[Congressional Record Volume 147, Number 99 (Tuesday, July 17, 2001)]
[Senate]
[Pages S7809-S7824]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. CLELAND (for himself and Mr. Miller):
S. 1184. A bill to designate the facility of the United States Postal
Service located at 2853 Candler Road in Decatur, Georgia, as the ``Earl
T. Shinhoster Post Office''; to the Committee on Governmental Affairs.
Mr. CLELAND. Mr. President, I rise today to recognize Mr. Earl
Shinhoster for his distinguished career of service to the public and
the cause of civil and human rights. In tribute to Mr. Shinhoster I
hereby introduce legislation to designate the facility of the United
States Postal Service located at 2853 Candler Road in Decatur, Georgia,
as the ``Earl T. Shinhoster Post Office.'' Before his tragic death on
June 12, 2000, he had been an active member of the National Association
for the Advancement of Colored People, NAACP, for more than 30 years as
both a volunteer and staff member, most recently as Acting Executive
Director and Chief Executive Officer of its National Board of Directors
in 1996, and Southeast Regional Director from 1978-1994.
In May 1998, Mr. Shinhoster was Chairman of the Georgia Delegation to
the National Summit on Africa and he was the Field Director for the
National Democratic Institute in Accra, Ghana from 1996 to 1997 where
he observed and monitored the 1996 Presidential and Parliamentary
elections. He also monitored and observed the electoral process in
South Africa and Nigeria. He was active on both the State and local
level serving in the administration of Georgia Governor George Busbee
from 1975 to 1978 as Director of the Governor's Office of Human
Affairs. In 1998, Mr. Shinhoster served as Coordinator of Voter
Education for the State's Election Division.
Earl Shinhoster earned his Bachelor of Arts degree in political
science from Morehouse College in Atlanta, GA in 1972 before pursuing
legal studies at Cleveland State University College of Law in
Cleveland, OH. The particular Post Office to be named after him is the
same Post Office in South DeKalb where he retrieved his mail and is
located in the same community where his family and friends still reside
today. I, along with Senator Miller, urge my colleagues to support this
legislation and recognize Mr. Shinhoster's long and distinguished
career as a public servant promoting civil and human rights in Georgia,
the United States, and around the world. I ask unanimous consent that
the text of the bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1184
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. DESIGNATION OF EARL T. SHINHOSTER POST OFFICE.
(a) In General.--The facility of the United States Postal
Service located at 2853 Candler Road in Decatur, Georgia,
shall be known and designated as the ``Earl T. Shinhoster
Post Office''.
(b) References.--Any reference in a law, map, regulation,
document, paper, or other record of the United States to the
facility referred to in subsection (a) shall be deemed to be
a reference to the Earl T. Shinhoster Post Office.
______
By Mr. WYDEN (for himself and Ms. Snowe):
S. 1185. A bill to amend title XVIII of the Social Security Act to
assure access of Medicare beneficiaries to prescription drug coverage
through the SPICE drug benefit program; to the Committee on Finance.
Mr. WYDEN. Mr. President, today Senator Snowe and I are introducing
our bipartisan legislation to provide a Medicare prescription drug
benefit. Yesterday, I spoke about our proposal, The Senior Prescription
Insurance Coverage Equity Act of 2001. I ask unanimous consent that the
text of the bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1185
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Seniors
Prescription Insurance Coverage Equity (SPICE) Act of 2001''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. SPICE drug benefit program.
``Part D--SPICE Drug Benefit Program
``Sec. 1860A. Establishment of SPICE drug benefit program.
``Sec. 1860B. SPICE prescription drug coverage.
``Sec. 1860C. Enrollment under SPICE drug benefit program.
``Sec. 1860D. Enrollment in a policy or plan.
``Sec. 1860E. Medicare Drug Plan for Noncompetitive Areas.
``Sec. 1860F. Selection of private entities to provide basic coverage.
``Sec. 1860G. Providing information to beneficiaries.
``Sec. 1860H. Premiums.
``Sec. 1860I. Approval for entities offering SPICE prescription drug
coverage.
``Sec. 1860J. Payments to entities.
``Sec. 1860K. Financial assistance to obtain SPICE prescription drug
coverage.
``Sec. 1860L. Employer incentive program for employment-based retiree
drug coverage.
``Sec. 1860M. SPICE Board.
``Sec. 1860N. SPICE Prescription Drug Account in the Federal
Supplementary Medical Insurance Trust Fund.''.
Sec. 3. SPICE prescription drug coverage under Medicare+Choice plans.
Sec. 4. Medigap revisions and transition provisions.
Sec. 5. Provision of information on SPICE drug benefit program under
health insurance information, counseling, and assistance
grants.
Sec. 6. Personal Digital Access Technology Demonstration Project.
SEC. 2. SPICE DRUG BENEFIT PROGRAM.
(a) In General.--Title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.) is amended by redesignating part D as
part E and by inserting after part C the following new part:
``Part D--SPICE Drug Benefit Program
``establishment of spice drug benefit program
``Sec. 1860A. (a) Access to SPICE Prescription Drug
Coverage.--
``(1) In general.--Beginning in 2003, the SPICE Board
(established under section 1860M) shall provide for a SPICE
drug benefit program under which all eligible medicare
beneficiaries who voluntarily enroll under this part shall be
entitled to obtain SPICE prescription drug coverage (meeting
the terms and conditions under this part) as follows:
``(A) Medicare+choice plan.--If the eligible medicare
beneficiary is eligible to enroll in a Medicare+Choice plan,
the beneficiary may enroll in the plan and obtain SPICE
prescription drug coverage (as defined in section 1860B(a))
through such plan.
``(B) Medicare supplemental policy.--If the eligible
medicare beneficiary is not enrolled in a Medicare+Choice
plan but is enrolled in a medicare supplemental policy, the
beneficiary may--
``(i) obtain SPICE prescription drug coverage through such
policy; or
``(ii) waive basic coverage (as defined in section
1860B(b)) pursuant to section 1860C(a)(3) and obtain
financial assistance pursuant to section 1860K(c) for stop-
loss coverage (as defined in section 1860B(c)) provided under
such policy.
``(C) Medicare drug plan for noncompetitive areas.--If the
eligible medicare beneficiary is not enrolled in a
Medicare+Choice plan, a medicare supplemental policy, or a
basic coverage plan under section 1860F, and there is a
Medicare Drug Plan for Noncompetitive Areas available in the
area in which the beneficiary resides, the beneficiary may
obtain SPICE prescription drug coverage under this part
through enrollment in such plan.
``(D) Basic coverage only through a private entity.--If the
eligible medicare beneficiary is not enrolled in a
Medicare+Choice plan, a medicare supplemental policy, or a
Medicare Drug Plan for Noncompetitive Areas, the beneficiary
may obtain basic coverage (including financial assistance for
such coverage under section 1860K(b) and access to negotiated
prices under section 1860B(d)) through enrollment in a plan
offered by a private entity with a contract to offer such
plan under section 1860F.
``(2) Voluntary nature of program.--Nothing in this part
shall be construed as requiring an eligible medicare
beneficiary to enroll in the program established under this
part.
``(3) Administration of benefits.--In providing SPICE
prescription drug coverage to an eligible medicare
beneficiary under this part, an entity offering a medicare
supplemental policy, a Medicare+Choice plan, a Medicare Drug
Plan for Noncompetitive Areas, or a basic coverage plan under
section 1860F may--
``(A) directly administer the benefits under such coverage;
or
``(B) contract with an entity that meets the applicable
requirements under this part to administer such benefits.
``(b) Access to Alternative Prescription Drug Coverage.--In
the case of an eligible medicare beneficiary who has
creditable prescription drug coverage (as defined in section
1860C(b)(4)) under a policy or plan, such beneficiary--
``(1) may continue to receive such coverage under such
policy or plan and not enroll under this part; and
``(2) pursuant to section 1860C(b)(3), is permitted to
subsequently enroll under this
[[Page S7810]]
part and obtain SPICE prescription drug coverage without any
penalty if such policy or plan terminated, ceased to provide,
or substantially reduced the value of the prescription drug
coverage under such plan or policy.
``(c) Financial Assistance.--
``(1) Under spice drug benefit program.--Under the SPICE
drug benefit program, the SPICE Board shall provide financial
assistance, with such assistance varying depending upon the
income of such beneficiary, for any eligible medicare
beneficiary enrolled under this part who voluntarily
obtains--
``(A) basic coverage (pursuant to subsection (b) of section
1860K); or
``(B) stop-loss coverage (pursuant to subsection (c) of
such section).
``(2) Assistance to group health plans that provide
prescription drug coverage to eligible medicare
beneficiaries.--Pursuant to the Employer Incentive Program
established under section 1860L, the SPICE Board shall make
payments to employers and other sponsors of employment-based
health care coverage to encourage such employers and sponsors
to provide adequate prescription drug coverage to retired
individuals.
``(d) Eligible Medicare Beneficiary Defined.--For purposes
of this part, the term `eligible medicare beneficiary' means
an individual who is entitled to benefits under part A and
enrolled under part B.
``(e) Financing.--The costs of providing benefits under
this part shall be payable from the SPICE Prescription Drug
Account (as established under section 1860N) within the
Federal Supplementary Medical Insurance Trust Fund under
section 1841.
``spice prescription drug coverage
``Sec. 1860B. (a) In General.--For purposes of this part,
the term `SPICE prescription drug coverage' means coverage
consisting of the following:
``(1) Basic coverage.--Basic coverage (as defined in
subsection (b)) and access to negotiated prices under
subsection (d), except as waived pursuant to section
1860C(a)(3).
``(2) Stop-loss coverage.--Stop-loss coverage (as defined
in subsection (c)).
``(b) Basic Coverage.--For purposes of this part, the term
`basic coverage' means coverage of covered outpatient drugs
(as defined in subsection (e)) that meets the following
requirements:
``(1) Deductible.--The coverage has an annual deductible--
``(A) for 2003, that is equal to $350; or
``(B) for a subsequent year, that is equal to the amount
specified under this paragraph for the previous year
increased by the percentage specified in paragraph (4) for
the year involved.
Any amount determined under subparagraph (B) that is not a
multiple of $5 shall be rounded to the nearest multiple of
$5.
``(2) Coinsurance.--The coverage has coinsurance (for the
cost of a covered outpatient drug above the annual deductible
specified in paragraph (1) for the year and up to the initial
coverage limit specified in paragraph (3) for the year) that
does not exceed 25 percent of the cost of such drug.
``(3) Initial coverage limit.--
``(A) In general.--The coverage has an initial coverage
limit for covered outpatient drugs in a year that is reached
when the eligible medicare beneficiary has incurred the
applicable amount of out-of-pocket expenses in the year.
``(B) Applicable amount defined.--For purposes of
subparagraph (A), the term `applicable amount' means--
``(i) for 2003, $3,000; or
``(ii) for a subsequent year, the amount specified in this
subparagraph for the previous year, increased by the annual
percentage increase described in paragraph (4) for the year
involved.
Any amount determined under clause (ii) that is not a
multiple of $25 shall be rounded to the nearest multiple of
$25.
``(C) Application.--In applying paragraph (1)--
``(i) incurred out-of-pocket expenses shall only include
expenses incurred for the annual deductible (described in
paragraph (1)) and coinsurance (described in paragraph (2));
and
``(ii) such expenses shall be treated as incurred without
regard to whether the individual or another person, including
a State program or other third-party coverage, has paid for
such expenses.
``(4) Annual percentage increase.--For purposes of this
part, the annual percentage increase specified in this
paragraph for a year is equal to the annual percentage
increase in average per capita aggregate expenditures for
benefits under this title, as determined by the Secretary for
the 12-month period ending in July of the previous year.
``(c) Stop-Loss Coverage.--For purposes of this part, the
term `stop-loss coverage' means coverage of covered
outpatient drugs in a year without any coinsurance after the
eligible medicare beneficiary has reached the initial
coverage limit specified in subsection (b)(3) for the year.
``(d) Access to Negotiated Prices.--Under SPICE
prescription drug coverage offered under a policy or plan,
the entity offering the policy or plan (or the administering
entity pursuant to subsection (a)(3)(B)) shall provide
beneficiaries with access to negotiated prices (including
applicable discounts) used for payment for covered outpatient
drugs, regardless of the fact that no benefits may be payable
under the coverage with respect to such drugs because of the
application of the annual deductible.
``(e) Covered Outpatient Drugs Defined.--
``(1) In general.--Except as provided in this subsection,
for purposes of this part, the term `covered outpatient drug'
means--
``(A) a drug that may be dispensed only upon a prescription
and that is described in subparagraph (A)(i) or (A)(ii) of
section 1927(k)(2); or
``(B) a biological product described in clauses (i) through
(iii) of subparagraph (B) of such section or insulin
described in subparagraph (C) of such section,
and such term includes any use of a covered outpatient drug
for a medically accepted indication (as defined in section
1927(k)(6)).
``(2) Exclusions.--
``(A) In general.--Such term does not include drugs or
classes of drugs, or their medical uses, which may be
excluded from coverage or otherwise restricted under section
1927(d)(2), other than subparagraph (E) thereof (relating to
smoking cessation agents) and except to the extent otherwise
specifically provided by the SPICE Board with respect to a
drug in any of such classes.
``(B) Avoidance of duplicate coverage.--A drug prescribed
for an individual that would otherwise be a covered
outpatient drug under this part shall not be so considered if
payment for such drug is available under part A or B or would
be available under part B but for the application of a
deductible under such part (but shall be so considered if
such payment is not available because benefits under part A
or B have been exhausted).
``(3) Application of formulary restrictions.--A drug
prescribed for an individual that would otherwise be a
covered outpatient drug under this part shall not be so
considered under a policy or plan if the policy or plan
excludes the drug under a formulary that meets the
requirements of section 1860I(c)(3) (including providing an
appeal process).
``(4) Application of general exclusion provisions.--An
entity may exclude from SPICE prescription drug coverage any
covered outpatient drug--
``(A) for which payment would not be made if section
1862(a) applied to part D; or
``(B) which are not prescribed in accordance with the
policy or plan or this part.
Such exclusions are determinations subject to reconsideration
and appeal pursuant to section 1860I(c)(6).
``enrollment under spice drug benefit program
``Sec. 1860C. (a) Establishment of Process.--
``(1) Establishment.--
``(A)In general.--The SPICE Board, in consultation with the
Secretary, the National Association of Insurance
Commissioners, issuers of medicare supplemental policies, and
Medicare+Choice organizations, shall establish a process
through which an eligible medicare beneficiary (including an
eligible medicare beneficiary enrolled in a Medicare+Choice
plan) may enroll under this part.
``(B) Similar to part b.--
``(i) In general.--Except as provided in clause (ii), the
process established under subparagraph (A) shall be similar
to the process for enrollment in part B under section 1837.
``(ii) Beneficiary must affirmatively enroll.--
Notwithstanding section 1837(f), such process shall require
that an eligible medicare beneficiary affirmatively enroll
under this part rather than deeming the beneficiary to be so
enrolled if certain requirements are met.
``(2) Requirement of enrollment.--An eligible medicare
beneficiary must enroll under this part in order to be
eligible to receive SPICE prescription drug coverage,
including financial assistance for basic and stop-loss
coverage under section 1860K.
``(3) Waiver of basic coverage for medigap enrollees.--
``(A) In general.--The process established under paragraph
(1) shall permit a beneficiary enrolled under this part and
enrolled under a medicare supplemental policy to--
``(i) waive the basic coverage available under this part;
and
``(ii) rescind such waiver in order to obtain such
coverage.
``(B) Rules.--If a beneficiary waives basic coverage
pursuant to subparagraph (A)(i), the following rules shall
apply:
``(i) Such waiver shall not effect the stop-loss coverage
that the beneficiary receives under the medicare supplemental
policy, including the entitlement to financial assistance
under section 1860K(c) for such coverage.
