[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2969 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 2969

To amend title XVIII of the Social Security Act to provide for extended 
   months of Medicare coverage of immunosuppressive drugs for kidney 
        transplant patients and other renal dialysis provisions.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 20, 2011

   Mr. Burgess (for himself, Mr. Kind, Mr. Lewis of California, Mrs. 
 Blackburn, Mr. Himes, Mr. Latham, Mr. Smith of New Jersey, Mr. Rogers 
of Michigan, Mr. Hurt, Mr. Young of Florida, Mr. Lance, Mr. Bachus, Mr. 
McKinley, Mr. Kildee, Ms. Schakowsky, Mr. Boren, Mr. Stark, Mr. Inslee, 
  and Mr. Lewis of Georgia) 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 provide for extended 
   months of Medicare coverage of immunosuppressive drugs for kidney 
        transplant patients and other renal dialysis provisions.

    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 ``Comprehensive Immunosuppressive Drug 
Coverage for Kidney Transplant Patients Act of 2011''.

SEC. 2. EXTENDED MONTHS OF COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR 
              KIDNEY TRANSPLANT PATIENTS AND OTHER RENAL DIALYSIS 
              PROVISIONS.

    (a) Medicare Entitlement to Immunosuppressive Drugs for Kidney 
Transplant Recipients.--
            (1) Kidney transplant recipients.--Section 226A(b)(2) of 
        the Social Security Act (42 U.S.C. 426-1(b)(2)) is amended by 
        inserting ``(except for eligibility for enrollment under part B 
        solely for purposes of coverage of immunosuppressive drugs 
        described in section 1861(s)(2)(J))'' before ``, with the 
        thirty-sixth month''.
            (2) Individuals eligible only for coverage of 
        immunosuppressive drugs.--
                    (A) Section 1836 of the Social Security Act (42 
                U.S.C. 1395o) is amended--
                            (i) by striking ``Every'' and inserting 
                        ``(a) In General.--Every''; and
                            (ii) by inserting at the end the following 
                        new subsection:
    ``(b) Individuals Eligible for Immunosuppressive Drug Coverage.--
Beginning on January 1, 2012, every individual whose insurance benefits 
under part A have ended (whether before, on, or after such date) by 
reason of section 226A(b)(2) is eligible for enrollment in the 
insurance program established by this part solely for purposes of 
coverage of immunosuppressive drugs.''.
                    (B) Conforming amendment.--Sections 1837, 1838, and 
                1839 of the Social Security Act (42 U.S.C. 1395(o), 42 
                U.S.C. 1395(p), 42 U.S.C. 1395(q)) are each amended by 
                striking ``1836'' and inserting ``1836(a)'' each place 
                it appears.
            (3) Enrollment for individuals only eligible for coverage 
        of immunosuppressive drugs.--Section 1837 of the Social 
        Security Act (42 U.S.C. 1395(p)) is amended by adding at the 
        end the following new subsection:
    ``(m)(1) Any individual who is eligible under section 1836(b) to 
enroll in the medical insurance program established under this part for 
purposes of coverage of immunosuppressive drugs may enroll only in such 
manner and form as may be prescribed by regulations, and only during an 
enrollment period described in this subsection.
    ``(2) An individual described in paragraph (1) may enroll beginning 
on the first day of the third month before the month in which the 
individual first satisfies section 1836(b).
    ``(3) An individual described in paragraph (1) whose entitlement 
for hospital insurance benefits under part A ends by reason of section 
226A(b)(2) on or after January 1, 2012, shall be deemed to have 
enrolled in the medical insurance program established by this part for 
purposes of coverage of immunosuppressive drugs.''.
            (4) Coverage period for individuals only eligible for 
        coverage of immunosuppressive drugs.--
                    (A) In general.--Section 1838 of the Social 
                Security Act (42 U.S.C. 1395(q)) is amended by adding 
                at the end the following new subsection:
    ``(g) In the case of an individual described in section 1836(b), 
the following rules shall apply:
            ``(1) In the case of such an individual who is deemed to 
        have enrolled in part B for coverage of immunosuppressive drugs 
        under section 1837(m)(3), such individual's coverage period 
        shall begin on the first day of the month in which the 
        individual first satisfies section 1836(b).
            ``(2) In the case of such an individual who enrolls in part 
        B for coverage of immunosuppressive drugs under section 
        1837(m)(2), such individual's coverage period shall begin on 
        the first day of the month in which the individual first 
