[Congressional Record Volume 152, Number 5 (Wednesday, January 25, 2006)]
[Senate]
[Pages S131-S134]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER (for himself, Mr. Reid, Mrs. Murray, Mr. 
        Bingaman, Mrs. Lincoln, Mr. Kennedy, Mrs. Clinton,

[[Page S132]]

        Mr. Lautenberg, Ms. Stabenow, Mr. Durbin, Mr. Kerry, Mr. 
        Schumer, Mr. Pryor, Mr. Leahy, Mr. Dayton, Mr. Jeffords, Mr. 
        Harkin, Ms. Mikulski, Mr. Johnson, Ms. Cantwell, Mr. Akaka, Mr. 
        Lieberman, Mr. Kohl, Ms. Landrieu, Mr. Sarbanes, and Mrs. 
        Boxer):
  S. 2183. A bill to provide for necessary beneficiary protections in 
order to ensure access to coverage under the Medicare part D 
prescription drug program; to the Committee on Finance.
 Mr. ROCKEFELLER. 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. 2183

       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 ``Requiring 
     Emergency Pharmaceutical Access for Individual Relief 
     (REPAIR) Act of 2006''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Transition requirements.
Sec. 3. Federal fallback for full-benefit dual eligible individuals for 
              2006.
Sec. 4. Identifying full-benefit dual eligible individuals in data 
              records.
Sec. 5. Prohibition on conditioning Medicaid eligibility for 
              individuals enrolled in certain creditable prescription 
              drug coverage on enrollment in the Medicare part D drug 
              program.
Sec. 6. Ensuring that full-benefit dual eligible individuals are not 
              overcharged.
Sec. 7. Reimbursement of States for 2006 transition costs.
Sec. 8. Facilitation of identification and enrollment through 
              pharmacies of full-benefit dual eligible individuals in 
              the Medicare part D drug program.
Sec. 9. State health insurance program assistance regarding the new 
              Medicare prescription drug benefit.
Sec. 10. Additional Medicare part D informational resources.
Sec. 11. GAO study and report on the imposition of co-payments under 
              part D for full-benefit dual eligible individuals 
              residing in a long-term care facility.
Sec. 12. State coverage of non-formulary prescription drugs for full-
              benefit dual eligible individuals during 2006.
Sec. 13. Protection for full-benefit dual eligible individuals from 
              plan termination prior to receiving functioning access in 
              a new part D plan.

     SEC. 2. TRANSITION REQUIREMENTS.

       (a) Requirement.--
       (1) In general.--Section 1860D-4(b) of the Social Security 
     Act (42 U.S.C. 1395w-104(b)) is amended by adding at the end 
     the following new paragraph:
       ``(4) Formulary transition.--The sponsor of a prescription 
     drug plan is required to provide at least a 30-day supply of 
     any drug that a new enrollee in the plan was taking prior to 
     enrolling in such plan. For individuals residing in a long-
     term care setting, the sponsor of a prescription drug plan is 
     required to provide at least a 90-day supply of any drug such 
     individual was taking prior to enrolling in such plan. A 
     formulary transition supply provided under this section shall 
     be made by the sponsor of a prescription drug plan without 
     imposing any prior authorization requirements or other access 
     restrictions for individuals stabilized on a course of 
     treatment and at the dosage previously prescribed by a 
     physician or recommended by a physician going forward.
       ``(5) Customer service.--The sponsor of a prescription drug 
     plan is required to provide--
       ``(A) accessible and trained customer service 
     representatives available for full business hours from coast 
     to coast to provide knowledgeable assistance to individuals 
     seeking help with Medicare Part D including, but not limited 
     to, beneficiaries, caseworkers, SHIP counselors, pharmacists, 
     doctors, and caregivers;
       ``(B) at least one dedicated phone line for pharmacists 
     with sufficient staff to reduce wait times for pharmacists 
     seeking Medicare Part D assistance to no more than 20 
     minutes; and
       ``(C) sufficient staff to reduce wait times for all 
     Medicare Part D-related calls to plan phone lines to no more 
     than 20 minutes.''.
       (2) Application.--The requirements under paragraphs (4) and 
     (5) of section 1860D-4(b) of the Social Security Act (42 
     U.S.C. 1395w-104(b)), as added by subsection (a), shall apply 
     to the plan serving as the national point of sale contractor 
     under part D of title XVIII of such Act.
       (b) Effective Date and Enforcement.--
       (1) Effective date.--The amendment made by subsection (a) 
     shall take effect on the date of enactment of this Act.
       (2) Enforcement.--The Secretary may impose a civil monetary 
     penalty in an amount not to exceed $15,000 for conduct that a 
     sponsor of a prescription drug plan or an organization 
     offering an MA-PD plan knows or should know is a violation of 
     the provisions of paragraph (4) or (5) of section 1860D-4(b) 
     of the Social Security Act (42 U.S.C. 1395w-104(b)), as added 
     by subsection (a). The provisions of section 1128A of the 
     Social Security Act (42 U.S.C. a-7a), other than subsections 
     (a) and (b) and the second sentence of subsection (f), shall 
     apply to a civil monetary penalty under the previous sentence 
     in the same manner as such provisions apply to a penalty or 
     proceeding under subsection (a) of such section 1128A(a).

