[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4142 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 4142

  To amend title 38, United States Code, to permit medicare-eligible 
veterans to receive an out-patient medication benefit, to provide that 
 certain veterans who receive such benefit are not otherwise eligible 
for medical care and services from the Department of Veterans Affairs, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 9, 2007

  Mr. Garrett of New Jersey introduced the following bill; which was 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
  To amend title 38, United States Code, to permit medicare-eligible 
veterans to receive an out-patient medication benefit, to provide that 
 certain veterans who receive such benefit are not otherwise eligible 
for medical care and services from the Department of Veterans Affairs, 
                        and for other purposes.

    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 ``Improving Medication Access for 
Veterans Act''.

SEC. 2. ELIGIBILITY OF MEDICARE-ELIGIBLE VETERANS FOR OUT-PATIENT 
              MEDICATION BENEFIT.

    (a) Restatement of Current Law on Drugs and Medications and 
Provision of Out-Patient Medication Benefit.--Chapter 17 of title 38, 
United States Code, is amended by inserting after section 1710B the 
following new section:
``Sec. 1710C. Drugs and medications; vaccines
    ``(a)(1) The Secretary shall furnish to each veteran who is 
receiving additional compensation or allowance under chapter 11 of this 
title, or increased pension as a veteran of a period of war, by reason 
of being permanently housebound or in need of regular aid and 
attendance, such drugs and medicines (subject to subsection (d)) as may 
be ordered on prescription of a duly licensed physician as specific 
therapy in the treatment of any illness or injury suffered by such 
veteran.
    ``(2) The Secretary shall continue to furnish such drugs and 
medicines ordered under paragraph (1) to any such veteran in need of 
regular aid and attendance whose pension payments have been 
discontinued solely because such veteran's annual income is greater 
than the applicable maximum annual income limitation, but only so long 
as such veteran's annual income does not exceed such maximum annual 
income limitation by more than $1,000.
    ``(b)(1) Any medicare-eligible veteran may elect to be furnished by 
the Secretary, on an out-patient basis, such drugs and medicines 
(subject to subsection (d)) as may be ordered on prescription of a duly 
licensed physician as specific therapy in the treatment of any illness 
or injury suffered by such veteran.
    ``(2) In this subsection, the term `medicare-eligible veteran' 
means any veteran who--
    ``(A) is entitled to or enrolled in hospital insurance benefits 
under part A of title XVIII of the Social Security Act (42 U.S.C. 1395 
et seq.); or
    ``(B) is enrolled in the supplementary medical insurance program 
under part B of such title (42 U.S.C. 1395j et seq.).
    ``(3) The Secretary shall furnish to any veteran who makes an 
election under paragraph (1), on an out-patient basis, such drugs and 
medicines as may be ordered on prescription of a duly licensed 
physician as specific therapy in the treatment of any illness or injury 
suffered by such veteran.
    ``(4)(A) Notwithstanding any other provision of law and except as 
provided in subparagraph (B), a veteran who makes an election under 
paragraph (1) shall not be eligible for care and services under this 
chapter during the year covered by the election.
            ``(B) Subparagraph (A) shall not apply with respect to any 
        veteran who has a compensable service-connected disability.
    ``(5) The furnishing of drugs and medicines under this subsection 
shall be subject to the provisions of section 1722A(b) of this title.
    ``(6)(A) An election under paragraph (1) shall be for a calendar 
year, and shall be irrevocable for the year covered by such election. 
An election may be renewed.
            ``(B) The Secretary shall prescribe the form, manner, and 
        timing of an election.
    ``(7) Before permitting a veteran to make an election under 
paragraph (1), the Secretary shall provide the veteran such educational 
materials and other information on the furnishing and receipt of drugs 
and medicines under this subsection as the Secretary considers 
appropriate to inform the veteran of the benefits and costs of being 
furnished drugs and medicines under this subsection, including 
materials and information on the consequences of making an election 
under paragraph (1) and on the fees, copayments, or other amounts 
required under section 1722A(b) of this title for drugs and medicines 
furnished under this subsection.
    ``(c)(1) In order to assist the Secretary of Health and Human 
Services in carrying out national immunization programs under other 
provisions of law, the Secretary may authorize the administration of 
immunizations to eligible veterans who voluntarily request such 