``(ii) The beneficiary shall not be liable for the basic
monthly premium under section 1860H(a).
``(iii) The beneficiary shall not receive basic coverage
but shall be entitled to negotiated prices for covered
outpatient drugs as if the beneficiary had not waived such
coverage.
``(iv) If the beneficiary subsequently rescinds such waiver
pursuant to subparagraph (A)(ii), the beneficiary shall be
subject to the late enrollment penalty under subsection (b).
``(b) Late Enrollment Penalty.--
``(1) In general.--Subject to the succeeding provisions of
this subsection, in the case of an eligible medicare
beneficiary whose coverage period under this part began
pursuant to an enrollment after the beneficiary's initial
enrollment period under part B (determined pursuant to
section 1837(d)) and not pursuant to the open enrollment
period described in subsection (c), the SPICE
[[Page S7811]]
Board shall establish procedures for increasing the amount of
the basic monthly premium under section 1860H(a) applicable
to such beneficiary--
``(A) by an amount that is equal to 25 percent of such
premium for each full 12-month period (in the same continuous
period of eligibility) in which the eligible medicare
beneficiary could have been enrolled under this part but was
not so enrolled; or
``(B) if determined appropriate by the SPICE Board, by an
amount that the SPICE Board determines is actuarily sound for
each such period.
``(2) Periods taken into account.--For purposes of
calculating any 12-month period under paragraph (1), there
shall be taken into account--
``(A) the months which elapsed between the close of the
eligible medicare beneficiary's initial enrollment period and
the close of the enrollment period in which the beneficiary
enrolled;
``(B) in the case of an eligible medicare beneficiary who
reenrolls under this part, the months which elapsed between
the date of termination of a previous coverage period and the
close of the enrollment period in which the beneficiary
reenrolled; and
``(C) in the case of an eligible medicare beneficiary who
is enrolled under this part but has waived basic coverage
pursuant to subsection (a)(3), the months which elapsed
between the effective date of such waiver and the effective
date of the rescission of such waiver.
``(3) Periods not taken into account.--
``(A) In general.--For purposes of calculating any 12-month
period under paragraph (1), subject to subparagraph (B),
there shall not be taken into account months for which the
eligible medicare beneficiary can demonstrate that the
beneficiary--
``(i) met such exceptional conditions (including conditions
recognized under section 1851(e)(4)(D)) as the SPICE Board
may provide; or
``(ii) had creditable prescription drug coverage (as
defined in paragraph (4)).
``(B) Application.--The exception described in subparagraph
(A)(ii) shall only apply with respect to a coverage period
the enrollment for which occurs before the end of the 63-day
period that begins on the first day of the month which
includes the date on which the policy or plan involved
terminates, ceases to provide, or substantially reduces the
value of the prescription drug coverage under such policy or
plan.
``(4) Prescription drug coverage.--For purposes of this
part, the term `creditable prescription drug coverage' means
any of the following:
``(A) Medicaid prescription drug coverage.--Prescription
drug coverage under a medicaid plan under title XIX,
including through the Program of All-inclusive Care for the
Elderly (PACE) under section 1934, through a social health
maintenance organization (referred to in section 4104(c) of
the Balanced Budget Act of 1997), or through a
Medicare+Choice project that demonstrates the application of
capitation payment rates for frail elderly medicare
beneficiaries through the use of a interdisciplinary team and
through the provision of primary care services to such
beneficiaries by means of such a team at the nursing facility
involved.
``(B) Prescription drug coverage under group health plan.--
Any outpatient prescription drug coverage under a group
health plan, including a health benefits plan under the
Federal Employees Health Benefit Plan under chapter 89 of
title 5, United States Code, and a qualified retiree
prescription drug plan as defined in section 1860L(e)(3).
``(C) Prescription drug coverage under certain medigap
policies.--Coverage under a medicare supplemental policy
under section 1882 that provides benefits for prescription
drugs but only if the policy was in effect on December 31,
2002, and only until the date such coverage is terminated.
``(D) State pharmaceutical assistance program.--Coverage of
prescription drugs under a State pharmaceutical assistance
program.
``(E) Veterans' coverage of prescription drugs.--Coverage
of prescription drugs for veterans under chapter 17 of title
38, United States Code.
``(5) Periods treated separately.--Any increase in an
eligible medicare beneficiary's basic monthly premium under
paragraph (1) with respect to a particular continuous period
of eligibility shall not be applicable with respect to any
other continuous period of eligibility which the beneficiary
may have.
``(6) Continuous period of eligibility.--
``(A) In general.--Subject to subparagraph (B), for
purposes of this subsection, an eligible medicare
beneficiary's `continuous period of eligibility' is the
period that begins with the first day on which the
beneficiary is eligible to enroll under section 1836 and this
part and ends with the beneficiary's death.
``(B) Separate period.--Any period during all of which an
eligible medicare beneficiary satisfied paragraph (1) of
section 1836 and which terminated during or before the month
preceding the month in which the beneficiary attained age 65
shall be a separate `continuous period of eligibility' with
respect to the beneficiary (and each such period which
terminates shall be deemed not to have existed for purposes
of subsequently applying this subparagraph).
``(c) Open Enrollment Period for Current Beneficiaries in
Which Late Enrollment Procedures Do Not Apply.--The SPICE
Board shall establish an applicable period, which shall begin
on the date on which the SPICE Board first begins to accept
enrollments under this part, during which any eligible
medicare beneficiary may enroll under this part without the
application of the late enrollment procedures established
under subsection (b)(1).
``(d) Period of Coverage.--
``(1) In general.--Except as provided in paragraph (2), an
eligible medicare beneficiary's coverage under the program
under this part shall be effective for the period provided in
section 1838, as if that section applied to the program under
this part.
``(2) Open enrollment.--An eligible medicare beneficiary
who enrolls under the program under this part pursuant to
subsection (c) shall be entitled to the benefits under this
part beginning on the first day of the month following the
month in which such enrollment occurs.
``(3) Rescission of waiver.--The SPICE Board shall
establish procedures regarding coverage periods for an
eligible medicare beneficiary enrolled under this part who
previously waived basic coverage under subsection (a)(3) and
now wishes to rescind such waiver.
``(4) Limitation.--Coverage under this part shall not begin
prior to January 1, 2003.
``(e) Termination.--
``(1) In general.--The causes of termination specified in
section 1838 shall apply to this part in the same manner as
they apply to part B.
``(2) Coverage terminated by termination of coverage under
parts a and b.--
``(A) In general.--In addition to the causes of termination
described in paragraph (1), the SPICE Board shall terminate
an individual's coverage under this part if the individual is
no longer enrolled in either part A or B.
``(B) Effective date.--The termination described in
subparagraph (A) shall be effective on the effective date of
termination of coverage under part A or (if earlier) under
part B.
``(3) Procedures regarding termination of a beneficiary
under a plan or policy.--The SPICE Board shall establish
procedures for determining the status of an eligible medicare
beneficiary's enrollment under this part if the beneficiary's
enrollment in a medicare supplemental policy, a
Medicare+Choice plan, a Medicare Drug Plan for Noncompetitive
Areas, or a basic coverage plan under section 1860F is
terminated by the entity offering such policy or plan for
cause (under the applicable requirements established under
this title).
``enrollment in a policy or plan
``Sec. 1860D. (a) Enrollment in Medicare Drug Plan for
Noncompetitive Areas.--The SPICE Board shall establish a
process through which an eligible medicare beneficiary who is
enrolled under this part (but not enrolled in a medicare
supplemental policy, a Medicare+Choice plan, or a basic
coverage plan under section 1860F) and resides in an area in
which a Medicare Drug Plan for Noncompetitive Areas is
available may enroll in such plan. Such process shall include
rules for enrollment, disenrollment, and termination of
enrollment in such plan.
``(b) Enrollment in a Medicare Supplemental Policy or a
Medicare+Choice Plan.--Enrollment in a medicare supplemental
policy or a Medicare+Choice plan is subject to the rules for
enrollment in such policy or plan under sections 1882 and
1851, respectively.
``(c) Enrollment in a Basic Coverage Plan offered by a
Private Entity with a Contract under this Part.--The SPICE
Board shall establish a process through which an eligible
medicare beneficiary who is enrolled under this part (but not
enrolled in a medicare supplemental policy, a Medicare+Choice
plan, or a Medicare Drug Plan for Noncompetitive Areas) may
enroll in a basic coverage plan offered by a private entity
with a contract under section 1860F to offer such plan. Such
process shall include rules for enrollment, disenrollment,
and termination of enrollment in such plan.
``(d) Coordination of enrollments, disenrollments, and
terminations of enrollments.--The SPICE Board shall establish
procedures for coordinating enrollments, disenrollments and
terminations of enrollments under plans described in
subsections (a) and (c) with enrollments, disenrollments and
terminations of enrollments under part C.
``medicare drug plan for noncompetitive areas
``Sec. 1860E. (a) In General.--The SPICE Board shall
provide for a Medicare Drug Plan for Noncompetitive Areas
that--
``(1) provides enrollees with SPICE prescription drug
coverage; and
``(2) is available to eligible medicare beneficiaries
residing in an area that has been designated by the SPICE
Board as a noncompetition area.
``(b) Designation of Noncompetition Area.--
``(1) In general.--The SPICE Board shall establish
procedures for designating areas as noncompetition areas.
``(2) Noncompetition area defined.--
``(A) In general.--For purposes of this section, the term
`noncompetition area' means an area in which only 1 or no
medicare supplemental policy is available to eligible
medicare beneficiaries residing in the area.
``(B) Construction regarding multiple policies offered by
single issuer.--If there is an entity that offers more that 1
type of
[[Page S7812]]
medicare supplemental policy in an area, then that area is
not a noncompetition area for purposes of this section.
``(c) Contracts.--In order to provide the Medicare Drug
Plan for Noncompetitive Areas under this section, the SPICE
Board shall do 1 of the following:
``(1) Single contract that covers all noncompetition
areas.--Enter into a contract with 1 entity to administer and
deliver the benefits under the plan in every designated
noncompetition area.
``(2) Multiple contracts.--Enter into a contract with 1
entity to administer and deliver the benefits under the plan
in 1 or more (but less than all) of the designated
noncompetition areas.
``(d) Bidding Process.--
``(1) In general.--The SPICE Board shall establish
procedures under which the SPICE Board accepts bids submitted
by entities and awards a contract (or contracts pursuant to
subsection (c)(2)) to an entity in order to administer and
deliver the benefits under the Medicare Drug Plan for
Noncompetitive Areas to eligible medicare beneficiaries.
``(2) Competitive procedures.--Competitive procedures (as
defined in section 4(5) of the Office of Federal Procurement
Policy Act (41 U.S.C. 403(5))) shall be used to enter into
contracts under this section.
``(e) Requirements for Entities.--
``(1) In general.--The SPICE Board may not award a contract
to an entity under this section unless the entity meets such
terms and conditions as the SPICE Board shall specify,
including the following:
``(A) The terms and conditions described in section
1860I(c).
``(B) The entity meets the quality and financial standards
specified by the SPICE Board.
``(C) The entity meets applicable State licensure
requirements.
``(2) Premiums.--The terms and conditions specified under
paragraph (1) shall--
``(A) permit an entity with a contract under this section
to require that beneficiaries enrolled in the plan covered by
the contract pay a premium for benefits provided under the
contract; and
``(B) except as provided in section 1860H(b)(3) (relating
to an increased premium for delayed enrollment under this
part), require that the amount of any such premium is the
same for all beneficiaries enrolled in the plan.
``selection of private entities to provide basic coverage plans
``Sec. 1860F. (a) Selection of Entities.--
``(1) In general.--The SPICE Board shall establish
procedures under which the SPICE Board--
``(A) accepts bids submitted by private entities for the
basic coverage plans which such entities intend to offer in
an area established under subsection (b); and
``(B) awards contracts to such entities to provide such
plans to eligible medicare beneficiaries in the area.
``(2) Competitive procedures.--Competitive procedures (as
defined in section 4(5) of the Office of Federal Procurement
Policy Act (41 U.S.C. 403(5))) shall be used to enter into
contracts under this section.
``(b) Areas for Contracts.--
``(1) In general.--The SPICE Board shall determine the
areas to award contracts under this section.
``(2) No administrative or judicial review.--The
determination of contract areas under paragraph (1) shall not
be subject to administrative or judicial review.
``(3) Multiple contracts.--If determined appropriate, the
SPICE Board may award more than 1 contract in a contract
area.
``(c) Requirements for Entities.--
``(1) In general.--The SPICE Board may not award a contract
to a private entity under this section unless the entity
meets such terms and conditions as the SPICE Board shall
specify, including the following:
``(A) The terms and conditions described in section
1860I(c).
``(B) The entity meets the quality and financial standards
specified by the SPICE Board.
``(C) The entity meets applicable State licensure
requirements.
``(D) Under the plan, the entity will provide basic
coverage with access to negotiated prices.
``(d) Private Entity Defined.--For purposes of this part,
the term `private entity' means any private entity that the
SPICE Board determines to be appropriate to provide basic
coverage plans to eligible medicare beneficiaries under this
part, including--
``(1) a pharmacy benefit management company;
``(2) a retail pharmacy delivery system;
``(3) a health plan or insurer;
``(4) any other private entity approved by the SPICE Board;
or
``(5) any combination of the entities described in
paragraphs (1) through (4) approved by the SPICE Board.
``providing information to beneficiaries
``Sec. 1860G. (a) Activities.--
``(1) In general.--The SPICE Board shall provide for
activities that are designed to broadly disseminate
information to eligible medicare beneficiaries (and
prospective eligible medicare beneficiaries) on the SPICE
drug benefit program under this part.
``(2) Late enrollment penalties to be well publicized.--The
SPICE Board shall ensure that information on the sanctions
for delayed enrollment under section 1860C(b) and on the
possibility of increased premiums for stop-loss coverage
under section 1860H(b)(3) are well publicized.
``(3) Special rule for initial enrollment under the
program.--
``(A) Consultation.--The SPICE Board shall consult with the
Secretary, issuers of medicare supplemental policies, State
insurance commissioners, Medicare+Choice organizations, and
interested consumer organizations in developing the
activities described in paragraph (1) that will be used to
provide information regarding the initial enrollment under
this part during the period described in section 1860C(c).
``(B) Timeframe.--The activities described in paragraph (1)
shall ensure that eligible medicare beneficiaries (and
prospective eligible medicare beneficiaries) are provided
with such information not later that December 1, 2002, in
order to ensure that coverage under this part may be
effective as of January 1, 2003.
``(4) Coordination with activities performed by the
secretary.--The SPICE Board shall work with the Secretary to
ensure that the activities provided under this subsection are
coordinated with the activities performed by the Secretary
that provide information with respect to benefits under this
title to eligible medicare beneficiaries and prospective
eligible medicare beneficiaries.
``(b) Requirements.--
``(1) In general.--The activities described in subsection
(a) shall--
``(A) be similar to the activities performed under section
1851 (including the approval of policy marketing materials
and maintaining a toll-free number and an Internet site); and
``(B) include provisions to ensure that consumer counselors
are available to provide face-to-face counseling to eligible
medicare beneficiaries (and prospective eligible medicare
beneficiaries) on the SPICE drug benefit program under this
part.
``(2) Contracts to provide consumer counseling.--The SPICE
Board may contract with private entities to provide the
consumer counseling described in paragraph (1)(B).
``(c) Coordination With Other Information.--The SPICE Board
shall, in cooperation with the Secretary, enter into such
arrangements as may be appropriate to disseminate the
information referred to in subsection (a) in coordination
with materials distributed by the Secretary to medicare
beneficiaries, including the medicare handbook under section
1804 and materials distributed under section 1851(d).