     SEC. 3. FEDERAL FALLBACK FOR FULL-BENEFIT DUAL ELIGIBLE 
                   INDIVIDUALS FOR 2006.

       (a) In General.--
       (1) In general.--If a full-benefit dual eligible individual 
     (as defined in section 1935(c)(6) of the Social Security Act 
     (42 U.S.C. 1396u-5(c)(6))), or an individual who is presumed 
     to be such an individual pursuant to subsection (b), presents 
     a prescription for a covered part D drug (as defined in 
     section 1860D-2(e) of such Act (42 U.S.C. 1395w-102(e))) at a 
     pharmacy in 2006 and the pharmacy is unable to locate or 
     verify the individual's enrollment through a reasonable 
     effort, including the use of the pharmacy billing system or 
     by calling an official Medicare hotline, or to bill for the 
     prescription through the plan serving as the national point 
     of sale contractor, the pharmacy may provide a 30-day supply 
     of the drug to the individual.
       (2) Refill.--The pharmacy may provide an additional 30-day 
     supply of a drug if the pharmacy continues to be unable to 
     locate the individual's enrollment through such reasonable 
     efforts or to bill for the prescription through the plan 
     serving as the national point of sale contractor when a 
     prescription is presented on or after the date that a 
     prescription refill is appropriate, but in no case after 
     December 31, 2006.
       (3) Cost-sharing.--The cost-sharing for a prescription 
     filled pursuant to this subsection shall be cost-sharing 
     provided for under section 1860D-14(a) of the Social Security 
     Act (42 U.S.C. 1395w-114(a)).
       (b) Presumptive Eligibility.--An individual shall be 
     presumed to be a full-benefit dual eligible individual (as so 
     defined) if the individual presents at the pharmacy with--
       (1) a government issued picture identification card;
       (2) reliable evidence of Medicaid enrollment, such as a 
     Medicaid card, recent history of Medicaid billing in the 
     pharmacy patient profile, or a copy of a current Medicaid 
     award letter; and
       (3) reliable evidence of Medicare enrollment, such as a 
     Medicare identification card, a Medicare enrollment approval 
     letter, a Medicare Summary Notice, or confirmation from an 
     official Medicare hotline.
       (c) Payments to Pharmacists.--
       (1) In general.--The Secretary of Health and Human Services 
     shall reimburse pharmacists, to the extent that such 
     pharmacists are not otherwise reimbursed by States or plans, 
     for the costs incurred in complying with the requirements 
     under subsection (a), including acquisition costs, dispensing 
     costs, and other overhead costs. Such payments shall be made 
     in a timely manner from the Medicare Prescription Drug 
     Account under section 1860D-16 of the Social Security Act (42 
     U.S.C. 1395w-116) and shall be deemed to be payments from 
     such Account under subsection (b) of such section.
       (2) Retroactive application to beginning of 2006.--The 
     costs incurred by a pharmacy which may be reimbursed under 
     paragraph (1) shall include costs incurred during the period 
     beginning on January 1, 2006, and before the date of 
     enactment of this Act.
       (d) Recovery of Costs From Plans by Secretary Not 
     Pharmacies.--The Secretary of Health and Human Services shall 
     establish a process for recovering the costs described in 
     subsection (c)(1) from prescription drug plans (as defined in 
     section 1860D-1(a)(3)(C) of the Social Security Act (42 
     U.S.C. 1394w-101(a)(3)(C))) and MA-PD plans (as defined in 
     section 1860D-41(a)(14) of such Act (42 U.S.C. 1395w-
     151(a)(14))) if the Secretary determines that such plans 
     should have incurred such costs. Amounts recovered pursuant 
     to the preceding sentence shall be deposited in the Medicare 
     Prescription Drug Account described in subsection (c)(1).

