[Congressional Record (Bound Edition), Volume 149 (2003), Part 12]
[Senate]
[Pages 15640-15649]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           TEXT OF AMENDMENTS

  SA 951. Mr. ALEXANDER proposed an amendment to the bill S. 504, to 
establish academies for teachers and students of American history and 
civics and a national alliance of teachers of American history and 
civics, and for other purposes; as follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``American History and Civics 
     Education Act of 2003''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) American history and civics.--The term ``American 
     history and civics'' means the key events, key persons, key 
     ideas, and key documents that shaped the institutions and 
     democratic heritage of the United States of America.
       (2) Chairman.--The term ``Chairman'' means the Chairman of 
     the National Endowment for the Humanities.
       (3) Educational institution.--The term ``educational 
     institution''--
       (A) means--
       (i) an institution of higher education;
       (ii) an educational institution created by a legislative 
     act of a State for the express purpose of teaching American 
     history and civics to elementary school and secondary school 
     students; or
       (iii) a nonprofit educational institution, library, or 
     research center; and
       (B) includes a consortium of entities described in 
     subparagraph (A).
       (4) Institution of higher education.--The term 
     ``institution of higher education'' has the meaning given the 
     term in section 101(a) of the Higher Education Act of 1965 
     (20 U.S.C. 1001(a)).
       (5) Key documents.--The term ``key documents'' means the 
     documents that established or explained the foundational 
     principles of democracy in the United States, including the 
     United States Constitution and the amendments to the 
     Constitution (particularly the Bill of Rights), the 
     Declaration of Independence, the Federalist Papers, and the 
     Emancipation Proclamation.
       (6) Key events.--The term ``key events'' means the critical 
     turning points in the history of the United States (including 
     the encounter of Native Americans with European settlers, the 
     American Revolution, the Civil War, the world wars of the 
     twentieth century, the civil rights movement, and the major 
     court decisions, legislation, literature, and the arts) that 
     established democracy and extended its promise in American 
     life.
       (7) Key ideas.--The term ``key ideas'' means the ideas that 
     shaped the democratic institutions and heritage of the United 
     States, including the notions of liberty, equal opportunity, 
     individualism, laissez faire, the rule of law, federalism and 
     e pluribus unum, the free exercise of religion, the 
     separation of church and state, and a belief in progress.
       (8) Key persons.--The term ``key persons'' means the men 
     and women who led the United States as Founding Fathers, 
     Native American leaders, elected officials, scientists, 
     inventors, pioneers, advocates of equal rights, 
     entrepreneurs, and artists.
       (9) State.--The term ``State'' means each of the 50 States 
     and the District of Columbia.
       (10) Teachers of american history and civics.--The term 
     ``teachers of American history and civics'' means 
     kindergarten through grade 12 teachers who teach American 
     history, government, or civics, or who incorporate such 
     subjects into their teaching.

     SEC. 3. PRESIDENTIAL ACADEMIES FOR TEACHING OF AMERICAN 
                   HISTORY AND CIVICS.

       (a) Establishment.--From amounts appropriated under 
     subsection (j), the National Endowment for the Humanities 
     shall award grants, on a competitive basis, to educational 
     institutions to establish Presidential Academies for Teaching 
     of American History and Civics (in this section referred to 
     as ``Academies'') that shall offer workshops for teachers of 
     American history and civics--
       (1) to strengthen such teachers' knowledge of the subjects 
     of American history and civics; and
       (2) to learn how better to teach such subjects.
       (b) Application.--
       (1) In general.--An educational institution that desires to 
     receive a grant under this section shall submit an 
     application to the National Endowment for the Humanities

[[Page 15641]]

     at such time, in such manner, and containing such information 
     as the National Endowment for the Humanities may require.
       (2) Contents.--An application submitted under paragraph (1) 
     shall--
       (A) include the criteria that will be used to determine 
     which teachers will be selected to attend workshops offered 
     by the Academy;
       (B) identify the individual the educational institution 
     intends to appoint to be the primary scholar at the Academy;
       (C) include a description of the curriculum to be used at 
     workshops offered by the Academy; and
       (D) provide an assurance that the recruitment plan for 
     which teachers will be selected to attend workshops offered 
     by the Academy will include teachers from schools receiving 
     assistance under part A of title I of the Elementary and 
     Secondary Education Act of 1965 (20 U.S.C. 6311 et seq.), 
     particularly those schools with high concentrations of 
     students described in section 1124(c) of such Act.
       (c) Number of Grants.--The National Endowment for the 
     Humanities shall award not more than 12 grants to different 
     educational institutions under this section.
       (d) Distribution.--The Chairman shall encourage equitable 
     distribution of grants under this section among the 
     geographical regions of the United States.
       (e) Grant Terms.--Grants awarded under this section shall 
     be for a term of 2 years.
       (f) Use of Funds.--
       (1) Workshops.--
       (A) In general.--An educational institution that receives a 
     grant under this section shall establish an Academy that 
     shall offer a workshop during the summer, or during another 
     appropriate time, for teachers of American history and 
     civics--
       (i) to strengthen such teachers' knowledge of the subjects 
     of American history and civics; and
       (ii) to learn how better to teach such subjects.
       (B) Duration of workshop.--A workshop offered pursuant to 
     this section shall be approximately 2 weeks in duration.
       (2) Academy staff.--
       (A) Primary scholar.--Each Academy shall be headed by a 
     primary scholar identified in the application submitted under 
     subsection (b) who shall--
       (i) be accomplished in the field of American history and 
     civics; and
       (ii) design the curriculum for and lead the workshop.
       (B) Core teachers.--Each primary scholar shall appoint an 
     appropriate number of core teachers. At the direction of the 
     primary scholar, the core teachers shall teach and train the 
     workshop attendees.
       (3) Selection of teachers.--
       (A) In general.--
       (i) Number of teachers.--Each year, each Academy shall 
     select kindergarten through grade 12 teachers of American 
     history and civics to attend the workshop offered by the 
     Academy.
       (ii) Flexibility in number of teachers.--Each Academy shall 
     select not more than 300 and not less than 50 teachers under 
     clause (i).
       (B) Teachers from public and private schools.--An Academy 
     may select teachers from public schools and private schools 
     to attend the workshop offered by the Academy.
       (g) Costs.--
       (1) In general.--Except as provided in paragraph (2), a 
     teacher who attends a workshop offered pursuant to this 
     section shall not incur costs associated with attending the 
     workshop, including costs for meals, lodging, and materials 
     while attending the workshop, and may receive a stipend to 
     cover such costs.
       (2) Travel costs.--A teacher who attends a workshop offered 
     pursuant to this section shall use non-Federal funds to pay 
     for such teacher's costs of transit to and from the Academy.
       (h) Evaluation.--
       (1) In general.--At the completion of all of the workshops 
     assisted in the third year grants are awarded under this 
     section, the National Endowment for the Humanities shall 
     conduct an evaluation and submit a report on its findings to 
     the relevant committees of Congress.
       (2) Content of evaluation.--The evaluation conducted 
     pursuant to paragraph (1) shall--
       (A) determine the overall success of the grant program 
     authorized under this section; and
       (B) highlight the best grantees' practices in order to 
     become models for future grantees.
       (i) Non-Federal Funds.--An educational institution 
     receiving Federal assistance under this section may 
     contribute non-Federal funds toward the costs of operating 
     the Academy.
       (j) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $7,000,000 for 
     each of fiscal years 2004 through 2007.