``premiums
``Sec. 1860H. (a) Premium for Basic Coverage for All
Beneficiaries.--
``(1) Annual establishment of basic monthly premium
rates.--The SPICE Board shall, during September of each year
(beginning in 2002), determine and promulgate a basic monthly
premium rate for the succeeding year in accordance with the
provisions of this subsection.
``(2) Actuarial determinations.--
``(A) Determination of annual benefit and administrative
costs for basic coverage.--The SPICE Board shall estimate
annually for the succeeding year the amount equal to the
total of the benefits (including financial assistance
provided under subsections (b) and (c) of section 1860K and
payments made to sponsors under section 1860L) and
administrative costs that will be payable from the SPICE
Prescription Drug Account within the Federal Supplementary
Medical Insurance Trust Fund for providing benefits under
this part in such calendar year.
``(B) Determination of basic monthly premium rates.--
``(i) In general.--The SPICE Board shall determine the
basic monthly premium rate for such succeeding year, which
shall be \1/12\ of the amount determined under subparagraph
(A), divided by the average total number of enrollees under
this part who have not waived basic coverage under section
1860C(a)(3) (as estimated for the year), and rounded (if such
rate is not a multiple of 10 cents) to the nearest multiple
of 10 cents.
``(ii) Premium reduced by amount of financial assistance.--
The amount that shall be charged a beneficiary for basic
coverage under this part is the basic monthly premium
determined under clause (i), reduced by the amount of the
financial assistance for basic coverage determined for the
beneficiary under section 1860K(b).
``(3) Publication of assumptions.--The SPICE Board shall
publish, together with the promulgation of the basic monthly
premium rates for the succeeding year, a statement setting
forth the actuarial assumptions and bases employed in
arriving at the amounts and rates determined under paragraphs
(1) and (2).
``(4) Collection of premiums.--Any basic monthly premium
applicable to an eligible medicare beneficiary pursuant to
this subsection, after application of the reduction described
in paragraph (2)(B)(ii) and any increase for late enrollment
under section 1860C(b), shall be collected and credited to
the SPICE Prescription Drug Account in the same manner as the
monthly premium determined under section 1839 is collected
and credited to the Federal Supplementary Medical Insurance
Trust Fund under section 1840.
``(b) Premiums for Stop-Loss Coverage.--
``(1) Beneficiary responsible for making payment directly
to entity.--Subject to paragraph (2), any eligible medicare
beneficiary who is receiving stop-loss coverage, either
through enrollment in a medicare supplemental policy, a
Medicare+Choice plan, or
[[Page S7813]]
a Medicare Drug Plan for Noncompetitive Areas, shall be
responsible for making payments for any premiums required
under the policy or plan for such coverage directly to the
entity offering such policy or plan.
``(2) Premium reduced by amount of financial assistance.--
The entity offering such policy or plan shall reduce the
premium described in paragraph (1) by the amount of the
financial assistance for stop-loss coverage determined for
the beneficiary under section 1860K(c).
``(3) Increase in premium for late enrollment or for lack
of continuous stop-loss coverage.--In the case of an eligible
medicare beneficiary who is subject to a late enrollment
penalty under section 1860C or who has not had continuous
stop-loss coverage under this part because the beneficiary
was enrolled in a basic coverage plan under section 1860F,
the entity offering the medicare supplemental policy, the
Medicare+Choice plan, or the Medicare Drug Plan for
Noncompetitive Areas in which the beneficiary is enrolled
may, notwithstanding any provision in this title, increase
the portion of the premium attributable to stop-loss coverage
that is otherwise applicable to such beneficiary for such
enrollment in a manner that reflects the additional actuarial
risk involved. Such a risk shall be established through an
appropriate actuarial opinion of the type described in
subparagraphs (A) through (C) of section 2103(c)(4).
``approval for entities offering spice prescription drug coverage
``Sec. 1860I. (a) Approval.--No payments may be made to an
entity offering a policy or plan that provides SPICE
prescription drug coverage under section 1860J unless the
entity has been approved by the SPICE Board.
``(b) Procedures.--
``(1) In general.--The SPICE Board shall establish
procedures for approving entities that offer policies and
plans that provide SPICE prescription drug coverage under
this part, including an entity with a contract under section
1860F.
``(2) Coordination.--The procedures established under
subparagraph (A) shall be coordinated with--
``(A) in the case of the approval of medicare supplemental
policies, the procedures for approval of such policies under
State law; and
``(B) in the case of the approval of Medicare+Choice plans,
the procedures established by the Secretary for approval of
such plans under part C.
``(c) Terms and Conditions.--The SPICE Board may not
approve an entity under subsection (b) unless the entity,
with respect to such policy or plan, meets such terms and
conditions as the SPICE Board shall specify, including the
following:
``(1) Dissemination of information.--
``(A) General information.--The entity shall disclose, in a
clear, accurate, and standardized form to each enrollee under
the policy or plan at the time of enrollment and at least
annually thereafter, the information described in section
1852(c)(1) relating to such policy or plan. Such information
shall include the following:
``(i) Access to covered outpatient drugs, including access
through pharmacy networks.
``(ii) How any formulary used by the entity functions.
``(iii) Coinsurance and deductible requirements.
``(iv) Grievance and appeals procedures.
``(B) Disclosure upon request of general coverage,
utilization, and grievance information.--Upon request of an
individual eligible to enroll under the policy or plan, the
entity shall provide the information described in section
1852(c)(2) (other than subparagraph (D)) to such individual.
``(C) Response to beneficiary questions.--The entity shall
have a mechanism for providing specific information regarding
the policy or plan to enrollees upon request and shall make
available, through the Internet website described in
paragraph (7) and in writing upon request, information on
specific changes in its formulary.
``(D) Claims information.--The entity shall furnish to each
enrollee under the plan or policy in a form easily
understandable to such enrollees an explanation of benefits
(in accordance with section 1806(a) or in a comparable
manner) and a notice regarding how close the enrollee is to
getting stop-loss coverage for the year, whenever
prescription drug benefits are provided under this part
(except that such notice need not be provided more often than
monthly).
``(2) Access to covered benefits.--
``(A) Assuring pharmacy access.--The entity shall secure
the participation of sufficient numbers of pharmacies to
ensure convenient access (including adequate emergency
access) for enrollees under the policy or plan. Nothing in
the preceding sentence shall be construed as requiring the
participation of all pharmacies in any area under a policy or
plan.
``(B) Access to negotiated prices for prescription drugs.--
The entity shall issue a card that may be used by an enrollee
under the policy or plan to assure access to negotiated
prices pursuant to section 1860B(d).
``(3) Formularies.--If an eligible entity uses a formulary
under the policy or plan, such entity shall--
``(A) establish the formulary based on the medical needs of
eligible medicare beneficiaries;
``(B) ensure that the formulary includes drugs within all
therapeutic categories and classes of covered outpatient
drugs (although not necessarily for all drugs within such
categories and classes);
``(C) have in place an appeals process--
``(i) under which any eligible medicare beneficiary could
receive any medically necessary covered outpatient drug that
is not on the formulary;
``(ii) that does not impose a significant financial burden
on an eligible medicare beneficiary or delay the provision of
medically necessary covered outpatient drugs to such a
beneficiary; and
``(iii) that provides for at least a level of protection
that is similar to or better than the level of protection
provided with respect to benefits under Medicare+Choice plans
under part C; and
``(D) provide notification to enrollees of any change in
the formulary at least 60 days prior to such change.
``(4) Cost and utilization management; quality assurance;
medication therapy management program.--
``(A) In general.--The entity shall have in place--
``(i) an effective cost and drug utilization management
program, including appropriate incentives to use generic
drugs when appropriate;
``(ii) quality assurance measures and systems to reduce
medical errors and adverse drug interactions, including a
medication therapy management program described in
subparagraph (B); and
``(iii) a program to control fraud, abuse, and waste.
``(B) Medication therapy management program.--
``(i) In general.--A medication therapy management program
described in this subparagraph is a program of drug therapy
management and medication administration that is designed to
assure that covered outpatient drugs under the policy or plan
are appropriately used to achieve therapeutic goals and
reduce the risk of adverse events, including adverse drug
interactions.
``(ii) Elements.--Such program may include--
``(I) enhanced beneficiary understanding of such
appropriate use through beneficiary education, counseling,
and other appropriate means; and
``(II) increased beneficiary adherence with prescription
medication regimens through medication refill reminders,
special packaging, and other appropriate means.
``(iii) Development of program in cooperation with licensed
pharmacists.--The program shall be developed in cooperation
with licensed pharmacists and physicians.
``(iv) Considerations in pharmacy fees.--The entity shall
take into account, in establishing fees for pharmacists and
others providing services under the medication therapy
management program, the resources and time used in
implementing the program.
``(C) Treatment of accreditation.--Section 1852(e)(4)
(relating to treatment of accreditation) shall apply to
policies and plans under this part with respect to the
following requirements, in the same manner as they apply to
Medicare+Choice plans under part C with respect to the
requirements described in a clause of section 1852(e)(4)(B):
``(i) Subparagraph (A) (including quality assurance),
including medication therapy management program under
subparagraph (B).
``(ii) Paragraph (2)(A) (relating to access to covered
benefits).
``(iii) Paragraph (8) (relating to confidentiality and
accuracy of enrollee records).
``(5) Grievance mechanism.--The entity shall provide
meaningful procedures for hearing and resolving grievances
between the entity (including any entity or individual
through which the entity provides covered benefits) and
enrollees of the policy or plan under this part in accordance
with section 1852(f).
``(6) Coverage determinations, reconsiderations, and
appeals.--The entity shall meet the requirements of section
1852(g) with respect to covered benefits under the policy or
plan it offers under this part in the same manner as such
requirements apply to a Medicare+Choice organization with
respect to benefits it offers under a Medicare+Choice plan
under part C.
``(7) Provide information on the internet.--The entity
shall maintain a web site on the Internet that provides
eligible medicare beneficiaries with information regarding
any policy or plan offered by the entity that provides SPICE
prescription drug coverage.
``(8) Confidentiality and accuracy of enrollee records.--
The entity shall meet the requirements of section 1852(h)
with respect to enrollees under this part in the same manner
as such requirements apply to a Medicare+Choice organization
with respect to enrollees under part C.
``(d) SPICE Board Models for Formularies.--
``(1) Model.--The SPICE Board may issue models for
formularies for use in providing covered outpatient drugs
under this part. Such models, and any revised models
(pursuant to paragraph (3)) shall meet the requirements of
subparagraphs (A) and (B) of subsection (c)(3).
``(2) Effect of compliance with a model.--If the SPICE
Board determines that a formulary used by an entity offering
a policy or plan that provides SPICE prescription drug
coverage is in compliance with a model formulary issued under
paragraph (1), or the revised model (as the case may be),
then the
[[Page S7814]]
entity shall be deemed to meet the requirements of
subparagraphs (A) and (B) of subsection (c)(3).
``(3) Revisions of models.--
``(A) In general.--The SPICE Board may periodically (but
not more frequently than annually) revise any model
established under this subsection.
``(B) Period to comply with revision.--If the SPICE Board
revises a model formulary pursuant to subparagraph (A), the
SPICE Board shall provide for an appropriate period of time
for entities who were in compliance with such model before
such revision to comply with the revised model.
``(e) Rule of Construction Regarding Cost-Effective
Provision of Benefits.--Nothing in this part shall be
construed as preventing an entity that provides SPICE
prescription drug coverage under a policy or plan from
employing mechanisms to provide such coverage economically,
including the use of--
``(1) formularies (pursuant to subsection (c)(3));
``(2) alternative methods of distribution;
``(3) generic drug substitution;
``(4) pharmacy networks; and
``(4) mail order pharmacies.
``payments to entities
``Sec. 1860J. (a) Payments for Administering Basic
Coverage.--
``(1) In general.--The SPICE Board shall establish
procedures for making payments to an entity offering a
medicare supplemental policy, a Medicare+Choice plan, a
Medicare Drug Plan for Noncompetitive Areas, or a basic
coverage plan under section 1860F for--
``(A) in accordance with the provisions of this part, the
costs of covered outpatient drugs provided under basic
coverage to eligible medicare beneficiaries--
``(i) enrolled under such policy or plan and under this
part; and
``(ii) entitled to such coverage; and
``(B) pursuant to paragraph (2), administering the basic
coverage on behalf of beneficiaries described in subparagraph
(A).
``(2) Administrative fee.--
``(A) Procedures.--The procedures established pursuant to
paragraph (1) shall provide for payment to the entity of an
administrative fee for each prescription filled by the entity
for an eligible medicare beneficiary enrolled in the policy
or plan offered by such entity. Subject to paragraph (3), the
entity shall not be at risk for providing basic coverage for
a beneficiary.
``(B) Amount.--The fee described in paragraph (1) shall
be--
``(i) negotiated by the SPICE Board; and
``(ii) consistent with such fees paid under private sector
pharmaceutical benefit contracts.
``(C) Reduction of administrative costs.--The SPICE Board
shall work with entities receiving payments under this
section on ways to control the administrative costs
associated with providing basic coverage under this part.
``(3) Risk corridors tied to performance measures and other
incentives for entity providing medicare drug plan for
noncompetitive areas.--In the case of payments to an entity
with a contract to provide a Medicare Drug Plan for
Noncompetitive Areas, the procedures established under
paragraph (1) may include the use of--
``(A) risk corridors tied to performance measures that have
been agreed to between the entity and the SPICE Board under
the contract; and
``(B) any other incentives that the SPICE Board determines
appropriate.
``(4) Secondary payer provisions.--The provisions of
section 1862(b) shall apply to basic coverage provided under
this part.
``(b) Payment of Financial Assistance to Entities for
Provision of Stop-Loss Coverage.--
``(1) In general.--The SPICE Board shall establish
procedures for making financial assistance payments for stop-
loss coverage to an entity offering a medicare supplemental
policy, a Medicare+Choice plan, or a Medicare Drug Plan for
Noncompetitive Areas on behalf of an eligible medicare
beneficiary enrolled in such policy or plan and under this
part.
``(2) Amount of financial assistance payment.--The amount
of the financial assistance payments on behalf of an eligible
medicare beneficiary for stop-loss coverage is equal to the
amount determined for the beneficiary under section 1860K(c).
``(3) Entity providing stop-loss coverage at risk.--The
entity providing stop-loss coverage, and not the SPICE Board,
shall be at risk for the provision of such coverage.
``financial assistance to obtain spice prescription drug coverage
``Sec. 1860K. (a) In General.--The SPICE Board shall
provide financial assistance, in accordance with this
section, with respect to eligible medicare beneficiaries who
have SPICE prescription drug coverage through enrollment in a
medicare supplemental policy, a Medicare+Choice plan, a
Medicare Drug Plan for Noncompetitive Areas, or a basic
coverage plan under section 1860F.
``(b) Assistance for Basic Coverage.--
``(1) In general.--The amount of financial assistance with
respect to an eligible medicare beneficiary for basic
coverage is equal to the following percentage of the basic
monthly premium determined under subsection (a) of section
1860H (without regard to any increase for late enrollment
under subsection (b) of such section):
``(A) 100 percent if income below 150 percent of poverty.--
In the case of an eligible medicare beneficiary who applies
for enhanced financial assistance under subsection (d) and
whose income (as determined under such subsection) does not
exceed 150 percent of the poverty line, the percentage is 100
percent.
``(B) Other percent if income between 150 and 175 percent
of poverty.--In the case of an eligible medicare beneficiary
who applies for enhanced financial assistance under
subsection (d) and whose income (as determined under such
subsection) is greater than 150 percent, but does not exceed
175 percent, of the poverty line, the SPICE Board shall
specify the percentage consistent with the following rules:
``(i) Range.--The percentage may not exceed 100 percent nor
be less than 25 percent.
