[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1024 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 1024

   To amend title XVIII of the Social Security Act to provide part D 
 eligible individuals with single chronic diseases access to services 
under medication therapy management programs under the Medicare part D 
                       prescription drug program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 7, 2013

Mrs. McMorris Rodgers 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 part D 
 eligible individuals with single chronic diseases access to services 
under medication therapy management programs under the Medicare part D 
                       prescription drug program.

    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 ``Medication Therapy Management 
Empowerment Act of 2013''.

SEC. 2. ACCESS TO SERVICES UNDER MEDICATION THERAPY MANAGEMENT PROGRAMS 
              FOR MEDICARE PART D ELIGIBLE INDIVIDUALS WITH SINGLE 
              CHRONIC DISEASES.

    Section 1860D-4(c)(2)(A) of the Social Security Act (42 U.S.C. 
1395w-104(c)(2)(A)) is amended--
            (1) in clause (ii), by striking subclause (I) and inserting 
        the following:
                                    ``(I) have--
                                            ``(aa) multiple chronic 
                                        diseases (such as diabetes, 
                                        asthma, hypertension, 
                                        hyperlipidemia, and congestive 
                                        heart failure); or
                                            ``(bb) subject to clause 
                                        (iii), any single chronic 
                                        disease, including diabetes, 
                                        hypertension, heart failure, 
                                        dyslipidemia, respiratory 
                                        disease (such as asthma, 
                                        chronic obstructive pulmonary 
                                        disease or chronic lung 
                                        disorder), bone disease-
                                        arthritis (such as osteoporosis 
                                        or osteoarthritis), rheumatoid 
                                        arthritis, or mental health 
                                        disorder (such as depression, 
                                        schizophrenia, or bipolar 
                                        disorder).''; and
            (2) by adding at the end the following:
                            ``(iii) Determinations relating to program 
                        costs for including individuals with single 
                        chronic diseases.--
                                    ``(I) Initial determinations.--With 
                                regard to any single chronic disease, 
                                clause (ii)(I)(bb) shall only be 
                                applied if the Chief Actuary for the 
                                Centers for Medicare & Medicaid 
                                Services determines that the 
                                application of such clause with regard 
                                to such disease is not projected to 
                                increase overall costs to the Medicare 
                                program under this title over the five 
                                year period beginning on the date of 
                                determination.
                                    ``(II) Review of determinations.--
                                In the case that clause (ii)(I)(bb) is 
                                applied with respect to a single 
                                chronic disease pursuant to a 
                                determination under subclause (I), not 
                                later than five years after such date 
                                of determination, the Chief Actuary for 
                                the Centers for Medicare & Medicaid 
                                Services shall review the effect of the 
                                application of such clause with respect 
                                to such disease on the actual cost of 
                                the Medicare program under this title 
                                during such five years. Based on such 
                                review, if the Chief Actuary is unable 
                                to determine that, with regard to such 
                                single chronic disease, the application 
                                of such clause did not increase costs 
                                to the Federal government under the 
                                Medicare program under this title over 
                                such period, then the Secretary shall 
                                review the findings of the Chief 
                                Actuary and determine whether such 
                                clause shall continue to be applied 
                                with regard to such single chronic 
                                disease. In conducting such review and 
                                making such determination, the 
                                Secretary shall consider the extent to 
                                which the application of such clause 
                                with regard to such single chronic 
                                disease effects the health outcomes of 
                                part D eligible individuals and any 
                                savings and costs to the Federal 
                                government under the Medicare program 
                                under this title.''.
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