     SEC. 4. IDENTIFYING FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS IN 
                   DATA RECORDS.

       (a) In General.--The Secretary of Health and Human Services 
     and a prescription drug plan or an MA-PD plan shall clearly 
     identify all full-benefit dual eligible individuals (as 
     defined in section 1935(c)(6) of the Social Security Act (42 
     U.S.C. 1396u-5(c)(6))) and reflect the low-income subsidy 
     status of such individual for each calender year (beginning 
     with 2006) in every data record file used to enroll or 
     adjudicate claims for such individuals.
       (b) Enrollment.--For each calendar year (beginning with 
     2006) and for each Medicaid beneficiary who is a full-benefit 
     dual eligible individual (as so defined), the Secretary of 
     Health and Human Services shall--
       (1) identify in the Medicare enrollment database that such 
     individual has dual eligible status that has been verified 
     with a State or the District of Columbia; and
       (2) ensure that such dual eligible status is reflected in 
     each data file necessary to ensure that such status is 
     transmitted to a prescription drug plan or an MA-PD plan when

[[Page S133]]

     the Secretary certifies the enrollment of such an individual 
     in a plan.
       (c) Definition of MA-PD Plan and Prescription Drug Plan.--
     For purposes of this section, the terms ``MA-PD plan'' and 
     ``prescription drug plan'' have the meaning given such terms 
     in sections 1860D-1(a)(3)(C) and 1860D-41(a)(14) of the 
     Social Security Act (42 U.S.C. 1395w-101(a)(3)(C); 1395w-
     151(a)(14)), respectively.

     SEC. 5. PROHIBITION ON CONDITIONING MEDICAID ELIGIBILITY FOR 
                   INDIVIDUALS ENROLLED IN CERTAIN CREDITABLE 
                   PRESCRIPTION DRUG COVERAGE ON ENROLLMENT IN THE 
                   MEDICARE PART D DRUG PROGRAM.

       (a) In General.--Section 1935 of the Social Security Act 
     (42 U.S.C. 1396v) is amended by adding at the end the 
     following:
       ``(f) Prohibition on Conditioning Eligibility for Medical 
     Assistance for Individuals Enrolled in Certain Creditable 
     Prescription Drug Coverage on Enrollment in Medicare 
     Prescription Drug Benefit.--
       ``(1) In general.--A State shall not condition eligibility 
     for medical assistance under the State plan for a part D 
     eligible individual (as defined in section 1860D-1(a)(3)(A)) 
     who is enrolled in creditable prescription drug coverage 
     described in any of subparagraphs (C) through (H) of section 
     1860D-13(b)(4) on the individual's enrollment in a 
     prescription drug plan under part D of title XVIII or an MA-
     PD plan under part C of such title.
       ``(2) Coordination of benefits with part d for other 
     individuals.--Nothing in this subsection shall be construed 
     as prohibiting a State from coordinating medical assistance 
     under the State plan with benefits under part D of title 
     XVIII for individuals not described in paragraph (1).''.
       (b) Nullification of State Plan Amendments, Redetermination 
     of Eligibility.--In the case of a State that, as of the date 
     of enactment of this Act, has an approved amendment to its 
     State plan under title XIX of the Social Security Act with a 
     provision that conflicts with section 1935(f) of such Act (as 
     added by subsection (a)), such provision is, as of such date 
     of enactment, null and void. The State shall redetermine any 
     applications for medical assistance that have been denied 
     solely on the basis of the application of such a State plan 
     amendment not later than 90 days after the date of enactment 
     of this Act.