``(ii) Sliding scale.--The percentage may not be higher for
eligible medicare beneficiaries whose income is higher.
``(C) 25 percent for other beneficiaries.--In the case of
any other eligible medicare beneficiary, the percentage is 25
percent.
``(2) Form of assistance.--Financial assistance under this
subsection shall be provided in the form of a reduction of
the basic monthly premium pursuant to section
1860H(a)(2)(B)(ii).
``(c) Assistance for Stop-Loss Coverage.--
``(1) Amount.--
``(A) In general.--The amount of financial assistance for
stop-loss coverage with respect to an eligible medicare
beneficiary enrolled under this part and in a medicare
supplemental policy, a Medicare+Choice plan, or a Medicare
Drug Plan for Noncompetitive Areas for stop-loss coverage is
equal to the following percentage of the national average
medigap stop-loss monthly premium for the region in which the
beneficiary resides (as determined under paragraph (2)):
``(i) 100 percent if income below 150 percent of poverty.--
In the case of an eligible medicare beneficiary described in
subsection (b)(1)(A), the percentage is 100 percent.
``(ii) Other percent if income between 150 and 175 percent
of poverty.--In the case of an eligible medicare beneficiary
described in subsection (b)(1)(B), the SPICE Board shall
specify the percentage consistent with the rules described in
clauses (i) and (ii) of such subsection.
``(iii) 25 percent for other beneficiaries.--In the case of
any other eligible medicare beneficiary, the percentage is 25
percent.
``(B) Form of assistance.--Financial assistance under this
subsection for beneficiaries shall be provided in the form of
a payment to the entity offering the policy or plan in which
the beneficiary is receiving stop-loss coverage pursuant to
section 1860J(b).
``(2) Establishment of national average medigap stop-loss
monthly premium.--
``(A) In general.--The SPICE Board shall, during September
of each year (beginning in 2002), estimate a national average
medigap stop-loss monthly premium for each region (as
determined by the Board) of the total geographic area served
by the programs under this part that will be applicable for
the succeeding year.
``(B) Definition of national average medigap stop-loss
monthly premium.--For purposes of subparagraph (A), the term
`national average medigap stop-loss monthly premium' means,
with respect to a region, the average of the portion of the
monthly premiums charged by medicare supplemental policies in
that region for providing stop-loss coverage to beneficiaries
enrolled under this part.
``(3) Limitations.--
``(A) Financial assistance may not exceed premium.--In the
case of financial assistance provided under this subsection
with respect to stop-loss coverage provided under a policy or
plan, the amount of the financial assistance may not exceed
the amount of the portion of the premium charged for
enrollment in the policy or plan that is related to the
provision of stop-loss coverage.
``(B) Entity must reduce premium.--No financial assistance
shall be made available with respect to stop-loss coverage
provided by an entity to an eligible medicare beneficiary
unless the entity provides assurances satisfactory to the
SPICE Board that the entity shall reduce the amount otherwise
charged the beneficiary for such coverage by an amount equal
to the amount of such assistance.
``(d) Application for Enhanced Financial Assistance.--
``(1) In general.--The SPICE Board shall establish
procedures under which a beneficiary who desires enhanced
financial assistance under this section may voluntarily apply
for an income determination.
``(2) Requirements regarding information.--
``(A) Information from beneficiary.--The procedures
established under paragraph (1) shall require the beneficiary
to submit with the application for enhanced financial
assistance such information that the SPICE Board determines
necessary to make the income determination with respect to
such beneficiary.
``(B) Information from other government agencies.--Under
the procedures established under paragraph (1), if an
individual voluntarily applies for enhanced financial
assistance under this section, the individual is deemed to
have consented to the SPICE Board seeking and using income-
related information from other Government agencies
[[Page S7815]]
in order to make the income determination with respect to
such beneficiary.
``(C) Restriction on use of information.--Information
obtained under subparagraph (A) or (B) may be used by
officers and employees of the SPICE Board only for the
purposes of, and to the extent necessary in, carrying out
their responsibilities under this part.
``(3) Periodic redeterminations.--Such income
determinations shall be valid for a period (of not less than
1 year) specified by the SPICE Board.
``(e) Income Determinations.--The SPICE Board shall
establish procedures for making income determinations under
this section.
``(f) Poverty Line.--In this section, the term `poverty
line' means the income official poverty line (as defined by
the Office of Management and Budget, and revised annually in
accordance with section 673(2) of the Omnibus Budget
Reconciliation Act of 1981) applicable to a family of the
size involved.
``employer incentive program for employment-based retiree drug coverage
``Sec. 1860L. (a) Program Authority.--The SPICE Board shall
develop and implement a program under this section to be
known as the `Employer Incentive Program' that encourages
employers and other sponsors of employment-based health care
coverage to provide adequate prescription drug benefits to
retired individuals by subsidizing, in part, the sponsor's
cost of providing coverage under qualifying plans.
``(b) Sponsor Requirements.--In order to be eligible to
receive an incentive payment under this section with respect
to coverage of an individual under a qualified retiree
prescription drug plan (as defined in subsection (e)(3)), a
sponsor shall meet the following requirements:
``(1) Assurances.--The sponsor shall--
``(A) annually attest, and provide such assurances as the
SPICE Board may require, that the coverage offered by the
sponsor is a qualified retiree prescription drug plan, and
will remain such a plan for the duration of the sponsor's
participation in the program under this section; and
``(B) guarantee that it will give notice to the SPICE Board
and covered retirees--
``(i) at least 120 days before terminating its plan; and
``(ii) immediately upon determining that the actuarial
value of the prescription drug benefit under the plan falls
below the actuarial value of the basic coverage under the
SPICE prescription drug coverage under this part.
``(2) Beneficiary information.--The sponsor shall report to
the SPICE Board, for each calendar quarter for which it seeks
an incentive payment under this section, the names and social
security numbers of all retirees (and their spouses and
dependents) covered under such plan during such quarter and
the dates (if less than the full quarter) during which each
such individual was covered.
``(3) Audits.--The sponsor and the employment-based retiree
health coverage plan seeking incentive payments under this
section shall agree to maintain, and to afford the SPICE
Board access to, such records as the SPICE Board may require
for purposes of audits and other oversight activities
necessary to ensure the adequacy of prescription drug
coverage, the accuracy of incentive payments made, and such
other matters as may be appropriate.
``(4) Other requirements.--The sponsor shall provide such
other information, and comply with such other requirements,
as the SPICE Board may find necessary to administer the
program under this section.
``(c) Incentive Payments.--
``(1) In general.--A sponsor that meets the requirements of
subsection (b) with respect to a quarter in a calendar year
shall be entitled to have payment made by the SPICE Board on
a quarterly basis (to the sponsor or, at the sponsor's
direction, to the appropriate employment-based health plan)
of an incentive payment, in the amount determined in
paragraph (2), for each retired individual (or spouse) who--
``(A) was covered under the sponsor's qualified retiree
prescription drug plan during such quarter; and
``(B) was eligible for, but was not enrolled in, the SPICE
drug benefit program under this part.
``(2) Amount of incentive.--The payment under this section
with respect to each individual described in paragraph (1)
for a month shall be equal to 25 percent of the basic monthly
premium amount payable by an eligible medicare beneficiary
enrolled under this part, as set for the calendar year
pursuant to section 1860H(a) and without application of and
financial assistance for such premium under section 1860K(b).
``(3) Payment date.--The incentive under this section with
respect to a calendar quarter shall be payable as of the end
of the next succeeding calendar quarter.
``(d) Civil Money Penalties.--A sponsor, health plan, or
other entity that the SPICE Board determines has, directly or
through its agent, provided information in connection with a
request for an incentive payment under this section that the
entity knew or should have known to be false shall be subject
to a civil monetary penalty in an amount up to 3 times the
total incentive amounts under subsection (c) that were paid
(or would have been payable) on the basis of such
information.
``(e) Definitions.--In this section:
``(1) Employment-based retiree health coverage.--The term
`employment-based retiree health coverage' means health
insurance coverage or other coverage of health care costs for
retired individuals (or for such individuals and their
spouses and dependents) based on their status as former
employees or labor union members.
``(2) Employer.--The term `employer' has the meaning given
the term in section 3(5) of the Employee Retirement Income
Security Act of 1974 (except that such term shall include
only employers of 2 or more employees).
``(3) Qualified retiree prescription drug plan.--The term
`qualified retiree prescription drug plan' means health
insurance coverage or other coverage of health care costs
included in employment-based retiree health coverage that--
``(A) provides coverage of the cost of prescription drugs
whose actuarial value (as defined by the SPICE Board) to each
retired beneficiary equals or exceeds the actuarial value of
the basic coverage provided to an individual enrolled in the
SPICE drug benefit program under this part; and
``(B) does not deny, limit, or condition the coverage or
provision of prescription drug benefits for retired
individuals based on age or any health status-related factor
described in section 2702(a)(1) of the Public Health Service
Act.
``(4) Sponsor.--The term `sponsor' has the meaning given
the term `plan sponsor' in section 3(16)(B) of the Employer
Retirement Income Security Act of 1974.
``spice board
``Sec. 1860M. (a) Establishment.--There is established
within the Department of Health and Human Services, a Seniors
Prescription Insurance Coverage Equity Office, which shall
be--
``(1) outside of the Centers for Medicare & Medicaid
Services; and
``(2) run by a board to be known as the SPICE Board.
``(b) Duties.--
``(1) Administration of spice drug benefit program.--
``(A) In general.--The SPICE Board shall administer the
SPICE drug benefit program under this part.
``(B) Noninterference.--In carrying out its duty under
subparagraph (A), the SPICE Board may not--
``(i) require a particular formulary or institute a price
structure for the reimbursement of covered outpatient drugs;
``(ii) interfere in any way with negotiations between
entities providing SPICE prescription drug coverage under
part D and drug manufacturers, wholesalers, or other
suppliers of covered outpatient drugs; and
``(iii) otherwise interfere with the competitive nature of
providing such coverage through such entities.
``(2) Ongoing studies.--The SPICE Board shall conduct
ongoing studies of the following issues:
``(A) The administration of this part.
``(B) The provision of information about the program under
the health insurance information, counseling, and assistance
grants under section 4360 of the Omnibus Budget
Reconciliation Act of 1990.
``(C) Ways in which drug utilization can be used to provide
better overall care for eligible medicare beneficiaries.
``(D) Savings and potential savings in Federal health care
programs which may occur, or can be attributed to, eligible
medicare beneficiary access to, and utilization of, covered
outpatient drugs.
``(E) Trends in premium increases and factors that
contribute to changes in premiums.
``(F) Integration of the SPICE drug benefit program into a
reformed medicare program.
``(G) The ability of eligible medicare beneficiaries to
afford SPICE prescription drug coverage.
``(H) The impact of the program on the prescription drug
benefits offered under group health plans.
``(I) The appropriateness of the levels of financial
assistance provided under this part.
``(3) Annual report.--
``(A) In general.--Not later than June 1 of each year
(beginning with 2004), the SPICE Board shall submit an annual
report to Congress on the program under this part.
``(B) Information on studies.--Such report shall include a
detailed statement on the issues studied under paragraph (2).
``(C) Recommendations.--Such report shall include such
recommendations for legislation and administrative actions as
the SPICE Board considers appropriate.
``(4) Provision of recommendations and information to
secretary.--The SPICE Board shall provide recommendations and
necessary information regarding the SPICE drug benefit
program to the Secretary in order for the Secretary to--
``(A) integrate such information with information regarding
the other programs under this title; and
``(B) provide health insurance information, counseling, and
assistance grants under section 4360 of the Omnibus Budget
Reconciliation Act of 1990.
``(c) Demonstration Project Authority.--
``(1) In general.--Subject to paragraph (2), the SPICE
Board shall have the authority to conduct demonstration
projects for the purpose of demonstrating ways to improve the
quality of services provided under the SPICE drug benefit
program, including ways to reduce medical errors.
``(2) Consultation with secretary.--The SPICE Board shall
consult with the Secretary before conducting any
demonstration project.
``(d) Membership of SPICE Board.--
``(1) Number and appointment.--
[[Page S7816]]
``(A) In general.--The SPICE Board shall be composed of 7
members appointed by the President, by and with the advice
and consent of the Senate.
``(B) Specific representatives.--In making appointments
under subparagraph (A), the President shall ensure that the
following groups are represented on the SPICE Board:
``(i) Consumers.
``(ii) Private health plan insurers (including insurers
that offer fee-for-service and managed care plans) with
expertise in the quality, scope, and marketing of health care
services.
``(iii) Certified geriatric pharmacists.
``(iv) The Centers for Medicare & Medicaid Services.
``(v) State insurance commissioners.
``(C) Secretary of hhs.--In addition to the 7 members
appointed under subparagraph (A), the Secretary shall be a
nonvoting, ex officio member of the SPICE Board.
``(2) Deadline for initial appointment.--The initial
members of the SPICE Board shall be appointed by not later
than 6 months after the date of enactment of this section.
``(3) Terms.--
``(A) In general.--The terms of the members of the SPICE
Board shall be for 6 years, except that of the members first
appointed--
``(i) three shall be appointed for terms of 6 years;
``(ii) two shall be appointed for terms of 4 years; and
``(iii) two shall be appointed for terms of 2 years.
``(B) Vacancies.--Any member appointed to fill a vacancy
occurring before the expiration of the term for which the
member's predecessor was appointed shall be appointed only
for the remainder of that term. A member may serve after the
expiration of that member's term until a successor has taken
office.
``(4) Chairperson.--The President shall designate the
chairperson of the SPICE Board, except that the
representative from the Centers for Medicare & Medicaid
Services may not be designated as chairperson.
``(e) Operation of the Board.--
``(1) Meetings.--The SPICE Board shall meet at the call of
the chairperson or upon the written request of a majority of
its members.
``(2) Quorum.--A majority of the members of the SPICE Board
shall constitute a quorum, but a lesser number of members may
hold hearings.
``(f) Powers of the SPICE Board.--
``(1) Hearings.--The SPICE Board may hold such hearings,
sit and act at such times and places, take such testimony,
and receive such evidence as the SPICE Board considers
advisable to carry out the purposes of this part.
``(2) Information from federal agencies.--Upon request of
the chairperson of the SPICE Board, the head of any Federal
department or agency shall furnish such information to the
SPICE Board as is necessary to carry out the functions of the
SPICE Board under this part.
``(3) Postal services.--The SPICE Board may use the United
States mails in the same manner and under the same conditions
as other departments and agencies of the Federal Government.
``(4) Gifts.--The SPICE Board may accept, use, and dispose
of gifts or donations of services or property.
``(g) Board Personnel Matters.--
``(1) Members.--
``(A) Compensation.--Each member of the SPICE Board who is
not an officer or employee of the Federal Government shall be
compensated at a rate equal to the daily equivalent of the
annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United
States Code, for each day (including travel time) during
which such member is engaged in the performance of the duties
of the SPICE Board. All members of the SPICE Board who are
officers or employees of the United States shall serve
without compensation in addition to that received for their
services as officers or employees of the United States.
``(B) Travel expenses.--The members of the SPICE Board
shall be allowed travel expenses, including per diem in lieu
of subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of
business in the performance of services for the SPICE Board.
``(C) Removal.--The President may remove a member of the
SPICE Board only for neglect of duty or malfeasance in
office.
``(2) Staff.--
``(A) In general.--The chairperson of the SPICE Board may,
without regard to the civil service laws and regulations,
appoint and terminate an executive director and such other
additional personnel as may be necessary to enable the SPICE
Board to perform its duties. The employment of an executive
director shall be subject to confirmation by the SPICE Board.
