II 111th CONGRESS 1st Session S. 1634 IN THE SENATE OF THE UNITED STATES August 6, 2009 Mr. Rockefeller (for himself, Mr. Akaka, and Mr. Brown) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend titles XVIII and XIX of the Social Security Act to protect and improve the benefits provided to dual eligible individuals under the Medicare and Medicaid programs.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the Medicare Prescription Drug Coverage Improvement Act. (b)

Table of contents

The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. TITLE I—Medicare and Medicaid improvements Sec. 101. Providing Federal coverage and payment coordination for low-income Medicare beneficiaries. Sec. 102. Creating a Medicare operated prescription drug plan option. Sec. 103. Accreditation requirement for all specialized Medicare Advantage plans and revisions relating to specialized Medicare Advantage plans for special needs individuals. Sec. 104. Providing better care coordination for low-income beneficiaries in Medicare part D. Sec. 105. Improving transition of new dual eligible individuals to Medicare prescription drug coverage and presumptive eligibility for low-income subsidies. Sec. 106. Required information on transition from skilled nursing facilities and nursing facilities to part D plans. Sec. 107. Streamlined pharmacy compliance packaging. Sec. 108. Lowering covered part D drug prices on behalf of Medicare beneficiaries. Sec. 109. Correction of flaws in determination of phased-down State contribution for Federal assumption of prescription drug costs for dually eligible individuals. Sec. 110. No impact on eligibility for benefits under other programs. Sec. 111. Quality indicators for dual eligible individuals. TITLE II—Additional Medicare and Medicaid improvements Subtitle A—Improving the financial assistance available to low-Income Medicare beneficiaries Sec. 201. Improving assets tests for Medicare Savings Program and low-income subsidy program. Sec. 202. Eliminating barriers to enrollment. Sec. 203. Elimination of part D cost-sharing for certain non-institutionalized full-benefit dual eligible individuals. Sec. 204. Exemption of balance in any pension or retirement plan from resources for determination of eligibility for low-income subsidy. Sec. 205. Cost-sharing protections for low-income subsidy-eligible individuals. Subtitle B—Other improvements Sec. 211. Enrollment improvements under Medicare parts C and D. Sec. 212. Medicare plan complaint system. Sec. 213. Uniform exceptions and appeals process. Sec. 214. Prohibition on conditioning Medicaid eligibility for individuals enrolled in certain creditable prescription drug coverage on enrollment in the Medicare part D drug program. Sec. 215. Office of the Inspector General annual report on part D formularies' inclusion of drugs commonly used by dual eligibles. Sec. 216. HHS ongoing study and annual reports on coverage for dual eligibles. Sec. 217. Authority to obtain information.