Long-Term Care Resident Part D 
Assistance Act of 2006''.

SEC. 2. PART D ASSISTANCE FOR RESIDENTS OF LONG-TERM CARE FACILITIES.

    (a) In General.--Section 1860D-42 of the Social Security Act (42 
U.S.C. 1395w-152) is amended by adding at the end the following new 
subsection:
    ``(c) Assistance for Residents of Long-Term Care Facilities.--
            ``(1) Procedures and waiver of requirements.--
                    ``(A) In general.--The Secretary shall establish 
                procedures and may waive requirements of this part as 
                necessary to provide assistance to residents of long-
                term care facilities with respect to coverage under 
                this part for the resident.
                    ``(B) Requirements.--The procedures under 
                subparagraph (A) shall include at least the following:
                            ``(i) Dedicated toll-free number.--The 
                        establishment of a toll-free telephone number 
                        for staff members of long-term care facilities 
                        to request information regarding coverage under 
                        this part for the resident.
                            ``(ii) Assistance in selecting a plan 
                        rather than auto enrollment in a random plan.--
                        Notwithstanding section 1860D-1(b)(1)(C), in 
                        the case of a part D eligible individual who is 
                        a full-benefit dual eligible individual (as 
                        defined in section 1935(c)(6)), who is a 
                        resident of a long-term care facility, and who 
                        has failed to enroll in a prescription drug 
                        plan or an MA-PD plan, rather than randomly 
                        enrolling such an individual in a plan pursuant 
                        to such section, the Secretary shall coordinate 
                        with the resident and the long-term care 
                        facility to facilitate selection of and 
                        enrollment in the most appropriate plan under 
                        this part for the resident.
                            ``(iii) Reimbursement of certain costs.--
                        The provision of reimbursement to long-term 
                        care facilities for the following costs:
                                    ``(I) Costs associated with new 
                                requirements.--Costs associated with 
                                the requirements under paragraph (2).
                                    ``(II) Prescription drug 
                                expenditures for covered part d 
                                drugs.--The amount that the long-term 
                                care facility expends for payment for 
                                covered part D drugs for residents of 
                                the long-term care facility who are 
                                part D eligible individuals enrolled in 
                                a prescription drug plan under this 
                                part but were unable to access on a 
                                timely basis prescription drug benefits 
                                to which they were entitled under such 
                                plan.
                                    ``(III) Providing part d assistance 
                                for residents of long-term care 
                                facilities.--Costs associated with 
                                providing part D assistance for 
                                residents of long-term care facilities 
                                (including technical assistance in 
                                filling prescriptions, time spent 
                                waiting on the telephone or online to 
                                determine what plan a resident is 
                                enrolled in, and costs associated with 
                                advocating for residents by filing 
                                appeals or facilitating plan changes).
            ``(2) Requirements for long-term care facilities.--
                    ``(A) In general.--In the case of a long-term care 
                facility receiving reimbursement under this title, the 
                facility shall have in place procedures for--
                            ``(i) educating residents who are part D 
                        eligible individuals about the prescription 
                        drug coverage available through plans under 
                        this part; and
                            ``(ii) providing technical assistance, 
                        phone support, and counseling for such 
                        residents to facilitate selection of and 
                        enrollment in the most appropriate plan under 
                        this part for the resident.
                    ``(B) Requirement.--The procedures under 
                subparagraph (A) shall include a requirement that the 
                facility periodically ascertain (and inform the 
                resident regarding) whether or not the plan in which 
                the resident is enrolled in--
                            ``(i) provides coverage of the covered part 
                        D drugs that the resident requires; and
                            ``(ii) has a contract with a pharmacy that 
                        supports the facility.''.
    (b) Effective Date.--The amendments made by this section shall take 
effect on the date of enactment of this Act.
                                 <all>