1.
This Act may be cited as the
Medicare Enhancements for Needed Drugs
Act of 2005
.
2.
GAO studies and reports on prices of prescription
drugs
(a)
Review and reports on retail prices of prescription
drugs
(1)
The Comptroller General of
the United States shall conduct a review of the retail cost of prescription
drugs in the United States during 2000 through 2003, with an emphasis on the
prescription drugs most utilized for individuals age 65 or older.
(2)
After conducting the review
under paragraph (1), the Comptroller General shall continuously review the
retail cost of such drugs through April 1, 2006, to determine the changes in
such costs.
(3)
(A)
Not later than September 1,
2005, the Comptroller General shall submit to Congress a report on the initial
review conducted under paragraph (1).
(B)
Not later than July 1, 2006,
January 1, 2007, and July 1, 2007, the Comptroller General shall submit to
Congress a report on the subsequent review conducted under paragraph
(2).
(b)
Annual GAO study and report on retail and acquisition prices of
certain prescription drugs
(1)
The Comptroller General of
the United States shall conduct an ongoing study that compares the average
retail cost in the United States for each of the 20 most utilized prescription
drugs for individuals age 65 or older with—
(A)
the average price at which
private health plans acquire each such drug;
(B)
the average price at which
the Department of Defense under the Defense Health Program acquires each such
drug;
(C)
the average price at which
the Department of Veterans Affairs under the laws administered by the Secretary
of Veterans Affairs acquires each such drug; and
(D)
the average negotiated price
for each such drug that eligible beneficiaries enrolled in a prescription drug
plan under part D of title XVIII of the Social
Security Act, as added by section 101 of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law
108–173), that provides only basic prescription drug coverage
have access to under such plans.
(2)
Not later than December 1,
2007, and annually thereafter, the Comptroller General shall submit to Congress
a report on the study conducted under paragraph (1), together with such
recommendations as the Comptroller General determines appropriate.
3.
Inclusion of average aggregate beneficiary costs and savings in
comparative information for basic medicare prescription drug plans
Section 1860D–1(c)(3) of the
Social Security Act (42 U.S.C.
1395w–101(c)(3)) is amended—
(1)
in subparagraph (A)—
(A)
in the matter preceding
clause (i), by striking subparagraph (B)
and inserting
subparagraphs (B) and (C)
; and
(B)
by adding at the end the
following new clause:
(vi)
Average aggregate beneficiary costs and savings
With respect to plan years
beginning on or after January 1, 2007, the average aggregate costs, including
deductibles and other cost-sharing, that a beneficiary will incur for covered
part D drugs in the year under the plan compared to the average aggregate costs
that an eligible beneficiary with no prescription drug coverage will incur for
covered part D drugs in the year.
;
and
(2)
by adding at the end the
following new subparagraph:
(C)
Average aggregate beneficiary costs and savings information
only for basic prescription drug plans
The Secretary shall not
provide comparative information under subparagraph (A)(vi) with respect
to—
(i)
a prescription drug plan
that provides supplemental prescription drug coverage; or
(ii)
a Medicare Advantage
plan.
.
4.
Negotiating fair prices for medicare prescription
drugs
(a)
Section
1860D–11 of the Social Security
Act (42 U.S.C. 1395w–111) is amended by striking subsection (i)
(relating to noninterference) and by inserting the following:
(i)
Authority To negotiate prices with manufacturers
(1)
In order to ensure that
beneficiaries enrolled under prescription drug plans and MA–PD plans pay the
lowest possible price, the Secretary shall have authority similar to that of
other Federal entities that purchase prescription drugs in bulk to negotiate
contracts with manufacturers of covered part D drugs, consistent with the
requirements and in furtherance of the goals of providing quality care and
containing costs under this part.
(2)
Mandatory responsibilities
The Secretary shall be
required to—
(A)
negotiate contracts with
manufacturers of covered part D drugs for each fallback prescription drug plan
under subsection (g); and
(B)
participate in negotiation
of contracts of any covered part D drug upon request of an approved
prescription drug plan or MA–PD plan.
(3)
Nothing in paragraph (2)
shall be construed to limit the authority of the Secretary under paragraph (1)
to the mandatory responsibilities under paragraph (2).
.
(b)
The amendment made by this
section 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).
5.
NAIC review and report on changes in medigap policies that
provide coverage of prescription drugs contained in the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003
(a)
The Secretary of Health and
Human Services shall request the National Association of Insurance
Commissioners to conduct a review of the changes to the rules relating to
medicare supplemental policies that provide prescription drug coverage
contained in subsection (v) of section 1882 of the
Social Security Act (42 U.S.C.
1395ss), as added by section 104(a) of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law
108–173).
(b)
Impact on medicare beneficiaries
The review conducted pursuant
to subsection (a) should focus on the impact the changes described in such
subsection will have on medicare beneficiaries.
(c)
The Secretary shall request
the National Association of Insurance Commissioners to submit to Congress, by
not later than January 1, 2006, a report on the review conducted pursuant to
subsection (a), together with such recommendations as the National Association
of Insurance Commissioners determines appropriate.