[Congressional Record Volume 155, Number 41 (Monday, March 9, 2009)]
[Senate]
[Pages S2911-S2913]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. REID:
  S. 546. A bill to amend title 10, United States Code, to permit 
certain retired members of the uniformed services who have a service-
connected disability to receive both disability compensation from the 
Department of Veterans Affairs for their disability and either retired 
pay by reason of their years of military service or Combat-Related 
Special Compensation; to the Committee on Armed Services.
  Mr. REID. Mr. President, I take a great deal of pride in the work 
done by the 110th Congress to fulfill our Government's obligations to 
our Nation's veterans. Our legislative accomplishments in those 2 years 
were significant.
  We significantly increased funding for the Department of Veterans 
Affairs; we enacted a comprehensive program that provides tuition and 
benefits to every veteran who serves after 9/11; we refused to allow 
our wounded warriors to fall through the cracks, remedying the 
substandard care that many were receiving, and broadening eligibility 
for treatment programs to address the war's physical and psychological 
toll; we brought attention and funding to veterans' mental health 
issues, improving the level of care and access to treatment for both 
veterans and their family members; and we added provisions to the 
Housing and Economic Recovery Act to help protect our veterans from 
becoming victims of the housing crisis.
  Indeed, we can be proud of these accomplishments, but I rise today to 
bring to light one area in which Congress can and must do more. For 
eight years I have been working to eliminate an unconscionable policy 
under which a veteran who is classified as `disabled' by the Veterans 
Administration is required, in essence, to pay his or her own 
disability compensation out of retirement pay received from the 
Department of Defense.
  As it stands now, a disabled veteran is, by law, prevented from 
collecting both disability pay and retired pay. Despite the fact that a 
veteran is eligible for each for a different reason, the law prohibits 
receiving both. The end result of this prohibition known as 
``Concurrent Receipt'' is that for every dollar a veteran receives as 
disability compensation, a dollar is deducted from his or her 
retirement pay. In some cases, this ban takes away a veteran's full 
retirement pay, wiping away the benefits he or she earned in 20 or more 
years of service.
  Since 2000, I have been working to end this absurd policy. In 2003, 
Congress passed the first legislation in this vein, which allowed 
veterans with at least a 50 percent disability rating to become 
eligible for concurrent receipt of benefits over a 10-year phase-in 
period. The following year we successfully eliminated the ten year 
phase-in for those veterans with a 100 percent disability rating. In 
2005, we passed legislation that permitted the concurrent receipt of 
retired and disability compensation to veterans who have been 
classified by the VA as ``unemployable,'' however this group of 
veterans has had to wait until this year to receive the benefit of this 
legislation. Our Nation's veterans should have to wait no longer.
  It is past time to eliminate the remaining bar to concurrent receipt 
of disability compensation and military retirement pay. I am proud to 
introduce the Retired Pay Restoration Act of 2009.
  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. 546

       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 ``Retired Pay Restoration Act 
     of 2009''.

     SEC. 2. ELIGIBILITY FOR PAYMENT OF BOTH RETIRED PAY AND 
                   VETERANS' DISABILITY COMPENSATION FOR CERTAIN 
                   MILITARY RETIREES WITH COMPENSABLE SERVICE-
                   CONNECTED DISABILITIES.

       (a) Extension of Concurrent Receipt Authority to Retirees 
     With Service-Connected Disabilities Rated Less Than 50 
     Percent.--
       (1) Repeal of 50 percent requirement.--Section 1414 of 
     title 10, United States Code, is amended by striking 
     paragraph (2) of subsection (a).
       (2) Computation.--Paragraph (1) of subsection (c) of such 
     section is amended by adding at the end the following new 
     subparagraph:
       ``(G) For a month for which the retiree receives veterans' 
     disability compensation for a disability rated as 40 percent 
     or less or has a service-connected disability rated as zero 
     percent, $0.''.
       (b) Clerical Amendments.--
       (1) The heading of section 1414 of such title is amended to 
     read as follows:

     ``Sec. 1414. Members eligible for retired pay who are also 
       eligible for veterans' disability compensation: concurrent 
       payment of retired pay and disability compensation''.

       (2) The item relating to such section in the table of 
     sections at the beginning of chapter 71 of such title is 
     amended to read as follows:

``1414. Members eligible for retired pay who are also eligible for 
              veterans' disability compensation: concurrent payment of 
              retired pay and disability compensation.''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on January 1, 2009, and shall apply to 
     payments for months beginning on or after that date.