     SEC. 4. CONGRESSIONAL ACADEMIES FOR STUDENTS OF AMERICAN 
                   HISTORY AND CIVICS.

       (a) Establishment.--From amounts appropriated under 
     subsection (j), the National Endowment for the Humanities 
     shall award grants, on a competitive basis, to educational 
     institutions to establish Congressional Academies for 
     Students of American History and Civics (in this section 
     referred to as ``Academies'') that shall offer workshops for 
     outstanding students of American history and civics to 
     broaden and deepen such students' understanding of American 
     history and civics.
       (b) Application.--
       (1) In general.--An educational institution that desires to 
     receive a grant under this section shall submit an 
     application to the National Endowment for the Humanities at 
     such time, in such manner, and containing such information as 
     the National Endowment for the Humanities may require.
       (2) Contents.--An application submitted under paragraph (1) 
     shall--
       (A) include the criteria that will be used to determine 
     which students will be selected to attend workshops offered 
     by the Academy;
       (B) identify the individual the educational institution 
     intends to appoint to be the primary scholar at the Academy;
       (C) include a description of the curriculum to be used at 
     workshops offered by the Academy; and
       (D) include a description of how the educational 
     institution will--
       (i) inform students from schools receiving assistance under 
     part A of title I of the Elementary and Secondary Education 
     Act of 1965 (20 U.S.C. 6311 et seq.), particularly those 
     schools with high concentrations of students described in 
     section 1124(c) of such Act, of the Academy; and
       (ii) provide such students with information on how to apply 
     to attend workshops offered by the Academy so that such 
     students may attend the workshops.
       (c) Number of Grants.--The National Endowment for the 
     Humanities shall award not more than 12 grants to different 
     educational institutions under this section.
       (d) Distribution.--The Chairman shall encourage equitable 
     distribution of grants under this section among the 
     geographical regions of the United States.
       (e) Grant Terms.--Grants awarded under this section shall 
     be for a term of 2 years.
       (f) Use of Funds.--
       (1) Workshops.--
       (A) In general.--An educational institution that receives a 
     grant under this section shall establish an Academy that 
     shall offer a workshop during the summer, or during another 
     appropriate time, for outstanding students of American 
     history, government, and civics to broaden and deepen such 
     students' understanding of American history and civics.
       (B) Duration of workshop.--A workshop offered pursuant to 
     this section shall be approximately 4 weeks in duration.
       (2) Academy staff.--
       (A) Primary scholar.--Each Academy shall be headed by a 
     primary scholar identified in the application submitted under 
     subsection (b) who shall--
       (i) be accomplished in the field of American history and 
     civics; and
       (ii) design the curriculum for and lead the workshop.
       (B) Core teachers.--Each primary scholar shall appoint an 
     appropriate number of core teachers. At the direction of the 
     primary scholar, the core teachers shall teach the workshop 
     attendees.
       (3) Selection of students.--
       (A) Number of students.--Each year, each Academy shall 
     select between 100 and 300 eligible students to attend the 
     workshop offered by the Academy.
       (B) Eligible students.--A student shall be eligible to 
     attend a workshop offered by an Academy if the student--
       (i) is recommended by the student's secondary school 
     principal (or other head of such student's academic program) 
     to attend the workshop; and
       (ii) will be a junior or senior in the academic year 
     following attendance at the workshop.
       (g) Costs.--
       (1) In general.--Except as provided in paragraph (2), a 
     student who attends a workshop offered pursuant to this 
     section shall not incur costs associated with attending the 
     workshop, including costs for meals, lodging, and materials 
     while attending the workshop.
       (2) Travel costs.--A student who attends a workshop offered 
     pursuant to this section shall use non-Federal funds to pay 
     for such student's costs of transit to and from the Academy.
       (h) Evaluation.--
       (1) In general.--At the completion of all of the workshops 
     assisted in the third year grants are awarded under this 
     section, the National Endowment for the Humanities shall 
     conduct an evaluation and submit a report on its findings to 
     the relevant committees of Congress.
       (2) Content of evaluation.--The evaluation conducted 
     pursuant to paragraph (1) shall--
       (A) determine the overall success of the grant program 
     authorized under this section; and
       (B) highlight the best grantees' practices in order to 
     become models for future grantees.
       (i) Non-Federal Funds.--An educational institution 
     receiving Federal assistance under this section may 
     contribute non-Federal funds toward the costs of operating 
     the Academy.