``(B) Compensation.--The chairperson of the SPICE Board may
fix the compensation of the executive director and other
personnel without regard to the provisions of chapter 51 and
subchapter III of chapter 53 of title 5, United States Code,
relating to classification of positions and General Schedule
pay rates, except that the rate of pay for the executive
director and other personnel may not exceed the rate payable
for level V of the Executive Schedule under section 5316 of
such title.
``(C) Detail of government employees.--Any Federal
Government employee may be detailed to the SPICE Board
without further reimbursement, and such detail shall be
without interruption or loss of civil service status or
privilege.
``(D) Procurement of temporary and intermittent services.--
The chairperson of the SPICE Board may procure temporary and
intermittent services under section 3109(b) of title 5,
United States Code, at rates for individuals which do not
exceed the daily equivalent of the annual rate of basic pay
prescribed for level V of the Executive Schedule under
section 5316 of such title.
``spice prescription drug account in the federal supplementary medical
insurance trust fund
``Sec. 1860N. (a) Establishment.--
``(1) In general.--There is created within the Federal
Supplementary Medical Insurance Trust Fund established by
section 1841 an account to be known as the `SPICE
Prescription Drug Account' (in this section referred to as
the `Account').
``(2) Funds.--The Account shall consist of such gifts and
bequests as may be made as provided in section 201(i)(1), and
such amounts as may be deposited in, or appropriated to, such
fund as provided in this part.
``(3) Separate from rest of trust fund.--Funds provided
under this part to the Account shall be kept separate from
all other funds within the Federal Supplementary Medical
Insurance Trust Fund.
``(b) Payments From Account.--
``(1) In general.--The Managing Trustee shall pay from time
to time from the Account such amounts as the SPICE Board
certifies are necessary to make payments to operate the
program under this part, including payments to entities under
section 1860J, payments to sponsors under section 1860L, and
payments with respect to administrative expenses under this
part in accordance with section 201(g).
``(2) Treatment in relation to part b premium.--Amounts
payable from the Account shall not be taken into account in
computing actuarial rates or premium amounts under section
1839.
``(c) Appropriations To Cover Government Contribution.--
There are authorized to be appropriated from time to time,
out of any moneys in the Treasury not otherwise appropriated,
to the Account an amount equal to the amount by which the
benefits and administrative costs of providing the benefits
under this part exceed the premiums collected under section
1860H(a)(4).''.
(b) Conforming Amendments to Federal Supplementary Medical
Insurance Trust Fund.--Section 1841 of the Social Security
Act (42 U.S.C. 1395t) is amended--
(1) in the last sentence of subsection (a)--
(A) by striking ``and'' before ``such amounts''; and
(B) by inserting before the period the following: ``, and
such amounts as may be deposited in, or appropriated to, the
SPICE Prescription Drug Account established by section
1860N''; and
(2) in subsection (g), by inserting after ``by this part,''
the following: ``the payments provided for under part D (in
which case the payments shall be made from the SPICE
Prescription Drug Account in the Trust Fund),''.
(c) Additional Conforming Changes.--
(1) Conforming references to previous part d.--Any
reference in law (in effect before the date of enactment of
this Act) to part D of title XVIII of the Social Security Act
is deemed a reference to part E of such title (as in effect
after such date).
(2) Secretarial submission of legislative proposal.--Not
later than 6 months after the date of enactment of this Act,
the Secretary of Health and Human Services shall submit to
the appropriate committees of Congress a legislative proposal
providing for such technical and conforming amendments in the
law as are required by the provisions of this Act.
SEC. 3. SPICE PRESCRIPTION DRUG COVERAGE UNDER
MEDICARE+CHOICE PLANS.
(a) Special Rules.--Section 1851 of the Social Security Act
(42 U.S.C. 1395w-21) is amended by adding at the end the
following new subsection:
``(j) Rules for Provision of SPICE Prescription Drug
Coverage.--
``(1) Plan required to provide coverage if beneficiary
enrolled in part d.--
``(A) In general.--In the case of an individual that is
enrolled in a Medicare+Choice plan and enrolled under part D,
the basic benefits required to be provided under section
1852(a)(1)(A) shall include SPICE prescription drug coverage
(as defined in section 1860B(a)) under the terms and
conditions for such coverage established under part D,
including the terms and conditions described in section
1860I(c).
``(B) Voluntary enrollment in part D.--An individual
enrolled in a Medicare+Choice plan shall not be required to
enroll under part D.
``(2) Limitation on enrollee liability.--In the case of an
individual described in paragraph (1)(A), with respect to
SPICE prescription drug coverage, a Medicare+Choice
organization may not require that such individual pay a
deductible or a coinsurance percentage that exceeds the
deductible or coinsurance percentage applicable for such
coverage pursuant to part D.
``(3) Premium for stop-loss coverage.--
``(A) In general.--Subject to subparagraph (B), a
Medicare+Choice organization offering
[[Page S7817]]
a Medicare+Choice plan on behalf of an individual described
in paragraph (1)(A) may require the individual to pay a
premium for stop-loss coverage (as defined in section
1860B(c). Any such premium shall be considered to be part of
the Medicare+Choice monthly basic premium (as defined in
section 1854(b)(2)(A)) that the individual is responsible
for.
``(B) Organization required to reduce premium by amount of
financial assistance.--A Medicare+Choice organization
receiving a payment for financial assistance for stop-loss
coverage on behalf of an individual described in paragraph
(1)(A) pursuant to subsection (b) of section 1860J shall
reduce any premium described in subparagraph (A) by the
amount of such financial assistance.
``(4) Payments to organization for spice prescription drug
coverage pursuant to part d rules.--The SPICE Board
(established under section 1860M) shall make payments to a
Medicare+Choice organization offering a Medicare+Choice plan
on behalf of an individual described in paragraph (1)(A)
pursuant to the payment mechanisms described in subsections
(a) and (b) of section 1860J. Such payments shall be
coordinated with payments made to such organization under
section 1853.
``(5) Coordinated enrollment.--The Secretary shall work
with the SPICE Board to coordinate enrollment under this part
with enrollment under part D.''.
(b) Effective Date.--The amendment made by this section
shall apply to items and services provided under a
Medicare+Choice plan on or after January 1, 2003.
SEC. 4. MEDIGAP REVISIONS AND TRANSITION PROVISIONS.
(a) Establishment of SPICE Medigap Policies.--Section 1882
of the Social Security Act (42 U.S.C. 1395ss) is amended by
adding at the end the following new subsection:
``(v) SPICE Medigap Policies.--
``(1) Revision of benefit packages.--
``(A) In general.--Notwithstanding subsection (p), the
benefit packages established under such subsection shall be
revised so that--
``(i) if the policyholder is enrolled under part D, basic
coverage (as defined in section 1860B(b)) is available as
part of each benefit package;
``(ii) each benefit package includes stop-loss coverage (as
defined in section 1860B(c)) in the core group of basic
benefits described in subsection (p)(2)(B);
``(iii) no benefit package (including each benefit package
classified as `H', `I', or `J' under the standards
established by such subsection (p)(2), and the benefit
package classified as `J' with a high deductible feature
described in subsection (p)(11)) includes prescription drug
coverage other than the basic coverage required under clause
(i) (if applicable), or the stop-loss coverage required under
clause (ii); and
``(iv) except as revised under the preceding clauses or
pursuant to subsection (p)(1)(E), the benefit packages are
identical to the benefit packages that were available on the
date of enactment of the Seniors Prescription Insurance
Coverage Equity (SPICE) Act of 2001.
``(B) Administration of benefits.--Pursuant to section
1860A(a)(3), an issuer of a medicare supplemental policy
revised under such subparagraph may directly administer the
prescription drug benefits required under the policy or may
contract with an entity that meets the applicable
requirements under part D to administer such benefits.
``(C) Manner of revision.--The benefit packages revised
under this section shall be revised in the manner described
in subparagraph (E) of subsection (p)(1), except that for
purposes of subparagraph (C) of such subsection, the
standards established under this subsection shall take effect
not later than January 1, 2003.
``(2) Guaranteed issuance and renewal of new policies.--The
provisions of subsections (q) and (s) shall apply to medicare
supplemental policies revised under this subsection in the
same manner as such provisions apply to medicare supplemental
policies issued under the standards established under
subsection (p).
``(3) Opportunity of current policyholders to purchase
revised policies.--
``(A) In general.--No medicare supplemental policy of an
issuer with a benefit package that is revised under paragraph
(1) shall be deemed to meet the standards in subsection (c)
unless the issuer--
``(i) provides written notice during the 60-day period
immediately preceding the period established under section
1860C(c), to each policyholder or certificate holder of a
medicare supplemental policy issued by that issuer (at the
most recent available address) of the offer described in
clause (ii) and of the fact that, so long as they retain
coverage under such policy, they are unable to obtain SPICE
prescription drug coverage (as defined in section 1860B(a))
under part D; and
``(ii) offers the policyholder or certificate holder under
the terms described in subparagraph (B), during at least the
period established under subsection (c) of section 1860C,
institution of coverage effective for the period described in
subsection (d) of such section, a medicare supplemental
policy with the benefit package that has been revised under
paragraph (1) of this subsection that the Secretary
determines is most comparable to the policy in which the
individual is enrolled.
``(B) Terms of offer described.--The terms described under
this subparagraph are terms which do not--
``(i) deny or condition the issuance or effectiveness of a
medicare supplemental policy described in subparagraph
(A)(ii) that is offered and is available for issuance to new
enrollees by such issuer;
``(ii) discriminate in the pricing of such policy because
of health status, claims experience, receipt of health care,
or medical condition; or
``(iii) impose an exclusion of benefits based on a
preexisting condition under such policy.
``(4) Opportunity of other eligible individuals to purchase
revised policies.--No medicare supplemental policy of an
issuer with a benefit package that is revised under paragraph
(1) shall be deemed to meet the standards in subsection (c)
unless, during at least the period established under section
1860C(c), the issuer permits each eligible medicare
beneficiary (as defined in section 1860A(d), but who is not
described in paragraph (3)) to purchase any medicare
supplemental policy that has been revised under paragraph (1)
with institution of coverage effective for the period
described in section 1860C(d) under the terms of the offer
described in paragraph (3)(B).
``(5) Grandfathering of current policyholders.--
``(A) In general.--Except as provided in subparagraph (B),
no person may sell, issue, or renew a medicare supplemental
policy with a benefit package that has not been revised under
this subsection on or after January 1, 2003.
``(B) Grandfathering.--Each policyholder or certificate
holder of a medicare supplemental policy as of December 31,
2002, may continue to receive benefits under such policy and
may renew such policy as if this subsection had not been
enacted, except that such beneficiary shall not be eligible
to enroll for SPICE prescription drug coverage (as defined in
section 1860B(a)) under part D during the period in which
such policy is in effect.
``(6) Penalties.--Each penalty under this section shall
apply with respect to policies revised under this subsection
as if such policies were issued under the standards
established under subsection (p), including the penalties
under subsections (a), (d), (p)(8), (p)(9), (q)(5),
(r)(6)(A), (s)(4), and (t)(2)(D).''.
(b) NAIC Study and Report.--
(1) Study.--The Secretary of Health and Human Services (in
this subsection referred to as the ``Secretary'') shall
contract with the National Association of Insurance
Commissioners (in this subsection referred to as the
``NAIC'') to conduct a study--
(A) to determine whether the portion of the benefit
packages revised under section 1882(v) of the Social Security
Act (as added by subsection (a)) relating to parts A and B of
the medicare program should be revised as a result of the
establishment of SPICE prescription drug coverage (as defined
in section 1860B(a) of such Act, as added by section 2) and
whether the total number of such benefit packages should be
reduced;
(B) to identify methods to ensure that any financial
assistance paid to issuers of medicare supplemental policies
on behalf of enrollees for providing stop-loss coverage (as
defined in section 1860B(c) of the Social Security Act, as
added by section 2) made available under the benefit packages
revised under section 1882(v) of such Act (as so added) is
not used to subsidize any other benefits, including the
benefits relating to parts A and B of the medicare program;
and
(C) to assess the practicality and viability of
establishing a medicare supplemental policy that only
provides SPICE prescription drug coverage (as so defined).
(2) Report.--Not later than 6 months after the date of
enactment of this Act, the NAIC shall submit to Congress and
the Secretary a report on the study conducted under paragraph
(1) together with such recommendations as the NAIC determines
appropriate.
SEC. 5. PROVISION OF INFORMATION ON SPICE DRUG BENEFIT
PROGRAM UNDER HEALTH INSURANCE INFORMATION,
COUNSELING, AND ASSISTANCE GRANTS.
Section 4360(b)(2)(A)(ii) of the Omnibus Budget
Reconciliation Act of 1990 (42 U.S.C. 1395b-4(b)(2)(A)(ii))
is amended by striking ``and information'' and inserting ``,
information regarding the SPICE drug benefit program under
part D of title XVIII of the Social Security Act, and
information''.
SEC. 6. PERSONAL DIGITAL ACCESS TECHNOLOGY DEMONSTRATION
PROJECT.
(a) Demonstration Project.--
(1) In general.--The SPICE Board (established under section
1860M of the Social Security Act (as added by section 2))
shall conduct a demonstration project for the purpose of
increasing the use of Personal Digital Access Technology in
prescribing covered outpatient drugs (as defined in section
1860B(e) (as so added)) for eligible medicare beneficiaries
receiving SPICE prescription drug coverage under part D of
title XVIII of such Act (as so added).
(2) Aspects of project.--The demonstration project shall
address ways in which the use of Personal Digital Access
Technology can be used to--
(A) avoid adverse drug reactions among such beneficiaries,
including problems due to therapeutic duplication, drug-
disease contraindications, drug-drug interactions (including
serious interactions with nonprescription or over-the-counter
drugs), incorrect drug dosage or duration of drug treatment,
drug-allergy interactions, and clinical abuse and misuse;
[[Page S7818]]
(B) transmit information about the coverage of covered
outpatient drugs under the policy or plan in which such a
beneficiary is receiving SPICE prescription drug coverage to
prescribing physicians;
(C) increase the use of generic drugs by such
beneficiaries; and
(D) increase the compliance of entities offering policies
or plans that provide SPICE prescription drug coverage with
the requirements under part D of title XVIII of the Social
Security Act (as added by section 2).
(3) Inclusion of providers.--In conducting the
demonstration project, the SPICE Board shall include--
(A) physicians;
(B) pharmacists;
(C) entities that offer policies or plans that provide
SPICE prescription drug coverage; and
(D) any entity (including a pharmacy benefits management
company) that contracts with an entity described in
subparagraph (C) to provide benefits under such policies or
plans.
(4) Duration of projects.--The demonstration project shall
be conducted over a 3-year period.
(b) Reports to Congress.--
(1) In general.--
(A) Initial report.--Not later than 18 months after the
SPICE Board implements the demonstration project, the SPICE
Board shall submit to Congress an initial report on the
demonstration project.
(B) Final report.--Not later that 6 months after the
conclusion of the project, the SPICE Board shall submit to
Congress a final report on the demonstration project.
(2) Contents of reports.--The reports described in
paragraph (1) shall include the following:
(A) A detailed description of the demonstration project.
(B) An evaluation of the demonstration project.
(C) Recommendations for legislation that the SPICE Board
determines to be appropriate as a result of the demonstration
project.
(D) Any other information regarding the demonstration
project that the SPICE Board determines to be appropriate.
(c) Funding.--Expenditures made for carrying out the
demonstration project shall be made from funds otherwise
appropriated to the Secretary of Health and Human Services.
Ms. SNOWE. Mr. President, I am pleased to join with my friend and
colleague, Senator Ron Wyden, in the introduction of the Seniors
Prescription Insurance Coverage Equity Act of 2001, or ``SPICE.'' I
want to thank him for his enthusiasm about and his commitment to this
joint venture.