     SEC. 3. COORDINATION OF SERVICE ELIGIBILITY FOR COMBAT-
                   RELATED SPECIAL COMPENSATION AND CONCURRENT 
                   RECEIPT.

       (a) Amendments To Standardize Similar Provisions.--
       (1) Qualified retirees.--Subsection (a) of section 1414 of 
     title 10, United States Code, as amended by section 2(a), is 
     amended--
       (A) by striking ``a member or'' and all that follows 
     through ``retiree')'' and inserting ``a qualified retiree''; 
     and
       (B) by adding at the end the following new paragraph:
       ``(2) Qualified retirees.--For purposes of this section, a 
     qualified retiree, with respect to any month, is a member or 
     former member of the uniformed services who--
       ``(A) is entitled to retired pay (other by reason of 
     section 12731b of this title); and
       ``(B) is also entitled for that month to veterans' 
     disability compensation.''.
       (2) Disability retirees.--Paragraph (2) of subsection (b) 
     of section 1414 of such title is amended to read as follows:
       ``(2) Special rule for retirees with fewer than 20 years of 
     service.--The retired pay of a qualified retiree who is 
     retired under chapter 61 of this title with fewer than 20 
     years of creditable service is subject to reduction by the 
     lesser of--
       ``(A) the amount of the reduction under sections 5304 and 
     5305 of title 38; or
       ``(B) the amount (if any) by which the amount of the 
     member's retired pay under such chapter exceeds the amount 
     equal to 2\1/2\ percent of the member's years of creditable 
     service multiplied by the member's retired pay base under 
     section 1406(b)(1) or 1407 of this title, whichever is 
     applicable to the member.''.
       (b) Effective Date.--The amendments made by this section 
     shall take effect on January 1, 2009, and shall apply to 
     payments for months beginning on or after that date.
                                 ______
                                 
      By Mr. BINGAMAN (for himself, Mr. Casey, Ms. Stabenow, and Mr. 
        Whitehouse):
  S. 547. A bill to amend title XIX of the Social Security Act to 
reduce the costs of prescription drugs for enrollees of Medicaid 
managed care organizations by extending the discounts offered under 
fee-for-service Medicaid to such organizations; to the Commmittee on 
Finance.
  Mr. BINGAMAN. Mr. President, I am introducing legislation today with 
Senators Casey, Stabenow, and Whitehouse entitled the Drug Rebate 
Equalization Act of 2009.
  The Medicaid drug rebate ensures that State Medicaid programs receive

[[Page S2912]]

the best price for prescription drugs for their beneficiaries. 
Unfortunately, health plans that serve over 10 million Medicaid 
beneficiaries cannot access the same discounts through the federal drug 
rebate program. Plans typically get no rebate on generic drugs and 
about a third of the rebate on branded drugs that states receive. 
States are paying more for the acquisition of prescription drugs for 
these health plan enrollees than for beneficiaries in fee-for-service 
Medicaid, thereby raising costs for Federal and State governments. In 
fact, the December 2008 Congressional Budget Office Health Options 
report found that equalizing the drug rebate between Medicaid fee-for-
service and managed care would save Federal taxpayers $11 billion over 
10 years.
  Even with this price disadvantage, the total cost of prescription 
drugs for health plans is less on a per member per month basis because 
of health plans' greater use of generics and case management. 
Unfortunately, many States are considering, or have already begun, 
carving out prescription drugs from health plans for the sole purpose 
of obtaining savings under the rebate--this undermines the plans' 
ability to maintain a comprehensive care and disease management program 
that includes prescription drugs. Not only will this legislation save 
money, it will eliminate this incentive and ensure that health plans 
can maintain a comprehensive care coordination system for their 
patients.
  This present drug rebate policy was passed by the Senate in 2005 as 
part of the Deficit Reduction Act. This year's version of the bill 
improves on last year's bill in several important ways. First, it 
requires States--not health plans--to collect the rebate. To protect 
plans against inappropriate cuts in payment, it requires states to 
publicly disclose information about savings obtained under the 
legislation. Second, the bill will reiterate that nothing in the 
legislation prevents a State from maintaining oversight control of its 
contracts with the health plans. Finally, the bill maintains the fee-
for-service prohibition against health plans ``double dipping'' into 
the Medicaid drug rebate and the 340b discount drug pricing program. 
These changes significantly improve the bill and will help improve its 
chances of passage.
  Extending the Medicaid drug rebate to enrollees in health plans is 
supported widely and includes the National Governors Association, the 
National Association of State Medicaid Directors, the National Medicaid 
Commission, the National Association of Community Health Centers, the 
Partnership for Medicaid, the Association for Community Affiliated 
Plans, and the Medicaid Health Plans of America. Last week, President 
Obama highlighted changes in Medicaid prescription drug rebates in his 
fiscal year 2010 budget to help pay for an expansion of health coverage 
for more Americans. I welcome President Obama's support and look 
forward to working with him to make this policy a reality.
  This legislation modernizes the Medicaid program, protects the 
ability of health plans to effectively coordinate prescription drugs as 
part of their care coordination systems, and will save Federal 
taxpayers $11 billion over 10 years.
  I urge my colleagues to join me in supporting this legislation.
  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. 547