[[Page 15642]]

       (j) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $14,000,000 for 
     each of fiscal years 2004 through 2007.

     SEC. 5. NATIONAL ALLIANCE OF TEACHERS OF AMERICAN HISTORY AND 
                   CIVICS.

       (a) Establishment.--
       (1) In general.--From amounts appropriated under subsection 
     (e), the National Endowment for the Humanities shall award 1 
     or more grants to organizations for the creation of a 
     national alliance of elementary school and secondary school 
     teachers of American history and civics.
       (2) Purpose.--The purpose of the national alliance is--
       (A) to facilitate the sharing of ideas among teachers of 
     American history and civics; and
       (B) to encourage best practices in the teaching of American 
     history and civics.
       (b) Application.--An organization that desires to receive a 
     grant under this section shall submit an application to the 
     National Endowment for the Humanities at such time, in such 
     manner, and containing such information as the National 
     Endowment for the Humanities may require.
       (c) Grant Term.--A grant awarded under this section shall 
     be for a term of 2 years and may be reapplied after the 
     initial term expires.
       (d) Use of Funds.--An organization that receives a grant 
     under this section may use the grant funds for any of the 
     following:
       (1) Creation of a website on the Internet to facilitate 
     discussion of new ideas on improving American history and 
     civics education.
       (2) Creation of in-State chapters of the national alliance, 
     to which individual teachers of American history and civics 
     may belong, that sponsors American history and civics 
     activities for such teachers in the State.
       (3) Seminars, lectures, or other events focused on American 
     history and civics, which may be sponsored in cooperation 
     with, or through grants awarded to, libraries, States' 
     humanities councils, or other appropriate entities.
       (4) Coordinate activities with other nonprofit educational 
     alliances that promote the teaching or study of subjects 
     related to American history and civics.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, and for any 
     administrative costs associated with carrying out sections 3 
     and 4, $4,000,000 for each of fiscal years 2004 through 2007.
                                 ______
                                 
  SA 952. Mrs. CLINTON submitted an amendment intended to be proposed 
by her to the bill S. 1 to amend title XVIII of the Social Security Act 
to make improvements in the medicare program, to provide prescription 
drug coverage under the medicare program, and for other purposes; which 
was ordered to lie on the table; as follows:

       On page 76, line 20, strike ``The'' and insert ``Except to 
     the extent necessary to provide eligible beneficiaries 
     already enrolled in a Medicare Prescription Drug plan with 
     the choice of avoiding disruption by remaining enrolled in 
     that plan, the''.
                                 ______
                                 
  SA 953. Mrs. CLINTON submitted an amendment intended to be proposed 
by her to the bill S. 1, to amend title XVIII of the Social Security 
Act to make improvements in the medicare program, to provide 
prescription drug coverage under the medicare program, and for other 
purposes; which was ordered to lie on the table; as follows:

       On page 608, between lines 10 and 11, insert the following:

     SEC. __. TRAINING FOR LONG-TERM CARE OMBUDSMAN.

       (a) In General.--The Secretary of Health and Human 
     Services, acting through the Director of the Administration 
     on Aging and in consultation with the Director of the Agency 
     for Healthcare Research and Quality and the Administrator of 
     the Centers for Medicare & Medicaid Services, shall authorize 
     a program, to be developed and implemented by the National 
     Long-Term Care Ombudsman Resource Center, for the training of 
     long-term care ombudsmen in the use of quality of care 
     information.
       (b) Training.--Under the program developed under subsection 
     (a), training shall be provided to long-term care ombudsman 
     to enable such ombudsman to educate consumers concerning--
       (1) nursing home quality of care issues;
       (2) available nursing home quality of care reports, 
     including existing quality data that the Administrator of the 
     Centers for Medicare & Medicaid Services has released for use 
     by the public in choosing long-term care facilities; and
       (3) the manner in which an individual can successfully 
     integrate quality information into health care decision 
     making regarding nursing home decisions.
       (c) Duties of Resource Center.--The National Long-Term Care 
     Ombudsman Resource Center shall--
       (1) develop and maintain a curriculum for ombudsmen;
       (2) develop, produce, and maintain training materials;
       (3) conduct train-the-trainer programs at regional and 
     national levels; and
       (4) act as a clearinghouse for best practices in 
     communicating the significance of nursing home quality 
     indicators to residents and their caregivers.
       (d) Pilot Programs.--The Secretary of Health and Human 
     Services shall award grants for the establishment of 1-year 
     pilot demonstration programs in 10 States using long-term 
     care ombudsmen to educate consumers regarding home health 
     care quality. Such pilot demonstration programs shall test 
     the effectiveness of having a committed position within the 
     State dedicated to helping consumers use home health care 
     quality indicators.
       (e) Report.--Not later than 18 months after the date of 
     enactment of this Act, and annually thereafter, the Secretary 
     of Health and Human Services shall submit to Congress a 
     report concerning the effectiveness of the program 
     established under this section, including the benefits of 
     providing for dedicated staff who are responsible for 
     educating consumers to use home health quality indicators in 
     their health care decision-making.
       (f) Authorization.--In addition to any other amounts 
     authorized to be appropriate for long-term care ombudsman 
     programs, there are authorized to be appropriated to carry 
     out this section $4,000,000 for fiscal year 2004 (of which 
     $1,000,000 shall be used to carry out subsection (d)), and 
     $2,000,000 for each fiscal year thereafter.
                                 ______
                                 
  SA 954. Mrs. CLINTON submitted an amendment intended to be proposed 
by her to the bill S. 1, to amend title XVIII of the Social Security 
Act to make improvements in the medicare program, to provide 
prescription drug coverage under the medicare program, and for other 
purposes; which was ordered to lie on the table; as follows:

