I 111th CONGRESS 1st Session H. R. 1407 IN THE HOUSE OF REPRESENTATIVES March 10, 2009 Mr. Doggett (for himself, Mr. Lincoln Diaz-Balart of Florida, Mr. Arcuri, Mr. Boswell, Mr. Kennedy, Mr. Langevin, Ms. McCollum, Mr. Snyder, and Mr. Souder) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals.

1.

Short title

This Act may be cited as the Medicare Part D Home and Community Services Copayment Equity Act of 2009.

2.

Elimination of part D cost-sharing for certain non-institutionalized 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 is a resident of a facility described in subclause (III) or who is receiving home and community-based services in a home setting provided under a home and community-based waiver approved for the State under section 1915 or 1115, 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 described in this subclause is an assisted living facility or a resident care program facility (as such terms are defined by the Secretary), a board and care facility (as defined in section 1903(q)(4)(B)), or any other facility that is licensed or certified by the State involved and is determined appropriate by the Secretary, such as a community mental health center that meets the requirements of section 1913(c) of the Public Health Service Act, a psychiatric health facility, a mental health rehabilitation center, and a mental retardation developmental disability facility. . (b)

Effective date

The amendments made by subsection (a) shall apply to drugs dispensed on or after the date of the enactment of this Act.