[Congressional Record Volume 153, Number 1 (Thursday, January 4, 2007)]
[Senate]
[Pages S134-S135]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CARDIN:
  S. 137. A bill to amend title XVIII of the Social Security Act to 
provide additional beneficiary protections; to the Committee on 
Finance.
  Mr. CARDIN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 137

       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 ``Preserving 
     Medicare for All Act of 2007''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Negotiation of prices for medicare prescription drugs.
Sec. 3. Guaranteed prescription drug benefits.
Sec. 4. Full reimbursement for qualified retiree prescription drug 
              plans.
Sec. 5. Repeal of comparative cost adjustment (cca) program.
Sec. 6. Repeal of MA Regional Plan Stabilization Fund.
Sec. 7. Repeal of cost containment provisions.
Sec. 8. Removal of exclusion of benzodiazepines from required coverage 
              under the Medicare prescription drug program.

     SEC. 2. NEGOTIATION OF PRICES FOR MEDICARE PRESCRIPTION 
                   DRUGS.

       Section 1860D-11 of the Social Security Act (42 U.S.C. 
     1395w-111) is amended by striking subsection (i) (relating to 
     noninterference) and inserting the following:
       ``(i) Negotiation; No National Formulary or Price 
     Structure.--
       ``(1) Negotiation of prices with manufacturers.--In order 
     to ensure that beneficiaries enrolled under prescription drug 
     plans and MA-PD plans pay the lowest possible price, the 
     Secretary shall have and exercise authority similar to that 
     of other Federal entities that purchase prescription drugs in 
     bulk to negotiate contracts with manufacturers of covered 
     part D drugs, consistent with the requirements and in 
     furtherance of the goals of providing quality care and 
     containing costs under this part.
       ``(2) No national formulary or price structure.--In order 
     to promote competition under this part and in carrying out 
     this part, the Secretary may not require a particular 
     formulary or institute a price structure for the 
     reimbursement of covered part D drugs.''.

     SEC. 3. GUARANTEED PRESCRIPTION DRUG BENEFITS.

       (a) In General.--Section 1860D-3 of the Social Security Act 
     (42 U.S.C. 1395w-103) is amended to read as follows:


               ``ASSURING ACCESS TO A CHOICE OF COVERAGE

       ``Sec. 1860D-3.  (a) Access to a Choice of Qualified 
     Prescription Drug Coverage.--
       ``(1) Choice of at least three plans in each area.--
     Beginning on January 1, 2008, the Secretary shall ensure that 
     each part D eligible individual has available, consistent 
     with paragraph (2), a choice of enrollment in--
       ``(A) a nationwide prescription drug plan offered by the 
     Secretary in accordance with subsection (b); and
       ``(B) at least 2 qualifying plans (as defined in paragraph 
     (3)) in the area in which the individual resides, at least 
     one of which is a prescription drug plan.

[[Page S135]]

       ``(2) Requirement for different plan sponsors.--The 
     requirement in paragraph (1)(B) is not satisfied with respect 
     to an area if only one entity offers all the qualifying plans 
     in the area.
       ``(3) Qualifying plan defined.--For purposes of this 
     section, the term `qualifying plan' means--
       ``(A) a prescription drug plan;
       ``(B) an MA-PD plan described in section 1851(a)(2)(A)(i) 
     that provides--
       ``(i) basic prescription drug coverage; or
       ``(ii) qualified prescription drug coverage that provides 
     supplemental prescription drug coverage so long as there is 
     no MA monthly supplemental beneficiary premium applied under 
     the plan, due to the application of a credit against such 
     premium of a rebate under section 1854(b)(1)(C); or
       ``(C) a nationwide prescription drug plan offered by the 
     Secretary in accordance with subsection (b).
       ``(b) HHS as PDP Sponsor for a Nationwide Prescription Drug 
     Plan.--
       ``(1) In general.--The Secretary, acting through the 
     Administrator of the Centers for Medicare & Medicaid 
     Services, shall take such steps as may be necessary to 
     qualify and serve as a PDP sponsor and to offer a 
     prescription drug plan that offers basic prescription drug 
     coverage throughout the United States. Such a plan shall be 
     in addition to, and not in lieu of, other prescription drug 
     plans offered under this part.
       ``(2) Premium; solvency; authorities.--In carrying out 
     paragraph (1), the Secretary--
       ``(A) shall establish a premium in the amount of $35 for 
     months in 2008 and, for months in subsequent years, in the 
     amount specified in this paragraph for months in the previous 
     year increased by the annual percentage increase described in 
     section 1860D-2(b)(6) (relating to growth in medicare 
     prescription drug costs per beneficiary) for the year 
     involved;
       ``(B) is deemed to have met any applicable solvency and 
     capital adequacy standards; and
       ``(C) shall exercise such authorities (including the use of 
     regional or other pharmaceutical benefit managers) as the 
     Secretary determines necessary to offer the prescription drug 
     plan in the same or a comparable manner as is the case for 
     prescription drug plans offered by private PDP sponsors.
       ``(c) Flexibility in Risk Assumed.--In order to ensure 
     access pursuant to subsection (a) in an area the Secretary 
     may approve limited risk plans under section 1860D-11(f) for 
     the area.''.
       (b) Conforming Amendment.--Section 1860D-11(g) of the 
     Social Security Act (42 U.S.C. 1395w-111(g)) is amended by 
     adding at the end the following new paragraph:
       ``(8) Application.--This subsection shall not apply on or 
     after January 1, 2008.''.

