[Congressional Record Volume 151, Number 42 (Tuesday, April 12, 2005)]
[Senate]
[Pages S3487-S3488]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CORZINE (for himself and Mr. Lautenberg):
  S. 764. A bill to amend title XVIII of the Social Security Act to 
improve the coordination of prescription drug coverage provided under 
State pharmaceutical assistance programs with the prescription drug 
benefit provided under the medicare program, and for other purposes; to 
the Committee on Finance.
  Mr. CORZINE. Mr. President, I rise today along with my colleague, 
Senator Lautenberg, to introduce legislation, the Preserving Access to 
Affordable Drugs (PAAD) Act. This legislation is essential to ensuring 
that our most vulnerable seniors who have existing prescription drug 
coverage do not see a reduction or disruption in their coverage once 
the Medicare prescription drug program goes into effect.
  Hundreds of thousands of seniors, including 190,000 in my State, 
currently enrolled in state pharmacy assistance programs (SPAPs) will 
be forced out of those programs and into a private drug plan under the 
Medicare prescription drug benefit. Additionally, approximately six 
million seniors, including 140,000 in New Jersey, who are dually 
eligible for Medicare and Medicaid will lose access to their Medicaid 
prescription drug benefits, which are more generous and provide greater 
access to a variety of drugs than the Medicare benefit will.
  No senior should be made worse off by the new Medicare law. The law 
should expand benefits--not reduce them. The PAAD Act will make 
critical changes to the Medicare law to ensure that the above-mentioned 
benefits are safeguarded.
  The PAAD Act will allow States to automatically enroll SPAP and 
dually eligible Medicaid beneficiaries into one or more preferred 
prescription drug plans to ensure that these beneficiaries are enrolled 
in a Medicare drug plan that maximizes both their Federal and State 
prescription drug coverage and ensures for a seamless transition to the 
new Medicare Part D drug benefit.
  The PAAD Act will ensure that New Jersey seniors who currently 
receive prescription drug benefits under PAAD or through the State's 
Medicaid program are not made worse off by the new Medicare law.
  The PAAD Act will allow New Jersey to provide supplemental Medicaid 
prescription drug benefits to low-income seniors and disabled who 
currently receive generous prescription drug benefits under the 
Medicaid program and who will now receive their prescription drug 
benefits through Medicare.
  One of the goals of medicine is to do no harm. The manner in which 
the Bush Administration has chosen to implement the Medicare law 
violates that tenet. The Medicare legislation signed by the President 
created the State Pharmaceutical Assistance Transition Commission 
specifically to address the coordination of benefits between SPAPS, 
State Medicaid drug programs, and the new Medicare drug plan. The 
Commission was explicit in its recommendation to CMS that states be 
permitted to automatically enroll these beneficiaries in preferred 
prescription drug plans to ``enhance benefits to enrollees, encourage 
enrollment, and promote coordination between Medicare Part D and 
[states].'' Members of the Commission recognized that many blind, 
disabled, and aged beneficiaries, those who most need coverage, would 
not be able to navigate the plan selection process and could face gaps 
in coverage. Yet, CMS recently denied New Jersey's request to 
automatically enroll those Medicare beneficiaries currently enrolled in 
New Jersey's PAAD and Medicaid programs into a preferred Medicare 
prescription drug plan. This ruling effectively blocks New Jersey's 
efforts to preserve the generous prescription drug coverage the state 
currently provides to the 190,000 seniors enrolled in New Jersey's PAAD 
program and the 140,000 seniors and disabled enrolled in the state's 
Medicaid program when the new Medicare prescription drug benefit goes 
into effect on January 1, 2006.

  Yesterday, I was joined by Senator Lautenberg in writing to the 
President to express our sincere dismay over the recent CMS ruling. It 
is clear that permitting states to automatically enroll these 
beneficiaries would guarantee that these seniors continue to receive 
the same level of prescription drug coverage, which is more generous 
than the coverage that will be available under the new Medicare 
benefit. Furthermore, auto enrollment would relieve beneficiaries from 
the anxiety of selecting the appropriate plan to ensure that their drug 
coverage is maximized. Certainly, beneficiaries who prefer to select 
their own prescription drug plan should have that choice, but those who 
want the state to act on their behalf to ensure that they receive the 
most comprehensive and seamless coverage should be afforded that 
option.
  This legislation is critical to preserving and protecting existing 
prescription drug coverage while expanding it to those who currently 
lack such coverage. States like New Jersey, Pennsylvania, and New York, 
States that have well-established, generous prescription drug plans for 
seniors and the disabled, should not be prevented from continuing to 
provide the same level of coverage under the new Medicare law. I look 
forward to working with my colleagues to pass this legislation and 
preserve prescription drug benefits for all seniors.
  Mr. President, 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. 764

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Preserving Access to 
     Affordable Drugs Act of 2005''.

     SEC. 2. STATE AS AUTHORIZED REPRESENTATIVE.

       (a) In General.--Section 1860D-1(b)(1) of the Social 
     Security Act (42 U.S.C. 1395w-101(b)(1)) is amended by adding 
     at the end the following new subparagraph:
       ``(D) State as authorized representative.--A State 
     Pharmaceutical Assistance Program (as defined in section 
     1860D-23(b)) may, at the option of the State operating the 
     Program, act as the authorized representative for any part D 
     eligible individual residing in the State who is enrolled in 
     the Program or described in section 1935(c)(6)(A)(ii) in 
     order to select one or more preferred prescription drug plans 
     to enroll such an individual, so long as the individual is 
     afforded the authority to decline such enrollment. A Program 
     that acts as an authorized representative for an individual 
     pursuant to the preceding sentence shall not be considered to 
     have violated section 1860D-23(b)(2) solely because of the 
     enrollment of such individual in a preferred prescription 
     drug plan.''.
       (b) Conforming Amendment to Anti-discrimination 
     Provision.--Section 1860D-23(b)(2) of the Social Security Act 
     (42 U.S.C. 1395w-133(b)(2)) is amended by inserting ``subject 
     to 1860D-1(b)(1)(D),'' after ``which,''.

     SEC. 3. FACILITATION OF COORDINATION.

       Section 1860D-24(c)(1) of the Social Security Act (42 
     U.S.C. 1395w-134(c)(1)) is amended by striking ``all methods 
     of operation'' and inserting ``its own methods of operation, 
     except that a PDP sponsor or MA organization may not require 
     a State Pharmaceutical Assistance Program or an RX plan 
     described in subsection (b) to apply such tools when 
     coordinating benefits''.

[[Page S3488]]

     SEC. 4. ALLOWING MEDICAID WRAP.

       Section 1935 of the Social Security Act (42 U.S.C. 1396u-5) 
     is amended by striking subsection (d).

     SEC. 5. EFFECTIVE DATE.

       The amendments made by this Act shall take effect as if 
     included in the enactment of the Medicare Prescription Drug, 
     Improvement, and Modernization Act of 2003 (Public Law 108-
     173; 117 Stat. 2066).
                                 ______