It was just about two years ago now that Senator Wyden and I
introduced this bill for the first time. SPICE 2001 is the product of
almost three years of work and development. Since 1999, when we first
tackled this issue, there has been much discussion about how to design
a prescription drug coverage plan that is both comprehensive and
affordable, that provides choice but guarantees availability of basic
coverage. And, perhaps most importantly, one that is workable for
seniors, the Medicare program and one that private providers will
offer. We believe we have struck this balance in SPICE 2001.
I believe that this bill is a benchmark for the Senate's
consideration of a comprehensive out-patient prescription drug program
under Medicare. I offer this bill today, with my friend Senator Wyden
because it is the product of a three year collaborative effort to
provide our Nation's seniors with prescription drug coverage, and I
offer it with the hopes that it will be considered as part of a broader
reform when the Senate takes one up.
Americans age 65 and older are only 12 percent of the population but
account for over 40 percent of all drug spending. Which isn't
surprising considering that over the past five years, per capita drug
spending for the Medicare population has approximately doubled,
reaching an estimated $1,756 this year.
This comes at a time where fewer retirees have health coverage from
their former employers than ever before. In 1998, an estimated 66
percent of large employers offered retiree health coverage, fewer than
40 percent did so in 2000. At a time when fewer and fewer of our
seniors have retiree health care coverage from their former employers,
and when the cost of prescription drugs are skyrocketing, no one can
argue that it isn't essential we ensure that Medicare beneficiaries
have comprehensive coverage for outpatient prescription drugs. And,
this is a problem, I might add, which will only grow when the 77
million Baby Boomers begin to enter Medicare in 2011.
For the past several years, Senator Wyden and I have been united in
our belief that we owe it to our seniors to develop the best and most
practical solution. SPICE 2001 represents a straightforward,
comprehensive, and responsible approach that should appeal to anyone
who believes that seniors need prescription drug coverage.
To accomplish these goals we have built upon the model of the first
SPICE bill and added components that have continued to be part of the
larger debate on this issue--that of public programs versus private
competition. As a result, SPICE 2001 now creates a partnership between
the Federal Government and private insurers to share the cost, and the
risk, of offering outpatient prescription drug coverage for our senior
population.
Specifically, SPICE 2001 creates a prescription drug coverage program
for all Medicare beneficiaries enrolled in both Part A and Part B, and
who choose to enroll. SPICE offers a premium subsidy of at least 25
percent to all enrollees. To provide extra assistance to those who need
it most, there is a 100 percent premium subsidy for those whose income
is at or under 150 percent of poverty, $12,885 for a single person and
$17,415 for a couple. Those whose income is between 150 percent and 175
percent of poverty, $15,033 for an individual and $20,318 for a couple,
will receive a subsidy based on a sliding scale down to 25 percent of
the cost of the premium.
SPICE 2001 offers two choices in the coverage so they can pick a plan
to best serve their needs. One option is basic coverage, with a $350
deductible and a 25 percent coinsurance requirement. This can be
purchased with a Stop-loss plan of $3,000 or separately.
The second option is stop-loss coverage. While only 17 percent of
beneficiaries have costs above $3,000, they account for almost 54
percent of all spending on prescription drugs. This coverage is
provided completely through the private insurer. According to CBO's
January 2001 baseline projections, 83 percent of those enrolled in
Medicare fee for service plans pay less than $3,000 for their drugs.
For these seniors, they might only want to purchase the basic coverage.
Those who need more than just the basic coverage can buy them both. For
those who can manage their spending and only want to protect themselves
from catastrophic expenses, they can purchase stop-loss coverage.
And, importantly, all SPICE enrollees receive the benefit of the
negotiated discount on the cost of their prescription drugs, starting
with their first prescription.
Choice is one of the cornerstones of this program. Seniors will not
only have the choice of their level of coverage but will be able to
choose from a variety to have their care delivered. SPICE can be run
through Medigap, Medicare+Choice plans, or private entities. In areas
where there are no insurers, the SPICE Board will have the authority to
negotiate with entities to bring them into the market.
One of the perennial arguments against government sponsored or
assisted prescription drug coverage for our retirees has been that if
we did it, employers wouldn't. We already know that fewer employers are
offering retiree health benefits than just 12 years ago, this is a
trend we hope to discourage. This is why the SPICE Board is authorized
to provide the 25 percent premium subsidy as an incentive to employers
who provide prescription drug coverage for their retirees. It is
critical we encourage employers to continue to offer this type of
coverage and we acknowledge that in this bill.
According to a 1998 Wall Street Journal poll, 80 percent of retirees
use a prescription drug every day. The average Medicare beneficiary
fills a prescription 18 times a year. It is long past time that we
ensure that these prescriptions are covered.
SPICE 2001 offers something for everyone interested in providing our
seniors with prescription drug coverage. It is a program that can be
incorporated in existing health plans, will be run through a government
Board whose sole purpose is ensuring that this program runs well, and
will foster competition and allow for choice in both coverage and
providers.
______
By Mr. DOMENICI (for himself, Mr. Inouye, Mr. Campbell, Mr.
Bingaman, Mr. Baucus, Mr. Crapo, Mr. Allard, Mr. Johnson, and
Mr. Kyl):
[[Page S7819]]
S. 1186. A bill to provide a budgetary mechanism to ensure that funds
will be available to satisfy the Federal Government's responsibilities
with respect to negotiated settlements of disputes related to Indian
water rights claims and Indian land claims; to the Committee on the
Budget and the Committee on Governmental Affairs, jointly, pursuant to
the order of August 4, 1977, with instructions that if one Committee
reports, the other Committee have thirty days to report or be
discharged.
Mr. DOMENICI. Mr. President, both as chairman and now as the ranking
member on the Budget Committee, I have been working over the last year
with the Western Governors' Association, the Western Regional Council,
the Native American Rights Fund, the Western States Water Council, as
well as several Indian tribes to correct what I believe to be a flaw in
the Budget Enforcement Act as it relates to the Federal funding of
Indian land and water settlements.
I, along with a group of bipartisan Senators, including the chairman
and ranking member of the Indian Affairs Committee are introducing
today legislation that will help Congress fulfill its commitment to
authorized Indian land and water settlements.
In FY 2002, the President's request for Indian land and water
settlements funding was $61 million. This represents an increase from
fiscal year 2001 of $23 million. The increase is due to the
authorization of several large settlements in California, Colorado,
Michigan, New Mexico, and Utah.
I am pleased to report that the full request was included in both the
Senate and House passed budget resolutions. In turn, the request was
fully appropriated in both the House and Senate versions of the fiscal
year 2002 Interior appropriations bill. This is a tremendous first step
in making sure the Congress fulfills its obligation regarding these
settlements. But it is only the first step.
In the near future, there are, at least, three additional large
settlements likely to come before Congress. The States involved in
these settlements are Arizona, Idaho, and Montana. Under current
budgetary treatment these settlements will be difficult to fund without
taking critical resources from other Bureau of Indian Affairs programs.
Currently, once the settlements have been agreed to by the parties
involved, the settlements come to Congress for authorization and
appropriation. When all appropriations have been distributed the
Indians give up any future claims to the land or the water.
Appropriations for these settlements are usually spread over 3-10
years depending on the size of the settlement. The payout in one year
for an individual settlement does not usually exceed $30 million.
I feel, however, that the current budget mechanisms have unfairly
treated the handling of Indian land and water settlements in relation
to other federally funded Indian programs.
The problem with the current status is that, due to the statutory
discretionary caps, the perception exists that there is not enough
money in BIA's budget to spend on settlements without taking money from
other programs in their budget, such as Indian school construction,
education, community development.
The legislation I am introducing today, the Fiscal Integrity of
Indian Settlements Protection Act of 2001, provides for a cap
adjustment similar to the one that deals with U.N. arrearages. It would
be for authorized Indian land and water settlements and would set a
ceiling on what could be spent in one year. Under this proposal, the
settlements would still have to be authorized and appropriated, but it
would hold the BIA budget harmless for the cost of the settlements.
Let me be clear, if these claims are not settled, the US government
still can be held liable in court. Claims that go through the court
process are authoritatively paid out of the Claims and Judgement Fund.
In most cases, negotiated settlements provide more water to the tribes
and a less expensive bill to the Federal Government.
Frankly, this simple cap adjustment for authorized and appropriated
monies for settlements provides a win-win situation for all parties
involved.
We have made good progress toward funding our Indian responsibilities
these past few years. This legislation is a very important step.
I, along with Senators Inouye, Campbell, Allard, Baucus, Bingaman,
Crapo, Johnson, and Kyl, urge my colleagues to support this bill and
future funding of Indian land and water settlements.
I ask unanimous consent that a letter from the Ad Hoc Group on Indian
Water Rights be printed in the Record.
There being no objection, the letter was ordered to be printed in the
Record, as follows:
Ad Hoc Group on
Indian Water Rights,
June 27, 2001.
Members of the United States Senate,
Washington, DC.
Dear Senator: We write to urge your support and co-
sponsorship of proposed legislation to be introduced shortly
entitled the ``Fiscal Integrity of Indian Settlements
Protection Act of 2001''. A ``Dear Colleague'' letter by
Senators Domenici, Bingaman, Crapo, Inouye, Kyl, and Campbell
was sent to your office on May 23, 2001, describing the bill.
Across the country, numerous negotiations are on-going to
settle complex Indian land and water claims. Funding for
these settlements is one of the biggest hurdles to overcome.
This legislation is important so that Indian land and water
right settlements can be completed in a timely manner,
consistent with the federal government's responsibility and
liability associated with them, and without taking scarce
resources from other critical programs within the Department
of the Interior.
Three settlements were approved by the last Congress and
others are expected to be submitted to this Congress. Under
current budgetary policy, funding of land and water right
settlements must be offset by a corresponding reduction in
some other discretionary component of the Interior
Department's budget. It is difficult for the Administration,
the states and the tribes to negotiate settlements knowing
that they may not be funded because funding can occur only at
the expense of some other tribe or essential Interior
Department program.
We believe that the funding of land and water right
settlements is an important obligation of the United States
government. The obligation is analogous to, and no less
serious than, the obligation of the United States to pay
judgments which are rendered against it. We urge that steps
be taken to change current budgetary policy to ensure that
any land or water settlement, once authorized by the Congress
and approved by the President, will be funded. If such a
change is not made, these claims will likely be relegated to
litigation, an outcome that should not be acceptable to the
Administration, the Congress, the tribes or the states.
The members of the Ad Hoc Group on Indian Water Rights have
consistently supported the negotiated settlement of Indian
land and water right disputes, and have been actively engaged
in drawing more awareness to the important issues associated
with settlement of land and water right claims. We believe
that unless the current budgetary processes for land and
water settlements are changed, funding will continue to be a
barrier to finalizing these settlements.
Again, we urge you to cosponsor the ``Fiscal Integrity of
Indian Settlements Protection Act of 2001'' and support its
passage to ensure congressional funding for Native American
land and water rights settlements once they have been
formally executed by the parties and authorized by Congress.
Sincerely,
Jane Dee Hull,
Co-Lead Governor on Indian Water Right Settlements, Western
Governors' Association.
John Kutzhaber,
Co-Lead Governor on Indian Water Right Settlements, Western
Governors' Association.
Kit Kimball,
Director, Western Regional Council.
John Echohawk,
Executive Director, Native American Rights Fund.
Michael Brophy,
Chairman, Western States Water Council.
______
By Mr. ROCKEFELLER (for himself and Mr. Cleland):
S. 1188. A bill to amend title 38, United States Code, to enhance the
authority of the Secretary of Veterans Affairs to recruit and retain
qualified nurses for the Veterans Health Administration, and for other
purposes, to the Committee on Veterans' Affairs.
Mr. ROCKEFELLER. Mr. President, I am proud to introduce today with
Senators Cleland and Specter the Department of Veterans Affairs Nurse
Recruitment and Retention Enhancement Act of 2001.
On June 14, 2001, the Committee on Veterans' Affairs held a hearing
to explore reasons for the imminent shortage of professional nurses in
the United
[[Page S7820]]
States, and how this shortage will affect health care for veterans
served by Department of Veterans Affairs' health care facilities.
Working conditions for nurses, never easy, have become even more
challenging in recent years. Managed care principles lead hospitals to
admit only the very sickest of patients with the most complex health
care needs. As the pool of highly trained nurses shrinks, many health
care providers rely heavily upon mandatory staff overtime to meet
staffing needs. Several registered nurses, including Sandra McMeans
from my state of West Virginia, testified before the committee that
unpredictable and dangerously long working hours lead to nurses'
fatigue and frustration, and patient care suffers.
The legislation we introduce today includes a requirement that VA
produce a policy on staffing standards. Such a policy shall be
developed in consultation with the VA Under Secretary for Health, the
Director of VA's National Center for Patient Safety, and VA's Chief
Nurse. While we leave it up to VA to develop the standards, the policy
must consider the numbers and skill mix required of staff in specific
medical settings, such as critical care and long-term care.
Because mandatory overtime was frequently cited at the committee's
June hearing as being of serious concern, the legislation includes a
requirement that the Secretary report to the Committee on Veterans'
Affairs on the use of overtime by licensed nursing staff and nursing
assistants in each facility. This is a critical first step to
determining what can be done to reduce the amount of mandatory
overtime. We will continue to monitor this issue with rigor and pledge
to work to reduce the burdens borne by our nurses.
In terms of providing sufficient pay, our legislation mandates that
VA provide Saturday premium pay to certain health professionals. These
group of professionals include licensed practical nurses, LPN's,
certified or registered respiratory therapists, licensed physical
therapists, licensed vocational nurses, pharmacists, and occupational
therapists. This group of workers are known as ``hybrids'' as they
straddle two different personnel authorities, titles 38 and 5 of the
United States Code. Hybrid status allows for the direct hiring and a
more flexible compensation system.
This is an issue of equity, especially for LPN's who work alongside
other nurses on Saturday. While registered nurses, RN's are mandated to
receive Saturday premium pay, they may be working alongside an LPN who
is not. Factoring in the looming nurse shortage, we should be doing all
we can to improve VA's ability to recruit and retain these caregivers.
Currently, hospital directors have the discretion to provide Saturday
premium pay. Of the 17,000 hybrid employees, 8,000 are not receiving
the pay premium.
In my own State of West Virginia, many LPN's are not receiving
Saturday premium pay. Deborah Dixon is an LPN at the VA Medical Center
in Huntington, WV. She works nights 6 days in a row, has 2 days off,
works nights 5 days, then has 1 day off, then works 4 nights and has 3
days off. As a result, she has off every third weekend. She says that
``LPN's deserve Saturday premium pay. It feels like discrimination. It
makes me wonder why LPN's are not being respected.
I believe this change in law will make pay more consistent and fair
for our health care workers.
Programs initiated within VA to improve conditions for nurses and
patients have focused on issues other than staffing ratios, pay, and
hours. A highly praised scholarship program that I spearheaded allows
VA nurses to pursue degrees and training in return for their service,
thus encouraging professional development and improving the quality of
health care. Included within the legislation we introduced today are
modifications to the existing scholarship and debt reduction programs.
These changes are intended to improve the programs by providing
additional flexibility to recipients.
In the Upper Midwest, the special skills of nurses and nurse
practitioners are being recognized in clinics that provide supportive
care close to the veterans who need it. The legislation before us seeks
to encourage more nurse-managed clinics and also includes a requirement
that VA evaluate these clinics.