       On page 46, between lines 13 and 14, insert the following:
       ``(i) Health Literacy Standards.--
       ``(1) In general.--For purposes of assisting eligible 
     entities in providing quality assurance measures as described 
     in subsection (c)(1)(B), the Secretary, acting through the 
     Director of the Agency for Healthcare Research and Quality, 
     the Administrator of Health Resources and Services 
     Administration, the Director of the National Library of 
     Medicine, and the Commissioner of Food and Drugs, shall 
     develop standardized materials that pharmacists may use to 
     assist non-English speaking or functionally illiterate 
     patients in the safe and appropriate use of prescription 
     drugs. Such materials may include the use of pictures and the 
     development of standardized translations in multiple 
     languages of prescription labels and bottle labels and other 
     patient safety initiative information. Such materials shall 
     be available electronically for direct access by pharmacists.
       ``(2) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     such sums as may be necessary for each of fiscal years 2004 
     and 2005.
                                 ______
                                 
  SA 955. Mr. CORZINE submitted an amendment intended to be proposed by 
him to the bill S. 1, to amend title XVIII of the Social Security Act 
to make improvements in the medicare program, to provide prescription 
drug coverage under the medicare program, and for other purposes; which 
was ordered to lie on the table; as follows:

       At the end of subtitle A of title I, add the following:

     SEC. __. CONFORMING CHANGES REGARDING FEDERALLY QUALIFIED 
                   HEALTH CENTERS.

       (a) Permitting FQHCs to Fill Prescriptions.--Section 
     1861(aa)(3) (42 U.S.C. 1395x(aa)(3)) is amended--
       (1) in subparagraph (A), by striking ``and'' after the 
     comma at the end;
       (2) in subparagraph (B), by inserting ``and'' after the 
     comma at the end; and
       (3) by adding at the end the following new subparagraph:
       ``(C) drugs and biologicals for which payment may otherwise 
     be made under this title,''.
       (b) Elimination of Per Visit Limit.--Section 1833(a)(3) (42 
     U.S.C. 1395l(a)(3)) is amended by inserting ``, except that 
     such regulations may not limit the per visit payment amount 
     with regard to drugs and biologicals described in section 
     1861(aa)(3)(C) and purchased under section 340B of the Public 
     Health Service Act'' after ``the Secretary may prescribe in 
     regulations''.
                                 ______
                                 
  SA 956. Mr. GRAHAM of Florida proposed an amendment to the bill S. 1, 
to amend title XVIII of the Social Security Act to make improvements in 
the medicare program, to provide prescription drug coverage under the 
medicare program, and for other purposes; as follows:

       On page 107, between lines 19 and 20, insert the following:
       ``(d) Beneficiary Not Responsible for Paying Applicable 
     Percent of the Monthly National Average Premium While the 
     Beneficiary is in the Coverage Gap.--

[[Page 15643]]

       ``(1) In general.--Notwithstanding subsection (c), if an 
     individual, with respect to any period of a year, has reached 
     the initial coverage limit under paragraph (3) of section 
     1860D-6(c) for the year but has not reached the annual out-
     of-pocket limit under paragraph (4) of such section for the 
     year, the applicable percent under subsection (c) during such 
     period shall be zero.
       ``(2) Process.--The Administrator shall establish a process 
     for carrying out paragraph (1). Under such process, the 
     Administrator shall--
       ``(A) require eligible entities offering Medicare 
     Prescription Drug plans, MedicareAdvantage organizations 
     offering MedicareAdvantage plans that provide qualified 
     prescription drug coverage, and entities with a contract 
     under section 1860D-13(e) to furnish the Administrator with 
     such information as the Administrator determines necessary to 
     carry out paragraph (1); and
       ``(B) furnish the Commissioner of Social Security with such 
     information as the Administrator determines necessary to 
     collect the appropriate monthly beneficiary obligation 
     pursuant to section 1860D-18.

       At the end of subtitle C of title IV, insert the following:

     SEC. __. MEDICARE SECONDARY PAYOR (MSP) PROVISIONS.

       (a) Technical Amendment Concerning Secretary's Authority to 
     Make Conditional Payment When Certain Primary Plans Do Not 
     Pay Promptly.--
       (1) In general.--Section 1862(b)(2) (42 U.S.C. 1395y(b)(2)) 
     is amended--
       (A) in subparagraph (A)(ii), by striking ``promptly (as 
     determined in accordance with regulations)'';
       (B) in subparagraph (B)--
       (i) by redesignating clauses (i) through (iii) as clauses 
     (ii) through (iv), respectively; and
       (ii) by inserting before clause (ii), as so redesignated, 
     the following new clause:
       ``(i) Authority to make conditional payment.--The Secretary 
     may make payment under this title with respect to an item or 
     service if a primary plan described in subparagraph (A)(ii) 
     has not made or cannot reasonably be expected to make payment 
     with respect to such item or service promptly (as determined 
     in accordance with regulations). Any such payment by the 
     Secretary shall be conditioned on reimbursement to the 
     appropriate Trust Fund in accordance with the succeeding 
     provisions of this subsection.''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall be effective as if included in the enactment of title 
     III of the Medicare and Medicaid Budget Reconciliation 
     Amendments of 1984 (Public Law 98-369).
       (b) Clarifying Amendments to Conditional Payment 
     Provisions.--Section 1862(b)(2) (42 U.S.C. 1395y(b)(2)) is 
     further amended--
       (1) in subparagraph (A), in the matter following clause 
     (ii), by inserting the following sentence at the end: ``An 
     entity that engages in a business, trade, or profession shall 
     be deemed to have a self-insured plan if it carries its own 
     risk (whether by a failure to obtain insurance, or otherwise) 
     in whole or in part.'';
       (2) in subparagraph (B)(ii), as redesignated by subsection 
     (a)(2)(B)--
       (A) by striking the first sentence and inserting the 
     following: ``A primary plan, and an entity that receives 
     payment from a primary plan, shall reimburse the appropriate 
     Trust Fund for any payment made by the Secretary under this 
     title with respect to an item or service if it is 
     demonstrated that such primary plan has or had a 
     responsibility to make payment with respect to such item or 
     service. A primary plan's responsibility for such payment may 
     be demonstrated by a judgment, a payment conditioned upon the 
     recipient's compromise, waiver, or release (whether or not 
     there is a determination or admission of liability) of 
     payment for items or services included in a claim against the 
     primary plan or the primary plan's insured, or by other 
     means.''; and
       (B) in the final sentence, by striking ``on the date such 
     notice or other information is received'' and inserting ``on 
     the date notice of, or information related to, a primary 
     plan's responsibility for such payment or other information 
     is received''; and
       (3) in subparagraph (B)(iii), as redesignated by subsection 
     (a)(2)(B), by striking the first sentence and inserting the 
     following: ``In order to recover payment made under this 
     title for an item or service, the United States may bring an 
     action against any or all entities that are or were required 
     or responsible (directly, as an insurer or self-insurer, as a 
     third-party administrator, as an employer that sponsors or 
     contributes to a group health plan, or large group health 
     plan, or otherwise) to make payment with respect to the same 
     item or service (or any portion thereof) under a primary 
     plan. The United States may, in accordance with paragraph 
     (3)(A) collect double damages against any such entity. In 
     addition, the United States may recover under this clause 
     from any entity that has received payment from a primary plan 
     or from the proceeds of a primary plan's payment to any 
     entity.''.
       (c) Clerical Amendments.--Section 1862(b) (42 U.S.C. 
     1395y(b)) is amended--
       (1) in paragraph (1)(A), by moving the indentation of 
     clauses (ii) through (v) 2 ems to the left; and
       (2) in paragraph (3)(A), by striking ``such'' before 
     ``paragraphs''.
                                 ______
                                 