     SEC. 6. ENSURING THAT FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS 
                   ARE NOT OVERCHARGED.

       (a) In General.--Section 1860D-14 of the Social Security 
     Act (42 U.S.C. 1395w-114) is amended--
       (1) by redesignating subsection (d) as subsection (e); and
       (2) by inserting after subsection (c) the following new 
     subsection:
       ``(d) Ensuring Full-Benefit Dual Eligible Individuals Are 
     Not Overcharged.--
       ``(1) In general.--The Secretary shall, as soon a possible 
     after the date of enactment of this subsection, establish 
     processes for the following:
       ``(A) Tracking inappropriate payments.--The Secretary shall 
     track full-benefit dual eligible individuals enrolled in a 
     prescription drug plan or an MA-PD plan to determine whether 
     such individuals were inappropriately subject under the plan 
     to a deductible or cost-sharing that is greater than is 
     required under section 1860D-14.
       ``(B) Reduction in payments to plans and refunds to 
     individuals.--If the Secretary determines under subparagraph 
     (A) that an individual was overcharged, the Secretary shall--
       ``(i) reduce payments to the sponsor of the prescription 
     drug plan under section 1860D-15 or to the organization 
     offering the MA-PD plan under section 1853 that 
     inappropriately charged the individual by an amount equal to 
     the inappropriate charges; and
       ``(ii) refund such amount to the individual within 60 days 
     of the determination that the individual was inappropriately 
     charged.

     If the Secretary does not provide for the refund under clause 
     (i) within the 60 days provided for under such clause, 
     interest at the rate established under section 6621(a)(1) of 
     the Internal Revenue Code of 1986 shall be payable from the 
     end of such 60-day period until the date of the refund.
       ``(2) Requirement.--The processes established under 
     paragraph (1) shall provide for the ability of an individual 
     to notify the Secretary if the individual believes that they 
     were inappropriately subject under the plan to a deductible 
     or cost-sharing that is greater than is required under 
     section 1860D-14.''.
       (b) Report to Congress.--Not later than January 1, 2007, 
     the Secretary of Health and Human Services shall submit a 
     report to Congress on the implementation of the processes 
     established under subsection (d) of section 1860D-14 of the 
     Social Security Act (42 U.S.C. 1395w-114), as added by 
     subsection (a).

     SEC. 7. REIMBURSEMENT OF STATES FOR 2006 TRANSITION COSTS.

       (a) Reimbursement.--
       (1) In general.--Notwithstanding section 1935(d) of the 
     Social Security Act (42 U.S.C. 1396u-5(d) or any other 
     provision of law, the Secretary of Health and Human Services 
     shall reimburse States for 100 percent of the costs incurred 
     by the State during 2006 for covered part D drugs (as defined 
     in section 1860D-2(e) of such Act (42 U.S.C. 1395w-102(e))) 
     for part D eligible individuals (as defined in section 1860D-
     1(a)(3)(A) of the Social Security Act (42 U.S.C. 1394w-
     101(a)(3)(A))) which the State reasonably expected would have 
     been covered under such part but were not because the 
     individual was unable to access on a timely basis 
     prescription drug benefits to which they were entitled under 
     such part. Such payments shall be made from the Medicare 
     Prescription Drug Account under section 1860D-16 of the 
     Social Security Act (42 U.S.C. 1395w-116) and shall be deemed 
     to be payments from such Account under subsection (b) of such 
     section.
       (2) Retroactive application to beginning of 2006.--The 
     costs incurred by a State which may be reimbursed under 
     paragraph (1) shall include costs incurred during the period 
     beginning on January 1, 2006, and before the date of 
     enactment of this Act.
       (b) Recovery of Costs From Plans by Secretary Not States.--
     The Secretary of Health and Human Services shall establish a 
     process for recovering the costs described in subsection 
     (a)(1) from prescription drug plans (as defined in section 
     1860D-1(a)(3)(C) of the Social Security Act (42 U.S.C. 1394w-
     101(a)(3)(C))) and MA-PD plans (as defined in section 1860D-
     41(a)(14) of such Act (42 U.S.C. 1395w-151(a)(14))) if the 
     Secretary determines that such plans should have incurred 
     such costs. Amounts recovered pursuant to the preceding 
     sentence shall be deposited in the Medicare Prescription Drug 
     Account described in subsection (a)(1).
       (c) State.--For purposes of this section, the term 
     ``State'' includes the District of Columbia.