There are various other provisions included in the bill. One
provision requires that VA nurses enrolled in the Federal Employee
Retirement System have the same ability to include unused sick leave as
part of the retirement year calculation that VA nurses enrolled in the
Civilian Retirement System have. The legislation also would amend the
treatment of part-time service performed by certain title 38 employees
prior to April 7, 1986, for purposes of retirement credit. Currently,
part-time service performed by title 5 employees prior to April 7,
1986, is treated as full-time service; however, title 38 employees'
part-time services prior to April 7, 1986, is counted as part-time
service and therefore results in lower annuities for these employees.
Retired nurses, such as Tonya Rich from Morgantown, WV, who has
contacted me, stress the inequity of the situation. In order to rectify
this, our legislation exempts registered nurses, physician assistants,
and expanded-function dental auxiliaries from the requirement that
part-time service performed prior to April 7, 1986, be prorated when
calculating retirement annuities.
This bill is a good start, but clearly, we must remain vigilant.
Although the nursing crisis has not yet reached its projected peak, the
shortage is already endangering patient safety in the areas of critical
and long-term care, where demands on nurses are greatest. We must
encourage higher enrollment in nursing schools, improve the work
environment, and offer nurses opportunities to develop as respected
professionals, while taking steps to ensure safe staffing levels in the
short-term.
We do not have the luxury of reflecting upon this problem at length;
we must act now. Fortunately, we have as allies hardworking nurses who
are dedicated to helping us find ways to improve working conditions and
to recruit more young people to the field.
I ask unanimous consent that the text of the bill be printed in the
Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1188
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Department
of Veterans Affairs Nurse Recruitment and Retention
Enhancement Act of 2001''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.
TITLE I--ENHANCEMENT OF RECRUITMENT AUTHORITIES
Sec. 101. Enhancement of employee incentive scholarship program.
Sec. 102. Enhancement of education debt reduction program.
Sec. 103. Report on requests for waivers of pay reductions for
reemployed annuitants to fill nurse positions.
TITLE II--ENHANCEMENT OF RETENTION AUTHORITIES
Sec. 201. Additional pay for Saturday tours of duty for additional
health care professional in the Veterans Health
Administration.
Sec. 202. Unused sick leave included in annuity computation of
registered nurses with the Veterans Health
Administration.
Sec. 203. Evaluation of Department of Veterans Affairs nurse managed
clinics.
Sec. 204. Staffing levels for operations of medical facilities.
Sec. 205. Annual report on use of authorities to enhance retention of
experienced nurses.
Sec. 206. Report on mandatory overtime for nurses and nurse assistants
in Department of Veterans Affairs facilities.
TITLE III--OTHER MATTERS
Sec. 301. Organizational responsibility of the Director of the Nursing
Service.
Sec. 302. Computation of annuity for part-time service performed by
certain health-care professionals before April 7, 1986.
Sec. 303. Modification of nurse locality pay authorities.
Sec. 304. Technical amendments.
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.
Except as otherwise expressly provided, whenever in this
Act an amendment or repeal is expressed in terms of an
amendment to, or repeal of, a section or other provision, the
reference shall be considered to be made
[[Page S7821]]
to a section or other provision of title 38, United States
Code.
TITLE I--ENHANCEMENT OF RECRUITMENT AUTHORITIES
SEC. 101. ENHANCEMENT OF EMPLOYEE INCENTIVE SCHOLARSHIP
PROGRAM.
(a) Permanent Authority.--(1) Section 7676 is repealed.
(2) The table of sections at the beginning of chapter 76 is
amended by striking the item relating to section 7676.
(b) Minimum Period of Department Employment for
Eligibility.--Section 7672(b) is amended by striking ``2
years'' and inserting ``one year''.
(c) Scholarship Amount.--Subsection (b) of section 7673 is
amended--
(1) in paragraph (1), by striking ``for any one year'' and
inserting ``for the equivalent of one year of full-time
coursework''; and
(2) by striking paragraph (2) and inserting the following
new paragraph (2):
``(2) in the case of a participant in the Program who is a
part-time student, shall bear the same ratio to the amount
that would be paid under paragraph (1) if the participant
were a full-time student in the course of education or
training being pursued by the participant as the coursework
carried by the student bears to full-time coursework in that
course of education or training.''.
(d) Limitation on Payment.--Subsection (c) of section 7673
is amended to read as follows:
``(c) Limitations on Period of Payment.--(1) The maximum
number of school years for which a scholarship may be paid
under subsection (a) to a participant in the Program shall be
six school years.
``(2) A participant in the Program may not receive a
scholarship under subsection (a) for more than the equivalent
of three years of full-time coursework.''.
(e) Full-Time Coursework.--Section 7673 is further amended
by adding at the end the following new subsection:
``(e) Full-Time Coursework.--For purposes of this section,
full-time coursework shall consist of the following:
``(1) In the case of undergraduate coursework, 30 semester
hours per undergraduate school year.
``(2) In the case of graduate coursework, 18 semester hours
per graduate school year.''.
(f) Annual Adjustment of Maximum Scholarship Amount.--
Section 7631 is amended--
(1) in subsection (a)(1), by striking ``and the maximum
Selected Reserve member stipend amount'' and inserting ``the
maximum Selected Reserve member stipend amount, the maximum
employee incentive scholarship amount,''; and
(2) in subsection (b)--
(A) by redesignating paragraph (4) as paragraph (6); and
(B) by inserting after paragraph (3) the following new
paragraph (4):
``(4) The term `maximum employee incentive scholarship
amount' means the maximum amount of the scholarship payable
to a participant in the Department of Veterans Affairs
Employee Incentive Scholarship Program under subchapter VI of
this chapter, as specified in section 7673(b)(1) of this
title and as previously adjusted (if at all) in accordance
with this section.''.
SEC. 102. ENHANCEMENT OF EDUCATION DEBT REDUCTION PROGRAM.
(a) Permanent Authority.--(1) Section 7684 is repealed.
(2) The table of sections at the beginning of chapter 76 is
amended by striking the item relating to section 7684.
(b) Eligible Individuals.--Subsection (a)(1) of section
7682 is amended--
(1) by striking ``under an appointment under section
7402(b) of this title in a position'' and inserting ``in a
position (as determined by the Secretary) providing direct-
patient care services or services incident to direct-patient
care services''; and
(2) by striking ``(as determined by the Secretary)'' and
inserting ``(as so determined)''.
(c) Maximum Debt Reduction Amount.--Section 7683(d)(1) is
amended--
(1) by striking ``for a year''; and
(2) by striking ``exceed--'' and all that follows through
the end of the paragraph and inserting ``exceed $44,000 over
a total of five years of participation in the Program, of
which not more than $10,000 of such payments may be made in
each of the fourth and fifth years of participation in the
Program.''.
(d) Annual Adjustment of Maximum Debt Reduction Payments
Amount.--(1) Section 7631, as amended by section 101(f) of
this Act, is further amended--
(A) in subsection (a)(1), by inserting before the period at
the end of the first sentence the following: ``and the
maximum education debt reduction payments amount''; and
(B) in subsection (b), by inserting after paragraph (4) the
following new paragraph (5):
``(5) The term `maximum education debt reduction payments
amount' means the maximum amount of education debt reduction
payments payable to a participant in the Department of
Veterans Affairs Education Debt Reduction Program under
subchapter VII of this chapter, as specified in section
7683(d)(1) of this title and as previously adjusted (if at
all) in accordance with this section.''.
(2) Notwithstanding section 7631(a)(1) of title 38, United
States Code, as amended by paragraph (1), the Secretary of
Veterans Affairs shall not increase the maximum education
debt reduction payments amount under that section in calendar
year 2002.
(e) Temporary Expansion of Individuals Eligible for
Participation in Program.--(1) Notwithstanding section
7682(c) of title 38, United States Code, the Secretary of
Veterans Affairs may treat a covered individual as being a
recently appointed employee in the Veterans Health
Administration under section 7682(a) of that title for
purposes of eligibility in the Education Debt Reduction
Program if the Secretary determines that the participation of
the individual in the Program under this subsection would
further the purposes of the Program.
(2) For purposes of this subsection, a covered individual
is any individual otherwise described by section 7682(a) of
title 38, United States Code, as in effect on the day before
the date of the enactment of this Act, who--
(A) was appointed as an employee in a position described in
paragraph (1) of that section, as so in effect, between
January 1, 1999, and September 30, 2000; and
(B) is an employee in such position, or in another position
described in paragraph (1) of that section, as so in effect,
at the time of application for treatment as a covered
individual under this subsection.
(3) The Secretary shall make determinations regarding the
exercise of the authority in this subsection on a case-by-
case basis.
(4) The Secretary may not exercise the authority in this
subsection after December 31, 2001. The expiration of the
authority in this subsection shall not affect the treatment
of an individual under this subsection before that date as a
covered individual for purposes of eligibility in the
Education Debt Reduction Program.
(5) In this subsection, the term ``Education Debt Reduction
Program'' means the Department of Veterans Affairs Education
Debt Reduction Program under subchapter VII of chapter 76 of
title 38, United States Code.
SEC. 103. REPORT ON REQUESTS FOR WAIVERS OF PAY REDUCTIONS
FOR REEMPLOYED ANNUITANTS TO FILL NURSE
POSITIONS.
(a) Report.--Not later than November 30 of each of 2001 and
2002, the Secretary of Veterans Affairs shall submit to the
Committees on Veterans' Affairs of the Senate and the House
of Representatives a report describing each request of the
Secretary, during the fiscal year preceding such report, to
the Director of the Office of Personnel Management for the
following:
(1) A waiver under subsection (i)(1)(A) of section 8344 of
title 5, United States Code, of the provisions of such
section in order to meet requirements of the Department of
Veterans Affairs for appointments to nurse positions in the
Veterans Health Administration.
(2) A waiver under subsection (f)(1)(A) of section 8468 of
title 5, United States Code, of the provisions of such
section in order to meet requirements of the Department for
appointments to such positions.
(3) A grant of authority under subsection (i)(1)(B) of
section 8344 of title 5, United States Code, for the waiver
of the provisions of such section in order to meet
requirements of the Department for appointments to such
positions.
(4) A grant of authority under subsection (f)(1)(B) of
section 8468 of title 5, United States Code, for the waiver
of the provisions of such section in order to meet
requirements of the Department for appointments to such
positions.
(b) Information on Responses to Requests.--The report under
subsection (a) shall specify for each request covered by the
report--
(1) the response of the Director to such request; and
(2) if such request was granted, whether or not the waiver
or authority, as the case may be, assisted the Secretary in
meeting requirements of the Department for appointments to
nurse positions in the Veterans Health Administration.
TITLE II--ENHANCEMENT OF RETENTION AUTHORITIES
SEC. 201. ADDITIONAL PAY FOR SATURDAY TOURS OF DUTY FOR
ADDITIONAL HEALTH CARE PROFESSIONAL IN THE
VETERANS HEALTH ADMINISTRATION.
(a) In General.--Section 7454(b) is amended--
(1) by inserting ``(1)'' after ``(b)''; and
(2) by adding at the end the following new paragraph:
``(2) Health care professionals employed in positions
referred to in paragraph (1) shall be entitled to additional
pay on the same basis as provided for nurses in section
7453(c) of this title.''.
(b) Applicability.--The amendments made by subsection (a)
shall take effect on the date of the enactment of this Act,
and shall apply with respect to pay periods beginning on or
after that date.
SEC. 202. UNUSED SICK LEAVE INCLUDED IN ANNUITY COMPUTATION
OF REGISTERED NURSES WITH THE VETERANS HEALTH
ADMINISTRATION.
(a) Annuity Computation.--Section 8415 of title 5, United
States Code, is amended by adding at the end the following:
``(i) In computing an annuity under this subchapter, the
total service of an employee who retires from the position of
a registered nurse with the Veterans Health Administration on
an immediate annuity, or dies while employed in that position
leaving any survivor entitled to an annuity, includes the
days of unused sick leave to the credit of that employee
under a formal leave system, except that such days shall not
be counted in
[[Page S7822]]
determining average pay or annuity eligibility under this
subchapter.''.
(b) Deposit Not Required.--Section 8422(d) of title 5,
United States Code, is amended--
(1) by inserting ``(1)'' before ``Under such regulations'';
and
(2) by adding at the end the following:
``(2) Deposit may not be required for days of unused sick
leave credited under section 8415(i).''.
(c) Effective Date.--The amendments made by this section
shall take effect 60 days after the date of the enactment of
this Act, and shall apply to individuals who separate from
service on or after that effective date.
SEC. 203. EVALUATION OF DEPARTMENT OF VETERANS AFFAIRS NURSE
MANAGED CLINICS.
(a) Evaluation.--The Secretary of Veterans Affairs shall
carry out an evaluation of the efficacy of the nurse managed
health care clinics of the Department of Veterans Affairs.
The Secretary shall complete the evaluation not later than 18
months after the date of the enactment of this Act.
(b) Clinics To Be Evaluated.--(1) In carrying out the
evaluation under subsection (a), the Secretary consider nurse
managed health care clinics, including primary care clinics
and geriatric care clinics, located in three different
Veterans Integrated Service Networks (VISNs) of the
Department.
(2) If there are not nurse managed health care clinics
located in three different Veterans Integrated Service
Networks as of the commencement of the evaluation, the
Secretary shall--
(A) establish nurse managed health care clinics in
additional Veterans Integrated Services Networks such that
there are nurse managed health care clinics in three
different Veterans Integrated Service Networks for purposes
of the evaluation; and
(B) include such clinics, as so established, in the
evaluation.
(c) Matters To Be Evaluated.--In carrying out the
evaluation under subsection (a), the Secretary shall address
the following:
(1) Patient satisfaction.
(2) Provider experiences.
(2) Cost of care.
(4) Access to care, including waiting time for care.
(5) The functional status of patients receiving care.
(6) Any other matters the Secretary considers appropriate.
(d) Report.--Not later than 18 months after the date of the
enactment of this Act, the Secretary shall submit to the
Committees on Veterans' Affairs of the Senate and the House
of Representatives a report on the evaluation carried out
under subsection (a). The report shall address the matters
specified in subsection (c) and include any other
information, and any recommendations, that the Secretary
considers appropriate.
SEC. 204. STAFFING LEVELS FOR OPERATIONS OF MEDICAL
FACILITIES.
(a) In General.--Section 8110(a) is amended--
(1) in paragraph (1), by inserting after ``complete care of
patients,'' in the fifth sentence the following: ``and in a
manner consistent with the policies of the Secretary on
overtime,''; and
(2) in paragraph (2)--
(A) by inserting ``, including the staffing required to
maintain such capacities,'' after ``all Department medical
facilities'';
(B) by striking ``and to minimize'' and inserting ``, to
minimize''; and
(C) by inserting before the period the following: ``, and
to ensure that eligible veterans are provided such care and
services in an appropriate manner''.
(b) Nationwide Policy on Staffing.--Paragraph (3) of that
section is amended--
(1) in subparagraph (A), by inserting ``the adequacy of
staff levels for compliance with the policy established under
subparagraph (C),'' after ``regarding''; and
(2) by inserting after subparagraph (B) the following new
subparagraph:
``(C) The Secretary shall, in consultation with the Under
Secretary for Health, establish a nationwide policy on the
staffing of Department medical facilities in order to ensure
that such facilities have adequate staff for the provision to
veterans of appropriate, high-quality care and services. The
policy shall take into account the staffing levels and
mixture of staff skills required for the range of care and
services provided veterans in Department facilities.''.
SEC. 205. ANNUAL REPORT ON USE OF AUTHORITIES TO ENHANCE
RETENTION OF EXPERIENCED NURSES.
(a) Annual Report.--(1) Subchapter II of chapter 73 is
amended by adding at the end the following new section:
``Sec. 7324. Annual report on use of authorities to enhance
retention of experienced nurses
``(a) Annual Report.--Not later than January 31 each year,
the Secretary, acting through the Under Secretary for Health,
shall submit to Congress a report on the use during the
preceding year of authorities for purposes of retaining
experienced nurses in the Veterans Health Administration, as
follows:
``(1) The authorities under chapter 76 of this title.