  SA 957. Mr. DAYTON submitted an amendment intended to be proposed by 
him to the bill S. 1, to amend title XVIII of the Social Security Act 
to make improvements in the medicare program, to provide prescription 
drug coverage under the medicare program, and for other purposes; which 
was ordered to lie on the table; as follows:

       At the appropriate place insert the following:

     SEC. __. LIMITATION ON PRESCRIPTION DRUG BENEFITS OF MEMBERS 
                   OF CONGRESS.

       (a) Limitation on Benefits.--Notwithstanding any other 
     provision of law, during calendar year 2004, the actuarial 
     value of the prescription drug benefit of any Member of 
     Congress enrolled in a health benefits plan under chapter 89 
     of title 5, United States Code, may not exceed the actuarial 
     value of any prescription drug benefit under title XVIII of 
     the Social Security Act passed by the 1st session of the 
     108th Congress and enacted in law.
       (b) Regulations.--The Office of Personnel Management shall 
     promulgate regulations to carry out this section.
                                 ______
                                 
  SA 958. Mr. KERRY proposed an amendment to the bill S. 1, to amend 
title XVIII of the Social Security Act to make improvements in the 
medicare program, to provide prescription drug coverage under the 
medicare program, and for other purposes; as follows:

       On page 204, after line 22, insert the following:

     SEC. __. ACCESS TO DISCOUNTED PRESCRIPTION DRUGS.

       (a) In General.--From amounts made available under 
     subsection (c), the Secretary of Health and Human Services 
     shall award grants to covered entities described in section 
     340B(a)(4) of the Public Health Service Act (42 U.S.C. 
     256b(a)(4)) to enable such entities to pay the start-up costs 
     associated with the establishment of pharmacies to provide 
     covered drugs under such section 340B.
       (b) Application.--To be eligible to receive a grant under 
     subsection (a), a covered entity shall prepare and submit to 
     the Secretary of Health and Human Services an application at 
     such time, in such manner, and containing such information as 
     the Secretary may require.
       (c) Funding.--The following sums are appropriated, out of 
     any money in the Treasury not otherwise appropriated to the 
     Prescription Drug Account established under section 1860DD-25 
     of the Social Security Act, $300,000,000 to carry out this 
     section. Amounts made available under this subsection shall 
     become available October 1, 2004, and shall remain available 
     until expended.
                                 ______
                                 
  SA 959. Mrs. LINCOLN submitted an amendment intended to be proposed 
by her to the bill S. 1, to amend title XVIII of the Social Security 
Act to make improvements in the medicare program, to provide 
prescription drug coverage under the medicare program, and for other 
purposes; as follows:

       At the end of subtitle B of title IV, add the following:

     SEC. __. MEDICARE DEMONSTRATION PROJECT FOR DIRECT ACCESS TO 
                   PHYSICAL THERAPY SERVICES.

       (a) In General.--The Secretary shall conduct a 
     demonstration project under this section (in this section 
     referred to as the ``project'') to demonstrate the impact of 
     allowing medicare fee-for-service beneficiaries direct access 
     to outpatient physical therapy services and physical therapy 
     services furnished as comprehensive rehabilitation facility 
     services on--
       (1) costs under the medicare program under title XVIII of 
     the Social Security Act; and
       (2) the satisfaction of beneficiaries receiving such 
     services.
       (b) Deadline for Establishment; Duration; Sites.--
       (1) Deadline.--The Secretary shall establish the project 
     not later than 1 year after the date of enactment of this 
     Act.
       (2) Duration; sites.-- The project shall--
       (A) be conducted for a period of 3 years;
       (B) include sites in at least 5 States; and
       (C) to the extent feasible, be conducted on a statewide 
     basis in each State included under subparagraph (B).
       (3) Early termination.--Notwithstanding paragraph (2)(A), 
     the Secretary may terminate the operation of the project at a 
     site before the end of the 3-year period specified in such 
     paragraph if the Secretary determines, based on actual data, 
     that the total amount expended for all services under this 
     title for individuals at such site for a 12-month period are 
     greater than the total amount that would have been expended 
     for such services for such individuals for such period but 
     for the operation of the project at such site.
       (c) Waiver of Medicare Requirements.--The Secretary shall 
     waive compliance with such requirements of the medicare 
     program

