II 109th CONGRESS 2d Session S. 2313 IN THE SENATE OF THE UNITED STATES February 16, 2006 Mr. Durbin (for himself and Mr. Dayton) 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 permit medicare beneficiaries enrolled in prescription drug plans and MA–PD plans that change their formularies or increase drug prices to enroll in other plans.

1.

Short title

This Act may be cited as the Medicare Drug Honest Pricing Act of 2006.

2.

Permitting medicare beneficiaries enrolled in prescription drug plans and MA–PD plans that change their formularies or increase drug prices to enroll in other plans

(a)

Special enrollment period

(1)

In general

Section 1860D–1(b)(3) of the Social Security Act (42 U.S.C. 1395w–101(b)(3)) is amended by adding at the end the following new subparagraphs: (F)

Enrollment under plans that change their formularies

In the case of a part D eligible individual who is enrolled in a prescription drug plan that uses a formulary, if the plan removes a covered part D drug from its formulary or changes the preferred or tiered cost-sharing status of such a drug and the individual is adversely affected by such change, there shall be a 60-day special enrollment period for the individual beginning on the date on which the individual receives a notice of such removal or change. (G)

Enrollment under plans that increase negotiated prices

In the case of a part D eligible individual who is enrolled in a prescription drug plan in which the negotiated price used for payment for any covered part D drug increases by 10 percent or more from the negotiated price used for payment for the drug as of January 1 of the year (as disclosed to the Secretary pursuant to section 1860D–2(d)(4)(A)). . (2)

Informing beneficiaries of negotiated prices

Section 1860D–2(d) of the Social Security Act (42 U.S.C. 1395w–102(d)) is amended by adding at the end the following new paragraph: (4)

Informing beneficiaries of negotiated prices

(A)

Requiring plans to disclose negotiated prices to the Secretary

Not later than November 8 of each year (beginning with 2006), each sponsor of a prescription drug plan shall disclose to the Secretary (in a manner specified by the Secretary) the negotiated price used for payment for each covered part D drug covered under the plan that will apply under the plan on January 1 of the subsequent year. (B)

Secretary to make negotiated prices available on the CMS website

Not later than November 15 of each year (beginning with 2006), the Secretary shall make information disclosed under subparagraph (A) available to the public through the Internet website of the Centers for Medicare & Medicaid Services. (C)

Requiring plans to inform beneficiaries of January 1 negotiated price

Not later than January 10 of each year (beginning with 2007), each sponsor of a prescription drug plan shall appropriately inform (as determined by the Secretary) part D eligible individuals enrolled in the plan for the year of the negotiated price used for payment for each covered part D drug that is covered under the plan that was disclosed to the Secretary under subparagraph (A). . (b)

Regulations

The Secretary of Health and Human Services shall promulgate regulations to carry out the amendments made by this section. (c)

Effective Date

The amendments made by subsection (a) shall take effect on January 1, 2007.