     SEC. 8. FACILITATION OF IDENTIFICATION AND ENROLLMENT THROUGH 
                   PHARMACIES OF FULL-BENEFIT DUAL ELIGIBLE 
                   INDIVIDUALS IN THE MEDICARE PART D DRUG 
                   PROGRAM.

       (a) In General.--The Secretary of Health and Human Services 
     shall provide for outreach and education to every pharmacy 
     that has participated in the Medicaid program under title XIV 
     of the Social Security Act, particularly independent 
     pharmacies, on the following:
       (1) The needs of full-benefit dual eligible individuals and 
     the challenges of meeting those needs.
       (2) The processes for the transition from Medicaid 
     prescription drug coverage to coverage under such part D for 
     such individuals.
       (3) The processes established by the Secretary to 
     facilitate, at point of sale, identification of drug plan 
     assignment of such population or enrollment of previously 
     unidentified or new full-benefit dual eligible individuals 
     into Medicare part D prescription drug coverage, including 
     how pharmacies can use such processes to help ensure that 
     such population makes a successful transition to Medicare 
     part D without a lapse in prescription drug coverage.
       (b) Holding Pharmacies Harmless for Certain Costs.--
       (1) In general.--The Secretary of Health and Human Services 
     shall provide for such payments to pharmacies as may be 
     necessary to reimburse pharmacies fully for--
       (A) transaction fees associated with the point-of-sale 
     facilitated identification and enrollment processes referred 
     to in subsection (a)(3); and
       (B) costs associated with technology or software upgrades 
     necessary to make any identification and enrollment inquiries 
     as part of the processes under subsection (a)(3).
       (2) Time.--Payments under paragraph (1) shall be made with 
     respect to fees and costs incurred during the period 
     beginning on December 1, 2005, and ending on June 1, 2006.
       (3) Payments from account.--Payments under paragraph (1) 
     shall be made from the Medicare Prescription Drug Account 
     under section 1860D-16 of the Social Security Act (42 U.S.C. 
     1395w-116) and shall be deemed to be payments from such 
     Account under subsection (b) of such section.

     SEC. 9. STATE HEALTH INSURANCE PROGRAM ASSISTANCE REGARDING 
                   THE NEW MEDICARE PRESCRIPTION DRUG BENEFIT.

       During the period beginning on the date that is 7 days 
     after the date of enactment of this Act and ending on May 15, 
     2006 (or a later date if determined appropriate by the 
     Secretary of Health and Human Services), the Secretary shall 
     ensure that an employee of the Centers for Medicare & 
     Medicaid Services is stationed at each State health insurance 
     counseling program (receiving funding under section 4360 of 
     the Omnibus Budget Reconciliation Act of 1990) in order to--
       (1) assist Medicare beneficiaries and counselors under such 
     program in better understanding the Medicare prescription 
     drug benefit under part D of title XVIII of the Social 
     Security Act; and
       (2) act as a liaison to the Secretary and the Administrator 
     of the Centers for Medicare & Medicaid Services regarding 
     issues related to oversight and enforcement of provisions 
     under the Medicare prescription drug benefit.

     SEC. 10. ADDITIONAL MEDICARE PART D INFORMATIONAL RESOURCES.

       (a) 1-800-MEDICARE.--The Secretary of Health and Human 
     Services shall increase the number of trained employees 
     staffing the toll-free telephone number 1-800-MEDICARE in 
     order to ensure that the average wait time for a caller does 
     not exceed 20 minutes.
       (b) Pharmacy Hotline.--The Secretary of Health and Human 
     Services shall--
       (1) establish a toll-free telephone number that is 
     dedicated to providing information regarding the Medicare 
     prescription drug benefit under title XVIII of the Social 
     Security Act to pharmacists; and
       (2) staff such telephone number in order to ensure that the 
     average wait time for a caller does not exceed 20 minutes.
       (c) State Health Insurance Program Hotline.--The Secretary 
     of Health and Human Services shall--

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       (1) establish a toll-free telephone number that is 
     dedicated to providing information regarding the Medicare 
     prescription drug benefit under title XVIII of the Social 
     Security Act to counselors working in State health insurance 
     counseling programs (receiving funding under section 4360 of 
     the Omnibus Budget Reconciliation Act of 1990); and
       (2) staff such telephone number in order to ensure that the 
     average wait time for a caller does not exceed 20 minutes.