[[Page 15644]]

     under title XVIII of the Social Security Act to the extent 
     and for the period the Secretary finds necessary to conduct 
     the demonstration project.
       (d) Evaluations and Reports.--
       (1) Evaluations.--
       (A) In general.--The Secretary shall conduct interim and 
     final evaluations of the project.
       (B) Focus.--The evaluations conducted under paragraph (1) 
     shall--
       (i) focus on the impact of the project on program costs 
     under title XVIII of the Social Security Act and patient 
     satisfaction with health care items and services for which 
     payment is made under such title; and
       (ii) include comparisons, with respect to episodes of care 
     involving direct access to physical therapy services and 
     episodes of care involving a physician referral for such 
     services, of--

       (I) the average number of claims paid per episode for 
     outpatient physical therapy services and physical therapy 
     services furnished as comprehensive outpatient rehabilitation 
     facility services;
       (II) the average number of physician office visits per 
     episode; and
       (III) the average expenditures under such title per 
     episode.

       (2) Interim and final reports.--The Secretary shall submit 
     to the Committee on Finance of the Senate and the Committees 
     on Ways and Means and Energy and Commerce of the House of 
     Representatives reports on the evaluations conducted under 
     paragraph (1) by--
       (A) in the case of the report on the interim evaluation, 
     not later than the end of the second year the project has 
     been in operation; and
       (B) in the case of the report on the final evaluation, not 
     later than 180 days after the closing date of the project.
       (3) Funding for evaluation.--There are authorized to be 
     appropriated such sums as may be necessary to provide for the 
     evaluations and reports required by this subsection.
       (e) Definitions.--In this section:
       (1) Comprehensive outpatient rehabilitation services.--
     Subject to paragraph (2), the term ``comprehensive outpatient 
     rehabilitation services'' has the meaning given to such term 
     in section 1861(cc) of the Social Security Act (42 U.S.C. 
     1395x(cc)).
       (2) Direct access.--The term ``direct access'' means, with 
     respect to outpatient physical therapy services and physical 
     therapy services furnished as comprehensive outpatient 
     rehabilitation facility services, coverage of and payment for 
     such services in accordance with the provisions of title 
     XVIII of the Social Security Act, except that sections 
     1835(a)(2), 1861(p), and 1861(cc) of such Act (42 U.S.C. 
     1395n(a)(2), 1395x(p), and 1395x(cc), respectively) shall be 
     applied--
       (A) without regard to any requirement that--
       (i) an individual be under the care of (or referred by) a 
     physician; or
       (ii) services be provided under the supervision of a 
     physician; and
       (B) by allowing a physician or a qualified physical 
     therapist to satisfy any requirement for--
       (i) certification and recertification; and
       (ii) establishment and periodic review of a plan of care.
       (3) Fee-for-service medicare beneficiary.--The term ``fee-
     for-service medicare beneficiary'' means an individual who--
       (A) is enrolled under part B of title XVIII of the Social 
     Security Act (42 U.S.C. 1395j et seq.); and
       (B) is not enrolled in--
       (i) a Medicare+Choice plan under part C of such title (42 
     U.S.C. 1395w-21 et seq.);
       (ii) a plan offered by an eligible organization under 
     section 1876 of such Act (42 U.S.C. 1395mm);
       (iii) a program of all-inclusive care for the elderly 
     (PACE) under section 1894 of such Act (42 U.S.C. 1395eee); or
       (iv) a social health maintenance organization (SHMO) 
     demonstration project established under section 4018(b) of 
     the Omnibus Budget Reconciliation Act of 1987 (Public Law 
     100-203).
       (4) Outpatient physical therapy services.--Subject to 
     paragraph (2), the term ``outpatient physical therapy 
     services'' has the meaning given to such term in section 
     1861(p) of the Social Security Act (42 U.S.C. 1395x(p)), 
     except that such term shall not include the speech-language 
     pathology services described in the fourth sentence of such 
     section.
       (5) Physician.--The term ``physician'' has the meaning 
     given to such term in section 1861(r)(1) of such Act (42 
     U.S.C. 1395x(r)(1)).
       (6) Qualified physical therapist.--The term ``qualified 
     physical therapist'' has the meaning given to such term for 
     purposes of section 1861(p) of such Act (42 U.S.C. 1395x(p)), 
     as in effect on the date of enactment of this Act.
                                 ______
                                 
  SA 960. Mr. DAYTON submitted an amendment intended to be proposed by 
him to the bill S. 1, to amend title XVIII of the Social Security Act 
to make improvements in the medicare program, to provide prescription 
drug coverage under the medicare program, and for other purposes; which 
was ordered to lie on the table; as follows:

       At the end of subtitle A of title V, add the following:

     SEC. __. STREAMLINING AND SIMPLIFICATION OF MEDICARE 
                   REGULATIONS.

       (a) In General.--The Secretary of Health and Human Services 
     shall conduct an analysis of the regulations issued under 
     title XVIII of the Social Security Act and related laws in 
     order to determine how such regulations may be streamlined 
     and simplified to increase the efficiency and effectiveness 
     of the medicare program without harming beneficiaries or 
     providers and to decrease the burdens the medicare payment 
     systems impose on both beneficiaries and providers.
       (b) Reduction in Regulations.--The Secretary, after 
     completion of the analysis under subsection (a), shall direct 
     the rewriting of the regulations described in subsection (a) 
     in such a manner as to--
       (1) reduce the number of words comprising all regulations 
     by at least two-thirds by October 1, 2004, and
       (2) ensure the simple, effective, and efficient operation 
     of the medicare program.
       (c) Application of the Paperwork Reduction Act.--The 
     Secretary shall apply the provisions of chapter 35 of title 
     44, United States Code (commonly known as the ``Paperwork 
     Reduction Act'') to the provisions of this Act to ensure that 
     any regulations issued to implement this Act are written in 
     plain language, are streamlined, promote the maximum 
     efficiency and effectiveness of the medicare and medicaid 
     programs without harming beneficiaries or providers, and 
     minimize the burdens the payment systems affected by this Act 
     impose on both beneficiaries and providers.
                                 ______
                                 