        satisfies section 1836(b) or the month following the month in 
        which the individual so enrolls, whichever is later.
            ``(3) The provisions of subsections (b) and (d) shall apply 
        with respect to an individual described in paragraph (1) or 
        (2).
            ``(4) In addition to the reasons for termination under 
        subsection (b), the coverage period of an individual described 
        in paragraph (1) or (2) shall end when the individual becomes 
        entitled to benefits under this title under section 226(a), 
        226(b), or 226A.''.
                    (B) Conforming amendments.--Section 1838(b) is 
                amended in the matter following paragraph (2) by adding 
                ``or section 1837(m)(3)'' after ``section 1837(f)'' 
                each place it appears.
            (5) Premiums for individuals only eligible for coverage of 
        immunosuppressive drugs.--Section 1839 of the Social Security 
        Act (42 U.S.C. 1395r) is amended--
                    (A) in subsection (b), by adding at the end the 
                following new sentence: ``No increase in the premium 
                shall be effected for individuals who are enrolled 
                pursuant to section 1836(b) for coverage only of 
                immunosuppressive drugs.''; and
                    (B) by adding at the end the following new 
                subsection:
    ``(j) Determination of Premium for Individuals Only Eligible for 
Coverage of Immunosuppressive Drugs.--The Secretary shall, during 
September of each year, determine and promulgate a monthly premium rate 
for the succeeding calendar year for individuals who enroll only for 
the purpose of coverage of immunosuppressive drugs under section 
1836(b). Such premium shall be equal to 35 percent of the monthly 
actuarial rate for enrollees age 65 and over, determined according to 
paragraph (1), for that succeeding calendar year. The monthly premium 
of each individual enrolled for coverage of immunosuppressive drugs 
under section 1836(b) for each month shall be the amount promulgated in 
this subsection. Such amount shall be adjusted in accordance with 
subsections (c) and (f).''.
            (6) Government contribution.--Section 1844(a) of the Social 
        Security Act (42 U.S.C. 1395(w)) is amended--
                    (A) in paragraph (3), by striking the period at the 
                end and inserting ``; plus'';
                    (B) by adding at the end the following new 
                paragraph:
            ``(4) a Government contribution equal to the estimated 
        aggregate reduction in premiums payable under part B that 
        results from establishing the premium at 35 percent of the 
        actuarial rate under section 1839(j) instead of 50 percent of 
        the actuarial rate for individuals who enroll only for the 
        purpose of coverage of immunosuppressive drugs under section 
        1836(b).''; and
                    (C) by adding at the end the following flush 
                matter:
        ``The Government contribution under paragraph (4) shall be 
        treated as premiums payable and deposited for purposes of 
        subparagraphs (A) and (B) of paragraph (1).''.
            (7) Extension of secondary payer requirements for esrd 
        beneficiaries eligible for coverage of immunosuppressive 
        drugs.--Section 1862(b)(1)(C) (42 U.S.C. 1395(y)(b)(1)) is 
        amended by adding at the end the following new sentence: ``With 
        regard to immunosuppressive drugs furnished to an individual 
        who enrolls for the purpose of coverage of immunosuppressive 
        drugs under section 1836(b) on or after January 1, 2012, this 
        subparagraph shall apply without regard to any time limitation, 
        except that when such individual becomes entitled to benefits 
        under this title under sections 226(a) or 226(b), or entitled 
        to or eligible for benefits under this title under section 
        226A, the provisions of subparagraphs (A) and (B), and the time 
        limitations under this subparagraph, respectively, shall 
        apply.''.
            (8) Ensuring coverage under the medicare savings program.--
        Section 1905(p)(1)(A) of the Social Security Act (42 U.S.C. 
        1396d(p)(1)(A)) is amended by inserting ``or an individual who 
        is enrolled under part B for the purpose of coverage of 
        immunosuppressive drugs under section 1836(b)'' after ``section 
        1818''.
            (9) Part d.--Section 1860D-1(a)(3)(A) of the Social 
        Security Act (42 U.S.C. 1395w-101(a)(3)(A)) is amended by 
        inserting ``(but not including an individual enrolled solely 
        for coverage of immunosuppressive drugs under section 
        1836(b))'' before the period at the end.
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