immunizations in connection with the provision of care for a disability 
under this chapter in any Department health care facility.
    ``(2) Any immunization under paragraph (1) shall be made using 
vaccine furnished by the Secretary of Health and Human Services at no 
cost to the Department. For such purpose, notwithstanding any other 
provision of law, the Secretary of Health and Human Services may 
provide such vaccine to the Department at no cost.
    ``(3) Section 7316 of this title shall apply to claims alleging 
negligence or malpractice on the part of Department personnel granted 
immunity under such section.
    ``(d) Drugs and medicines may be furnished under subsections (a) 
and (b) only if included on the National Prescription Drug Formulary of 
the Department, except that the Secretary may authorize the furnishing 
of a drug or medicine not included on that formulary under such 
circumstances as the Secretary determines warranted.''.
    (b) Copayment Requirements.--
            (1) In general.--Section 1722A of such title is amended--
                    (A) in subsection (a)(1), by inserting ``(other 
                than a veteran covered by subsection (b))'' after 
                ``require a veteran'';
                    (B) by redesignating subsections (b) and (c) as 
                subsections (c) and (d), respectively; and
                    (C) by inserting after subsection (a) the following 
                new subsection (b):
    ``(b)(1) In the case of a veteran who is furnished medications on 
an out-patient basis under section 1710C(b) of this title, the 
Secretary shall require the veteran to pay, at the election of the 
Secretary, one or more of the following:
            ``(A) An annual enrollment fee in an amount determined 
        appropriate by the Secretary.
            ``(B) A copayment for each 30-day supply of such 
        medications in an amount determined appropriate by the 
        Secretary.
            ``(C) An amount equal to the cost to the Secretary of such 
        medications, as determined by the Secretary.
    ``(2)(A) In determining the amounts to be paid by a veteran under 
paragraph (1), and the basis of payment under one or more subparagraphs 
of that paragraph, the Secretary shall ensure that the total amount 
paid by veterans for medications under that paragraph in a year is not 
less than the costs of the Department in furnishing medications to 
veterans under section 1710C(b) of this title during that year, 
including the cost of purchasing and furnishing medications, and other 
costs of administering that section.
            ``(B) The Secretary shall take appropriate actions to 
        ensure, to the maximum extent practicable, that amounts paid by 
        veterans under paragraph (1) in a year are equal to the costs 
        of the Department referred to in subparagraph (A) in that year.
    ``(3) In determining amounts under paragraph (1), the Secretary may 
take into account the following:
            ``(A) Whether or not the medications furnished are generic 
        medications or brand name medications.
            ``(B) Whether or not the medications are furnished by mail.
            ``(C) Any other matters the Secretary considers 
        appropriate.
    ``(4) The Secretary may from time to time adjust any amount 
determined by the Secretary under paragraph (1), as previously adjusted 
under this paragraph, in order to meet the purpose specified in 
paragraph (2).''.
            (2) Deposit of collections in medical care collections 
        fund.--Paragraph (4) of section 1729A(b) of such title is 
        amended to read as follows:
            ``(4) Subsection (a) or (b) of section 1722A of this 
        title.''.
    (c) Conforming Amendments.--
            (1) Enrollment ineligibility.--Section 1707 of such title 
        is amended by adding at the end the following new subsection:
    ``(c) Notwithstanding any other provision of law, a veteran who 
makes an election authorized by section 1710C(b) of this title (other 
than a veteran covered by paragraph (4)(B) of that section) shall not, 
for the period of such election, be eligible for care and services 
under this chapter, except as provided in that section.''.
            (2) Repeal of restated provisions.--Section 1712 of such 
        title is amended by striking subsections (d) and (e).
    (d) Clerical Amendments.--
            (1) Section heading.--The heading for section 1712 of such 
        title is amended to read as follows:
``Sec. 1712. Dental care''.
            (2) Table of sections.--The table of sections at the 
        beginning of chapter 17 of such title is amended--
                    (A) by inserting after the item relating to section 
                1710B the following new item:

``1710C. Drugs and medications; vaccines.''; and
                    (B) by striking the item relating to section 1712 
                and inserting the following new item:

``1712. Dental care.''.
                                 <all>