  SA 961. Mrs. MURRAY submitted an amendment intended to be proposed by 
her to the bill S. 1, to amend title XVIII of the Social Security Act 
to make improvements in the medicare program, to provide prescription 
drug coverage under the medicare program, and for other purposes; which 
was ordered to lie on the table; as follows:

       At the end of subtitle A of title II, add the following:

     SEC. __. IMPROVEMENTS IN MEDICAREADVANTAGE BENCHMARK 
                   DETERMINATIONS.

       (a) Revision of National Average Used in Calculation of 
     Blend.--Section 1853(c)(4)(B)(i)(II) (42 U.S.C. 1395w-
     23(c)(4)(B)(i)(II)), as amended by section 203, is amended by 
     inserting ``who are enrolled in a MedicareAdvantage plan'' 
     after ``the average number of medicare beneficiaries''.
       (b) Change in Budget Neutrality.--Section 1853(c) (42 
     U.S.C. 1395w-23(c)), as amended by section 203, is amended--
       (1) in paragraph (1)(A)--
       (A) in clause (ii), by striking the comma at the end and 
     inserting a period; and
       (B) by striking the flush matter following clause (ii); and
       (2) by striking paragraph (5).
       (c) Inclusion of Costs of DOD and VA Military Facility 
     Services to Medicare-eligible Beneficiaries in Calculation of 
     Medicare+Choice Payment Rates.--
       (1) For purposes of calculating medicare+choice payment 
     rates.--Section 1853(c)(3) (42 U.S.C. 1395w-23(c)(3)), as 
     amended by section 203, is amended--
       (A) in subparagraph (A), by striking ``subparagraph (B)'' 
     and inserting ``subparagraphs (B) and (E)''; and
       (B) by adding at the end the following new subparagraph:
       ``(E) Inclusion of costs of dod and va military facility 
     services to medicare-eligible beneficiaries.--In determining 
     the area-specific Medicare+Choice capitation rate under 
     subparagraph (A) for a year (beginning with 2006), the annual 
     per capita rate of payment for 1997 determined under section 
     1876(a)(1)(C) shall be adjusted to include in the rate the 
     Secretary's estimate, on a per capita basis, of the amount of 
     additional payments that would have been made in the area 
     involved under this title if individuals entitled to benefits 
     under this title had not received services from facilities of 
     the Department of Defense or the Department of Veterans 
     Affairs.''.
       (2) For purposes of calculating local fee-for-service 
     rates.--Section 1853(d)(5) (42 U.S.C. 1395w-23(d)(5)), as 
     amended by section 203, is amended--
       (A) in subparagraph (A), by striking ``subparagraph (B)'' 
     and inserting ``subparagraphs (B) and (C)''; and
       (B) by adding at the end the following new subparagraph:
       ``(C) Inclusion of costs of dod and va military facility 
     services to medicare-eligible beneficiaries.--In determining 
     the local fee-for-service rate under subparagraph (A) for a 
     year (beginning with 2006), the annual per capita rate of 
     payment for 1997 determined under section 1876(a)(1)(C) shall 
     be adjusted to include in the rate the Secretary's estimate, 
     on a per capita basis, of the amount of additional payments 
     that would have been made in the area involved under this 
     title if individuals entitled to benefits under this title 
     had not received services from facilities of the Department 
     of Defense or the Department of Veterans Affairs.''.
       (d) Effective Date.--The amendments made by this section 
     shall apply with respect 


[[Page 15645]]

     to plan years beginning on and after January 1, 2006.
                                 ______
                                 
  SA 962. Mr. SMITH (for himself and Mr. Bingaman) submitted an 
amendment intended to be proposed by him to the bill S. 1, to amend 
title XVIII of the Social Security Act to make improvements in the 
medicare program, to provide prescription drug coverage under the 
medicare program, and for other purposes; which was ordered to lie on 
the table; as follows:

       At the end of title VI, insert the following:

     SEC. __. REIMBURSEMENT FOR FEDERALLY QUALIFIED HEALTH CENTERS 
                   PARTICIPATING IN MEDICARE MANAGED CARE.

       (a) Reimbursement.--
       (1) In general.--Section 1833(a)(3) (42 U.S.C. 1395l(a)(3)) 
     is amended to read as follows:
       ``(3) in the case of services described in section 
     1832(a)(2)(D)--
       ``(A) except as provided in subparagraph (B), the costs 
     which are reasonable and related to the cost of furnishing 
     such services or which are based on such other tests of 
     reasonableness as the Secretary may prescribe in regulations, 
     including those authorized under section 1861(v)(1)(A), less 
     the amount a provider may charge as described in clause (ii) 
     of section 1866(a)(2)(A), but in no case may the payment for 
     such services (other than for items and services described in 
     section 1861(s)(10)(A)) exceed 80 percent of such costs; or
       ``(B) with respect to the services described in clause (ii) 
     of section 1832(a)(2)(D) that are furnished to an individual 
     enrolled with a MedicareAdvantage plan under part C pursuant 
     to a written agreement described in section 1853(j), the 
     amount by which--
       ``(i) the amount of payment that would have otherwise been 
     provided under subparagraph (A) (calculated as if `100 
     percent' were substituted for `80 percent' in such 
     subparagraph) for such services if the individual had not 
     been so enrolled; exceeds
       ``(ii) the amount of the payments received under such 
     written agreement for such services (not including any 
     financial incentives provided for in such agreement such as 
     risk pool payments, bonuses, or withholds),