     SEC. 4. FULL REIMBURSEMENT FOR QUALIFIED RETIREE PRESCRIPTION 
                   DRUG PLANS.

       (a) Elimination of True Out-of-Pocket Limitation.--Section 
     1860D-2(b)(4)(C)(ii) of the Social Security Act (42 U.S.C. 
     1395w-102(b)(4)(C)(ii) is amended--
       (1) by inserting ``under a qualified retiree prescription 
     drug plan (as defined in section 1860D-22(a)(2)),'' after 
     ``under section 1860D-14,''; and
       (2) by inserting ``, under such a qualified retiree 
     prescription drug plan,'' after ``(other than under such 
     section''.
       (b) Equalization of Subsidies.--Notwithstanding any other 
     provision of law, the Secretary of Health and Human Services 
     shall provide for such increase in the special subsidy 
     payment amounts under section 1860D-22(a)(3) of the Social 
     Security Act (42 U.S.C. 1395w-132(a)(3)) as may be 
     appropriate to provide for payments in the aggregate 
     equivalent to the payments that would have been made under 
     section 1860D-15 of such Act (42 U.S.C. 1395w-115) if the 
     individuals were not enrolled in a qualified retiree 
     prescription drug plan. In making such computation, the 
     Secretary shall not take into account the application of the 
     amendments made by section 1202 of the Medicare Prescription 
     Drug, Improvement, and Modernization Act of 2003 (Public Law 
     108-173; 117 Stat. 2480).
       (c) Effective Date.--This section, and the amendments made 
     by this section, shall take effect on January 1, 2008.

     SEC. 5. REPEAL OF COMPARATIVE COST ADJUSTMENT (CCA) PROGRAM.

       Subtitle E of title II of the Medicare Prescription Drug, 
     Improvement, and Modernization Act of 2003 (Public Law 108-
     173; 117 Stat. 2214), and the amendments made by such 
     subtitle, are repealed.

     SEC. 6. REPEAL OF MA REGIONAL PLAN STABILIZATION FUND.

       (a) In General.--Subsection (e) of section 1858 of the 
     Social Security Act (42 U.S.C. 1395w-27a) is repealed.
       (b) Conforming Amendment.--Section 1858(f)(1) of the Social 
     Security Act (42 U.S.C. 1395w-27a(f)(1)) is amended by 
     striking ``subject to subsection (e),''.

     SEC. 7. REPEAL OF COST CONTAINMENT PROVISIONS.

       Subtitle A of title VIII of the Medicare Prescription Drug, 
     Improvement, and Modernization Act of 2003 (Public Law 108-
     173; 117 Stat. 2357) is repealed and any provisions of law 
     amended by such subtitle are restored as if such subtitle had 
     not been enacted.

     SEC. 8. REMOVAL OF EXCLUSION OF BENZODIAZEPINES FROM REQUIRED 
                   COVERAGE UNDER THE MEDICARE PRESCRIPTION DRUG 
                   PROGRAM.

       (a) Removal of Exclusion.--
       (1) In general.--Section 1860D-2(e)(2) of the Social 
     Security Act (42 U.S.C. 1395w-102(e)(2)) is amended--
       (A) by striking ``subparagraph (E)'' and inserting 
     ``subparagraphs (E) and (J)''; and
       (B) by inserting ``and benzodiazepines'' after ``smoking 
     cessation agents''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall apply to prescriptions dispensed on or after January 1, 
     2008.
       (b) Review of Benzodiazepine Prescription Policies to 
     Assure Appropriateness and to Avoid Abuse.--The Secretary of 
     Health and Human Services shall review the policies of 
     Medicare prescription drug plans (and MA-PD plans) under 
     parts C and D of title XVIII of the Social Security Act 
     regarding the filling of prescriptions for benzodiazepine to 
     ensure that these policies are consistent with accepted 
     clinical guidelines, are appropriate to individual health 
     histories, and are designed to minimize long term use, guard 
     against over-prescribing, and prevent patient abuse.
       (c) Development by Medicare Quality Improvement 
     Organizations of Educational Guidelines for Physicians 
     Regarding Prescribing of Benzodiazepines.--The Secretary of 
     Health and Human Services shall provide, in contracts entered 
     into with Medicare quality improvement organizations under 
     part B of title XI of the Social Security Act, for the 
     development by such organizations of appropriate educational 
     guidelines for physicians regarding the prescribing of 
     benzodiazepines.
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