     SEC. 11. GAO STUDY AND REPORT ON THE IMPOSITION OF CO-
                   PAYMENTS UNDER PART D FOR FULL-BENEFIT DUAL 
                   ELIGIBLE INDIVIDUALS RESIDING IN A LONG-TERM 
                   CARE FACILITY.

       (a) Study.--The Comptroller General of the United States 
     shall conduct a study on how mental health patients who are 
     full-benefit dual eligible individuals (as defined in section 
     1935(c)(6) of the Social Security Act (42 U.S.C. 1396u-
     5(c)(6))) and who reside in long-term care facilities, 
     including licensed assisted living facilities, will be 
     affected by the imposition of co-payments for covered part D 
     drugs under part D of title XVIII of such Act. Such study 
     shall include a review of issues that relate to the potential 
     harm of displacement due to an inability to access needed 
     medications because of such co-payments.
       (b) Report.--Not later than 6 months after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall submit a report to Congress on the study 
     conducted under subsection (a) together with recommendations 
     for such legislation as the Comptroller General determines is 
     appropriate.

     SEC. 12. STATE COVERAGE OF NON-FORMULARY PRESCRIPTION DRUGS 
                   FOR FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS 
                   DURING 2006.

       (a) State Coverage of Non-Formulary Prescription Drugs for 
     Full-Benefit Dual Eligible Individuals During 2006.--For 
     prescriptions filled during 2006, notwithstanding section 
     1935(d) of the Social Security Act (42 U.S.C. 1396v(d)), a 
     State (as defined for purposes of title XIX of such Act) may 
     provide (and receive Federal financial participation for) 
     medical assistance under such title with respect to 
     prescription drugs provided to a full-benefit dual eligible 
     individual (as defined in section 1935(c)(6) of such Act (42 
     U.S.C. 1396v(c)(6)) that are not on the formulary of the 
     prescription drug plan under part D or the MA-PD plan under 
     part C of title XVIII of such Act in which such individual is 
     enrolled.
       (b) Application.--
       (1) Medicare as primary payer.--Nothing in subsection (a) 
     shall be construed as changing or affecting the primary payer 
     status of a prescription drug plan under part D or an MA-PD 
     plan under part C of title XVIII of the Social Security Act 
     with respect to prescription drugs furnished to any full-
     benefit dual eligible individual (as defined in section 
     1935(c)(6) of such Act (42 U.S.C. 1396v(c)(6)) during 2006.
       (2) Third party liability.--Nothing in subsection (a) shall 
     be construed as limiting the authority or responsibility of a 
     State under section 1902(a)(25) of the Social Security Act 
     (42 U.S.C. 1396a(a)(25)) to seek reimbursement from a 
     prescription drug plan, an MA-PD plan, or any other third 
     party, of the costs incurred by the State in providing 
     prescription drug coverage during 2006.

     SEC. 13. PROTECTION FOR FULL-BENEFIT DUAL ELIGIBLE 
                   INDIVIDUALS FROM PLAN TERMINATION PRIOR TO 
                   RECEIVING FUNCTIONING ACCESS IN A NEW PART D 
                   PLAN.

       (a) In General.--Notwithstanding any other provision of 
     law, the Secretary of Health and Human Services shall not 
     terminate coverage of a full-benefit dual eligible individual 
     (as defined in section 1935(c)(6) of the Social Security Act 
     (42 U.S.C. 1396v(c)(6)) unless such individual has 
     functioning access to a prescription drug plan under part D 
     or an MA-PD plan under part C of title XVIII of such Act. 
     Such access shall include entry of the individual into the 
     computer system of such plan and an acknowledgment by the 
     plan that the individual is eligible for a full premium 
     subsidy under section 1860D-14 of such Act (42 U.S.C. 1395w-
     114).
       (b) Effective Date.--This section shall take effect on the 
     date of enactment of this Act.

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