``(2) The authority under VA Directive 5102.1, relating to
the Department of Veterans Affairs nurse qualification
standard, dated November 10, 1999, or any successor
directive.
``(3) Any other authorities available to the Secretary for
those purposes.
``(b) Report Elements.--Each report under subsection (a)
shall specify for the period covered by such report, for each
Department medical facility and for each Veterans Integrated
Service Network, the following:
``(1) The number of waivers requested under the authority
referred to in subsection (a)(2), and the number of waivers
granted under that authority, to promote to the Nurse II
grade or Nurse III grade under the Nurse Schedule under
section 7404(b)(1) of this title any nurse who has not
completed a bachelors of science in nursing in a recognized
school of nursing, set forth by age, race, and years of
experience of the individuals subject to such waiver requests
and waivers, as the case may be.
``(2) The programs carried out to facilitate the use of
nursing education programs by experienced nurses, including
programs for flexible scheduling, scholarships, salary
replacement pay, and on-site classes.''.
(2) The table of sections at the beginning of chapter 73 is
amended by inserting after the item relating to section 7323
the following new item:
``7324. Annual report on use of authorities to enhance retention of
experienced nurses.''.
(b) Initial Report.--The initial report required under
section 7324 of title 38, United States Code, as added by
subsection (a), shall be submitted in 2002.
SEC. 206. REPORT ON MANDATORY OVERTIME FOR NURSES AND NURSE
ASSISTANTS IN DEPARTMENT OF VETERANS AFFAIRS
FACILITIES.
(a) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs
shall submit to the Committees on Veterans' Affairs of the
Senate and the House of Representatives a report on the
mandatory overtime required of licensed nurses and nurse
assistants providing direct patient care at Department of
Veterans Affairs medical facilities during 2001.
(b) Mandatory Overtime.--For purposes of the report under
subsection (a), mandatory overtime shall consist of any
period in which a nurse or nurse assistant is mandated or
otherwise required, whether directly or indirectly, to work
or be in on-duty status in excess of--
(1) a scheduled workshift or duty period;
(2) 12 hours in any 24-hour period; or
(3) 80 hours in any period of 14 consecutive days.
(c) Elements.--The report under subsection (a) shall
include the following:
(1) A description of the amount of mandatory overtime
described in that subsection at each Department medical
facility during the period covered by the report.
(2) A description of the mechanisms employed by the
Secretary to monitor overtime of the nurses and nurse
assistants referred to in that subsection.
(3) An assessment of the effects of the mandatory overtime
of such nurses and nurse assistants on patient care,
including its contribution to medical errors.
(4) Recommendations regarding mechanisms for preventing
requirements for amounts of mandatory overtime in other than
emergency situations by such nurses and nurse assistants.
(5) Any other matters that the Secretary considers
appropriate.
TITLE III--OTHER MATTERS
SEC. 301. ORGANIZATIONAL RESPONSIBILITY OF THE DIRECTOR OF
THE NURSING SERVICE.
Section 7306(a)(5) is amended by inserting ``, and report
directly to,'' after ``responsible to''.
SEC. 302. COMPUTATION OF ANNUITY FOR PART-TIME SERVICE
PERFORMED BY CERTAIN HEALTH-CARE PROFESSIONALS
BEFORE APRIL 7, 1986.
Section 7426 is amended--
(1) by redesignating subsection (c) as subsection (d); and
(2) by inserting after subsection (b) the following new
subsection (c):
``(c) The provisions of subsection (b) shall not apply to
the part-time service before April 7, 1986, of a registered
nurse, physician assistant, or expanded-function dental
auxiliary. In computing the annuity under the applicable
provision of law specified in that subsection of an
individual covered by the preceding sentence, the service
described in that sentence shall be credited as full-time
service.''.
SEC. 303. MODIFICATION OF NURSE LOCALITY PAY AUTHORITIES.
Section 7451 is amended--
(1) in subsection (d)(3)--
(A) in subparagraph (A), by striking ``beginning rates of''
each time it appears;
(B) in subparagraph (B), by striking ``beginning rates
of''; and
(C) in subparagraph (C)(i), by striking ``beginning rates
of'' each time it appears;
(2) in subsection (d)(4)--
(A) by striking ``or at any other time that an adjustment
in rates of pay is scheduled to take place under this
subsection'' in the first sentence; and
(B) by striking the second sentence; and
(3) in subsection (e)(4)--
(A) in subparagraph (A), by striking ``grade in a'';
(B) in subparagraph (B)--
(i) by striking ``grade of a''; and
(ii) by striking ``that grade'' and inserting ``that
position''; and
(C) in subparagraph (D), by striking ``grade of a''.
SEC. 304. TECHNICAL AMENDMENTS.
Section 7631(b) is amended by striking ``this subsection''
each place it appears and inserting ``this section''.
[[Page S7823]]
______
By Mr. HOLLINGS (for himself, Mr. Inouye, and Mr. Dorgan):
S. 1189. A bill to require the Federal Communications Commission to
amend its daily newspaper cross-ownership rules, and for other
purposes; to the Committee on Commerce, Science, and Transportation.
Mr. HOLLINGS. Mr. President, I rise to introduce legislation, the
Media Ownership Act of 2001, designed to rectify the increasing trend
toward consolidation and away from a vibrant exchange of news and
information in today's media marketplace. I am joined in this effort by
my colleagues, Senators Inouye and Dorgan, who for years have
demonstrated their tireless pursuit of the public interest in the
sensible regulation of media ownership.
This legislation is necessary to stem the tide toward concentration
in the broadcast and newspaper industries and force a thorough and
reasoned examination of the claims that further consolidation will
serve the public interest. While the phrase ``public interest'' may
have a vague ring to it, its meaning should be quite clear to the five
members of the Federal Communications Commission, which itself observed
just a few months ago that it has both ``the duty and authority under
the Communications Act to promote diversity and competition among media
voices.''
Notwithstanding that duty, it has come to my attention that the FCC
is planning a Notice of Proposed Rulemaking to relax or eliminate the
newspaper-broadcast cross ownership rule. In addition, I understand
that the FCC may consider revising, among other media ownership
restrictions, the 35 percent national broadcast ownership cap later
this year. I do not believe that those rules should be changed at this
time. Others disagree. This legislation will enhance our debate on
these issues.
Locally relevant, independent programmers and distributors of media
content are critically important energizers of civic discourse in this
country. Indeed, that independence, localism and diversity are what
separate our nation from countries where information is not allowed to
flow freely. Accordingly, any proceeding to revisit existing ownership
rules involving broadcast, print, or cable television must examine the
potential impact that undue influence over local and national media
outlets may have on our democracy.
Because Congress understood the difficulty the Commission faces in
quantifying democratic values such as localism and diversity, it gave
the Commission the explicit and implicit statutory authority and
responsibility to establish and maintain ownership caps in the media
industry. Pursuant to that authority, the FCC has imposed limits on the
ownership of broadcast and cable television properties, and on the
cross-ownership within a market between broadcast and cable television
stations, broadcast television and radio stations, and broadcast
television and radio stations and newspapers.
These ownership restrictions are based on factors outside the bounds
of a traditional competitive analysis, and carry with them the
authority to prevent consolidation before it rises to the level
necessary to trigger antitrust intervention. for example, in light of
the importance of promoting localism and diversity, a higher importance
must be ascribed to preserving the balance of power between the
networks and local stations than would otherwise be expected under
traditional competition analysis.
The reasons for this are simple, diversity in ownership promotes
competition. Diversity in ownership creates opportunities for smaller
companies, and local businessmen and women. Diversity in ownership
allows creative programming and controversial points of views to find
an outlet. Diversity in ownership promotes choices for advertisers. And
diversity in ownership and the related restriction on national
ownership groups preserves localism. And what in turn does this mean?
Millions of Americans regularly receive their local news by watching
their local broadcast stations or reading their daily newspaper. For
these citizens, localism still matters.
The proponents of increased consolidation, however, claim that the
transformed media landscape demands a deregulatory response. In my
view, the burden should rest on those who wish to change the rules of
the game to justify those changes. If localism and diversity can be
preserved in a consolidated marketplace, prove it. Arguments alone are
not persuasive.
Prior to the 1996 Telecommunications Act, the top radio station group
owned 39 stations and generated annual revenues of $495 million. Today,
the top group owns over 1100 stations and generates revenues of almost
$3.2 billion annually. This consolidation directly undercut diversity
and localism in the radio marketplace. A year before Congress passed
the Telecommunications Act, the FCC lifted the rules that prohibited
broadcast networks from owning and creating their own television
programming. This sanctioned consolidation freed the networks to seek
economic stakes in, and ownership of, television programs. As the
Washington Post reported last fall in an article entitled, ``Even Hits
can Miss in TV's New Economy'', ``Just as supermarket might reserve its
best shelf space for its house brands, the networks have begun to favor
their in house programs over shows created by others, which are often
less profitable in the long term.'' So we see what deregulation has
brought us with radio and the market for television programming.
Similar consolidation among other major media outlets should only be
allowed after a thorough analysis that justifies permitting such
concentration.
The legislation that we introduce today addresses the FCC's lack of
enforcement of the newspaper-broadcast cross ownership rule. The FCC's
jurisdiction over newspaper broadcast ownership combinations arises
from its authority to oversee broadcast communications licenses. In
practice, the FCC has applied the rule only when there is a transfer or
renewal of a broadcast license. So, if a broadcast station owner
acquires a newspaper in the same market, there is no FCC review of the
cross ownership until the station's license is up for renewal. If a
newspaper owner acquires a broadcast station, however, the rule is
immediately triggered because the FCC has to approve the transfer of
the station's broadcast license for the transaction to go forward. When
the rule was adopted, television broadcast licenses were renewed every
three years. Accordingly, even when the FCC did not immediately enforce
the rule, the combined entity was aware it would have to come into
compliance, either by requesting a waiver, or divesting either the
station or newspaper, within a short period of time.
Today, however, broadcast station licenses are only renewed every
eight years, thereby creating a significant loophole in the cross
ownership rule, if it is only enforced by the Commission at the time of
license renewals. Our bill would require the FCC to review immediately
existing cross ownership combinations. The legislation requires a
broadcast licensee to inform the FCC when it acquires a newspaper that
would place the license in violation of the newspaper-broadcast cross
ownership rule. Upon receipt of this information, the FCC could take a
range of action under the legislation, including forcing divestiture,
or granting a waiver to allow the combination to go forward.
In addition, our legislation steps up a process whereby we in
Congress can scrutinize any alternative that the Commission devises to
replace the current media ownership rules, and compare the efficacy of
a new cap or ownership measurement system against the current rules, to
determine whether a new measurement provides a better mechanism to
promote diversity and localism. Accordingly, our bill requires the FCC
to provide to the House and Senate Commerce Committees, any proposed
media ownership rule changes eighteen months before they become
effective. These proposals must be transmitted to the Commerce
committees along with clear and ample explanation of how the new
formulations will better meet the Commission's public interest
obligation to promote competition, diversity, and localism.
The legislation we are introducing takes two important steps. First,
it forces the FCC to enforce the current version of the FCC's
newspaper-broadcast cross ownership rule. Second, it provides a check
on those who might otherwise move quickly to repeal other media
ownership limits without regard
[[Page S7824]]
to the impact of the consequent consolidation on diversity, localism,
and competition in the media marketplace.
I ask unanimous consent that the text of the bill be printed in the
Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1189
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. FCC DAILY NEWSPAPER CROSS-OWNERSHIP RULE.
(a) Immediate Review.--
(1) In general.--The Federal Communications Commission
shall modify section 73.3555(d) of its regulations (47 C.F.R.
73.3555(d)) to provide for the immediate review of a license
for any AM, FM, or TV broadcast station held by any party
(including all parties under common control) that acquires
direct or indirect ownership, operation, or control of a
daily newspaper.
(2) Notice to commission.--The modification under paragraph
(1) shall require that any licensee covered by that paragraph
notify the Committee of the acquisition of the ownership,
operation, or control of a daily newspaper upon the
acquisition of such ownership, operation, or control.
(b) Remedial Action.--The Commission shall further modify
section 73.3555(d) of its regulations (47 C.F.R. 73.3555(d))
to require modification or revocation of the license, or
divestiture of such ownership, operation, or control of the
daily newspaper, unless the Commission determines that direct
or indirect ownership, operation, or control of the daily
newspaper by that party will not cause a result described in
paragraph (1), (2), or (3) of that section.
(c) 6-Month Deadline for Compliance.--Under the regulations
as modified under subsection (b), if the Commission does not
make a determination described in subsection (b), the
Commission shall require the modification, revocation, or
divestiture to be completed not later than the earlier of--
(1) the date that is 180 days after the date on which the
Commission issues the order requiring the modification,
revocation, or divestiture; or
(2) the date by which the Commission's regulations require
the license to be renewed.
(d) Application to Existing Arrangements.--
(1) In general.--In applying its regulations, as modified
pursuant to this section, to any license for an AM, FM, or TV
broadcast station that is held on the date of the enactment
of this Act by a party that also, as of that date, has direct
or indirect ownership, operation, or control of a daily
newspaper, the Commission--
(A) may grant a permanent or temporary waiver from the
modification, revocation, or divestiture requirements of the
modified regulation if the Commission determines that the
waiver is consistent with the principles of competition,
diversity, and localism in the public interest; and
(B) shall not apply the modified regulation so as to
require modification, revocation, or divestiture in
circumstances in which section 73.3555(d) of the Commission's
regulations (47 C.F.R. 73.3555(d)) does not apply because of
Note 4 to that section.
(2) Notice to commission.--A licensee of a license
described by paragraph (1) shall notify the Commission not
later than 30 days after the date of the enactment of this
Act that the license is covered by paragraph (1).
SEC. 2. REVIEW BASED ON TRANSACTIONS.
The Federal Communications Commission shall further modify
section 73.3555 of its regulations (47 C.F.R. 73.3555) so
that the Commission will determine compliance with section
73.3555(d) of its regulations, as modified by the Commission
pursuant to section 1 of this Act, whenever a party
(including all parties under common control)--
(1) that holds a license for an AM, FM, or TV broadcast
station acquires direct or indirect ownership, operation, or
control of a daily newspaper; or
(2) that directly or indirectly owns, operates, or controls
a daily newspaper acquires a license for an AM, FM, or TV
broadcast station.
SEC. 3. FCC TO JUSTIFY REPEAL OR MODIFICATION OF REGULATIONS
UNDER REGULATORY REFORM.
Section 11 of the Communications Act of 1934 (47 U.S.C.
161) is amended--
(1) by redesignating subsection (b) as subsection (c); and
(2) by inserting after subsection (a) the following new
subsection (b):
``(b) Relaxation or Elimination of Media Ownership Rules.--
If, as a result of a review under subsection (a)(1), the
Commission makes a determination under subsection (a)(2) with
respect to its regulations governing multiple ownership (47
C.F.R. 73.3555), then not less than 18 months before the
proposed repeal or modification under subsection (c) is to
take effect, the Commission shall transmit to the Committee
on Commerce, Science, and Transportation of the Senate and
the Committee on Commerce of the House of Representatives--
``(1) a statement of the proposed repeal or modification;
and
``(2) an explanation of the basis for its determination,
including an explanation of how the proposed repeal or
modification is expected to promote competition, diversity,
and localism in the public interest.''.
SEC. 4. DEADLINE FOR MODIFICATION OF REGULATIONS.
The Federal Communications Commission shall complete the
modifications of its regulations required by sections 1 and 2
of this Act not later than 1 year after the date of the
enactment of this Act.
____________________