       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 ``Drug Rebate Equalization Act 
     of 2009''.

     SEC. 2. EXTENSION OF PRESCRIPTION DRUG DISCOUNTS TO ENROLLEES 
                   OF MEDICAID MANAGED CARE ORGANIZATIONS.

       (a) In General.--Section 1903(m)(2)(A) (42 U.S.C. 
     1396b(m)(2)(A)) is amended--
       (1) in clause (xi), by striking ``and'' at the end;
       (2) in clause (xii), by striking the period at the end and 
     inserting ``; and''; and
       (3) by adding at the end the following:
       ``(xiii) such contract provides that (I) payment for 
     covered outpatient drugs dispensed to individuals eligible 
     for medical assistance who are enrolled with the entity shall 
     be subject to the same rebate required by the agreement 
     entered into under section 1927 as the State is subject to, 
     and (II) capitation rates paid to the entity shall be based 
     on actual cost experience related to rebates and subject to 
     the Federal regulations requiring actuarially sound rates.''.
       (b) Conforming Amendments.--Section 1927 (42 U.S.C. 1396r-
     8) is amended--
       (1) in subsection (d)--
       (A) in paragraph (1), by adding at the end the following:
       ``(C) Notwithstanding the subparagraphs (A) and (B)--
       ``(i) a Medicaid managed care organization with a contract 
     under section 1903(m) may exclude or otherwise restrict 
     coverage of a covered outpatient drug on the basis of 
     policies or practices of the organization, such as those 
     affecting utilization management, formulary adherence, and 
     cost sharing or dispute resolution, in lieu of any State 
     policies or practices relating to the exclusion or 
     restriction of coverage of such drugs, provided, however, 
     that any such exclusions and restrictions of coverage shall 
     be subject to any contractual requirements and oversight by 
     the State as contained in the Medicaid managed care 
     organization's contract with the State, and the State shall 
     maintain approval authority over the formulary used by the 
     Medicaid managed care organization; and
       ``(ii) nothing in this section or paragraph (2)(A)(xiii) of 
     section 1903(m) shall be construed as requiring a Medicaid 
     managed care organization with a contract under such section 
     to maintain the same such policies and practices as those 
     established by the State for purposes of individuals who 
     receive medical assistance for covered outpatient drugs on a 
     fee-for service basis.''; and
       (B) in paragraph (4), by inserting after subparagraph (E) 
     the following:
       ``(F) Notwithstanding the preceding subparagraphs of this 
     paragraph, any formulary established by Medicaid managed care 
     organization with a contract under section 1903(m) may be 
     based on positive inclusion of drugs selected by a formulary 
     committee consisting of physicians, pharmacists, and other 
     individuals with appropriate clinical experience as long as 
     drugs excluded from the formulary are available through prior 
     authorization, as described in paragraph (5).''; and
       (2) in subsection (j), by striking paragraph (1) and 
     inserting the following:
       ``(1) Covered outpatients drugs are not subject to the 
     requirements of this section if such drugs are--
       ``(A) dispensed by health maintenance organizations, 
     including Medicaid managed care organizations that contract 
     under section 1903(m); and
       ``(B) subject to discounts under section 340B of the Public 
     Health Service Act.''.
       (c) Reports.--Each State with a contract with a Medicaid 
     managed care organization under section 1903(m) of the Social 
     Security Act (42 U.S.C. 1396b(m)) shall report to the 
     Secretary on a quarterly basis the total amount of rebates in 
     dollars and volume received from manufacturers (as defined in 
     section 1927(k)(5) of such Act (42 U.S.C. 1396r-8(k)(5)) for 
     drugs provided to individuals enrolled with such an 
     organization as a result of the amendments made by this 
     section for both brand-name and generic drugs. The Secretary 
     shall review the reports submitted by States under this 
     subsection and, after such review, make publically available 
     the aggregate data contained in such reports.
       (d) Effective Date.--This section and the amendments made 
     by this section take effect on the date of enactment of this 
     Act and apply to rebate agreements entered into or renewed 
     under section 1927 of the Social Security Act (42 U.S.C. 
     1396r-8) on or after such date.
                                 ______
                                 
