1.This Act may be cited as the
Medicare Prescription Drug Savings and
Choice Act of 2005
.
2.Establishment of
medicare operated prescription drug plan option
(a)Subpart 2 of part D
of the Social Security Act is amended
by inserting after section 1860D–11 the following new section:
1860D–11A.Medicare operated prescription drug plan
option(a)Notwithstanding any
other provision of this part, for each year (beginning with 2006), in addition
to any plans offered under section 1860D–11, the Secretary shall offer one or
more medicare operated prescription drug plans (as defined in subsection (c))
with a service area that consists of the entire United States and shall enter
into negotiations with pharmaceutical manufacturers to reduce the purchase cost
of covered part D drugs for eligible part D individuals in accordance with
subsection (b).
(b)Notwithstanding section 1860D–11(i), for
purposes of offering a medicare operated prescription drug plan under this
section, the Secretary shall negotiate with pharmaceutical manufacturers with
respect to the purchase price of covered part D drugs and shall encourage the
use of more affordable therapeutic equivalents to the extent such practices do
not override medical necessity as determined by the prescribing physician. To
the extent practicable and consistent with the previous sentence, the Secretary
shall implement strategies similar to those used by other Federal purchasers of
prescription drugs, and other strategies, to reduce the purchase cost of
covered part D drugs.
(c)Medicare
operated prescription drug plan definedFor purposes of this part, the term
medicare operated prescription drug plan means a prescription drug
plan that offers qualified prescription drug coverage and access to negotiated
prices described in section 1860D–2(a)(1)(A). Such a plan may offer
supplemental prescription drug coverage in the same manner as other qualified
prescription drug coverage offered by other prescription drug plans.
(d)Monthly
beneficiary premium
(1)Qualified
prescription drug coverageThe monthly beneficiary premium for
qualified prescription drug coverage and access to negotiated prices described
in section 1860D–2(a)(1)(A) to be charged under a medicare operated
prescription drug plan shall be uniform nationally. Such premium for months in
2006 shall be $35 and for months in succeeding years shall be based on the
average monthly per capita actuarial cost of offering the medicare operated
prescription drug plan for the year involved, including administrative
expenses.
(2)Supplemental
prescription drug coverageInsofar as a medicare operated prescription
drug plan offers supplemental prescription drug coverage, the Secretary may
adjust the amount of the premium charged under paragraph (1).
(3)Requirement for
at least one plan with a $35 premium in 2006The Secretary shall ensure that at least
one medicare operated prescription drug plan offered in 2006 has a monthly
premium of
$35.
.
(b)
(1)Section 1860D–3(a) of the
Social Security Act (42 U.S.C.
1395w–103(a)) is amended by adding at the end the following new
paragraph:
(4)Availability of
the medicare operated prescription drug plan
(A)A medicare operated
prescription drug plan (as defined in section 1860D–11A(c)) shall be offered
nationally in accordance with section 1860D–11A.
(B)Relationship to
other plans
(i)Subject to clause
(ii), a medicare operated prescription drug plan shall be offered in addition
to any qualifying plan or fallback prescription drug plan offered in a PDP
region and shall not be considered to be such a plan for purposes of meeting
the requirements of this subsection.
(ii)Designation as
a Fallback planNotwithstanding any other provision of this
part, the Secretary may designate the medicare operated prescription drug plan
as the fallback prescription drug plan for any fallback service area (as
defined in section 1860D–11(g)(3)) determined to be appropriate by the
Secretary.
.
(2)Section 1860D–13(c)(3) of such Act (42
U.S.C. 1395w–113(c)(3)) is amended—
(A)in the heading, by inserting and
medicare operated prescription drug plans
after Fallback
plans
; and
(B)by inserting or a medicare operated
prescription drug plan
after a fallback prescription drug
plan
.
(3)Section 1860D–16(b)(1) of such Act (42
U.S.C. 1395w–116(b)(1)) is amended—
(A)in subparagraph (C), by striking
and
after the semicolon at the end;
(B)in subparagraph (D), by striking the period
at the end and inserting ; and
; and
(C)by adding at the end the following new
subparagraph:
(E)payments for expenses incurred with respect
to the operation of medicare operated prescription drug plans under section
1860D–11A.
.
(4)Section 1860D–41(a) of such Act (42 U.S.C.
141(a)) is amended by adding at the end the following new paragraph:
(19)Medicare
operated prescription drug planThe term medicare operated
prescription drug plan has the meaning given such term in section
1860D–11A(c).
.
(c)The amendments 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; 117 Stat. 2071).
April 22, 2005
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