II 109th CONGRESS 2d Session S. 2203 IN THE SENATE OF THE UNITED STATES January 26, 2006 Mrs. Clinton (for herself and Mr. Nelson of Florida) 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 eliminate cost-sharing under part D of such title for certain full-benefit dual eligible individuals.

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.