      By Mr. BROWN (for himself and Mrs. Hutchison):
  S. 554. A bill to improve the safety of motorcoaches, and for other 
purposes; to the Committee on Commerce, Science, and Transportation.
  Mr. BROWN. Mr. President, last week was the two year anniversary of a 
horrific motorcoach crash involving the Bluffton University baseball 
team. Seven Ohioans--Tyler Williams, Cody Holp, Scott Harmon, Zack 
Arend, David Joseph Betts, and Jerome and Jean Niemeyer--lost their 
lives that day.
  As their bus rolled along Interstate-75 on March 2, 2007, the 
Bluffton players and coaches were hours away from beginning their 
spring break in Florida. But as the team slept in preparation for their 
season opener later in the week, their motorcoach crashed through a 
retaining wall and fell thirty feet to the highway below.
  Since then I have talked with family members of the players on the 
bus that day and other passenger safety advocates, and time and again 
the conversations came back to one thing: we need commonsense 
motorcoach safety measures that will protect both passengers and other 
motorists on the road.
  In the 110th Congress, Senator Hutchison and I introduced the 
Motorcoach Enhanced Safety Act to finally require basic safety devices 
like seat belts and stronger windows on motorcoaches.

[[Page S2913]]

  Bus trips should not turn into tragedies, and that is why today we 
are again introducing the Motorcoach Enhanced Safety Act of 2009. We 
need these new standards now to ensure the safety of every rider and 
driver on the road.
  In 2007, the American Bus Association reported that over 750 million 
passenger trips covering more than 60 billion miles were made by 
motorcoaches in the United States.
  More and more people are choosing buses for their transportation, and 
it seems every week you read about another serious motorcoach accident 
. . . the crash involving a minor-league hockey team from Albany, New 
York; the fatal motorcoach accidents in Texas; the tour bus crash in 
Arizona that killed 7 passengers. The number of serious accidents and 
tragic deaths will only grow if we do not take action.
  Our legislation directs the Secretary of the Department of 
Transportation to implement numerous safety regulations already 
recommended by the National Transportation Safety Board. Incredibly, 
many of these recommendations--including seatbelts, fire extinguishers, 
increased driver training, and stronger windows--have languished for 
years.
  Our bill places firm timelines on the development and implementation 
of these rules and does so in a manner consistent with the 
recommendations of the National Transportation Safety Board--the 
guardian of our Nation's travel safety.
  This includes safety belts and stronger seating systems to ensure 
occupants stay in their seats in a crash.
  Stronger and better glazing on windows to prevent passengers from 
being easily ejected out of the motorcoach, crush-resistant roofs that 
can better withstand rollovers, improved protection against fires by 
reducing flammability of the motorcoach interior, and better training 
for operators in the case of fire.
  John Betts' son David was a second baseman on the Bluffton baseball 
team and was on the bus when it crashed in Atlanta 2 years ago. Mr. 
Betts lost his son in that tragic accident, but has since been a 
tireless advocate for motorcoach safety reform.
  In testimony before the Senate Commerce Subcommittee on Surface 
Transportation and Merchant Marine Infrastructure, Safety, and 
Security, Mr. Betts said:

       Motorcoach transportation may be one of the safest modes 
     when you look at statistics of lives lost per miles traveled 
     compared to other modes of transportation. However, as family 
     members here today representing those who had a loved one die 
     in such a crash, our first response is that such statistics 
     are not comforting. As a father, am I to disregard David's 
     death as his being one of the unlucky few? As NTSB 
     recommendations languish here in the United States, Europe 
     and Australia have already required basic occupant safety 
     protection measures such as seat belts.

  Mr. Betts eloquent words challenge Congress to take action so that 
other Americans do not tragically, needlessly, lose their lives, and it 
is my hope that we will swiftly pass this long overdue bill.

                          ____________________