     less the amount the Federally qualified health center may 
     charge as described in section 1857(e)(3)(C);''.
       (b) Continuation of MedicareAdvantage Monthly Payments.--
       (1) In general.--Section 1853 (42 U.S.C. 1395w-23), as 
     amended by this Act, is amended by adding at the end the 
     following new subsection:
       ``(j) Payment Rule for Federally Qualified Health Center 
     Services.--If an individual who is enrolled with a 
     MedicareAdvantage plan under this part receives a service 
     from a Federally qualified health center that has a written 
     agreement with such plan for providing such a service 
     (including any agreement required under section 1857(e)(3))--
       ``(1) the Secretary shall pay the amount determined under 
     section 1833(a)(3)(B) directly to the Federally qualified 
     health center not less frequently than quarterly; and
       ``(2) the Secretary shall not reduce the amount of the 
     monthly payments to the MedicareAdvantage plan made under 
     section 1853(a) as a result of the application of paragraph 
     (1).''.
       (2) Conforming amendments.--
       (A) Paragraphs (1) and (2) of section 1851(i) (42 U.S.C. 
     1395w-21(i)(1)), as amended by this Act, are each amended by 
     inserting ``1853(j),'' after ``1853(i),''.
       (B) Section 1853(c)(5) is amended by striking ``subsections 
     (a)(3)(C)(iii) and (i)'' and inserting ``subsections 
     (a)(3)(C)(iii), (i), and (j)(1)''.
       (c) Additional MedicareAdvantage Contract Requirements.--
     Section 1857(e) (42 U.S.C. 1395w-27(e)) is amended by adding 
     at the end the following new paragraph:
       ``(3) Agreements with federally qualified health centers.--
       ``(A) Payment levels and amounts.--A contract under this 
     part shall require the MedicareAdvantage plan to provide, in 
     any contract between the plan and a Federally qualified 
     health center, for a level and amount of payment to the 
     Federally qualified health center for services provided by 
     such health center that is not less than the level and amount 
     of payment that the plan would make for such services if the 
     services had been furnished by a provider of services that 
     was not a Federally qualified health center.
       ``(B) Cost-sharing.--Under the written agreement described 
     in subparagraph (A), a Federally qualified health center must 
     accept the MedicareAdvantage contract price plus the Federal 
     payment provided for in section 1833(a)(3)(B) as payment in 
     full for services covered by the contract, except that such a 
     health center may collect any amount of cost-sharing 
     permitted under the contract under this part, so long as the 
     amounts of any deductible, coinsurance, or copayment comply 
     with the requirements under section 1854(e).''.
       (d) Safe Harbor From Antikickback Prohibition.--Section 
     1128B(b)(3) (42 U.S.C. 1320a-7b(b)(3)) is amended--
       (1) in subparagraph (E), by striking ``and'' after the 
     semicolon at the end;
       (2) in subparagraph (F), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following new subparagraph:
       ``(G) any remuneration between a Federally qualified health 
     center (or an entity controlled by such a health center) and 
     a MedicareAdvantage plan pursuant to the written agreement 
     described in section 1853(j).''.
       (e) Effective Date.--The amendments made by this section 
     shall apply to services provided on or after January 1, 2006, 
     and contract years beginning on or after such date.
                                 ______
                                 
  SA 963. Mrs. LINCOLN (for herself, Mr. Conrad, Mr. Miller, and Mr. 
Carper) proposed an amendment to the bill S. 1, to amend title XVIII of 
the Social Security Act to make improvements in the medicare program, 
to provide prescription drug coverage under the medicare program, and 
for other purposes; as follows:
       On page 83, strike lines 1 through 7, and insert the 
     following:
       ``(5) Contract to be available in designated area for 2 
     years.--Notwithstanding paragraph (1), if the Administrator 
     enters into a contract with an entity with respect to an area 
     designated under subparagraph (B) of such paragraph for a 
     year, the following rules shall apply:
       ``(A) The contract shall be for a 2-year period.
       ``(B) The Secretary is not required to make the 
     determination under paragraph (1)(A) with respect to the 
     second year of the contract for the area.
       ``(C) During the second year of the contract, an eligible 
     beneficiary residing in the area may continue to receive 
     standard prescription drug coverage (including access to 
     negotiated prices for such beneficiaries pursuant to section 
     1860D-6(e)) under such contract or through any Medicare 
     Prescription Drug plan that is available in the area.

       At the end of title VI, add the following:

     SEC. __. MEDICARE SECONDARY PAYOR (MSP) PROVISIONS.

       (a) Technical Amendment Concerning Secretary's Authority to 
     Make Conditional Payment When Certain Primary Plans Do Not 
     Pay Promptly.--
       (1) In general.--Section 1862(b)(2) (42 U.S.C. 1395y(b)(2)) 
     is amended--
       (A) in subparagraph (A)(ii), by striking ``promptly (as 
     determined in accordance with regulations)'';
       (B) in subparagraph (B)--
       (i) by redesignating clauses (i) through (iii) as clauses 
     (ii) through (iv), respectively; and
       (ii) by inserting before clause (ii), as so redesignated, 
     the following new clause:
       ``(i) Authority to make conditional payment.--The Secretary 
     may make payment under this title with respect to an item or 
     service if a primary plan described in subparagraph (A)(ii) 
     has not made or cannot reasonably be expected to make payment 
     with respect to such item or service promptly (as determined 
     in accordance with regulations). Any such payment by the 
     Secretary shall be conditioned on reimbursement to the 
     appropriate Trust Fund in accordance with the succeeding 
     provisions of this subsection.''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall be effective as if included in the enactment of title 
     III of the Medicare and Medicaid Budget Reconciliation 
     Amendments of 1984 (Public Law 98-369).
       (b) Clarifying Amendments to Conditional Payment 
     Provisions.--Section 1862(b)(2) (42 U.S.C. 1395y(b)(2)) is 
     further amended--
       (1) in subparagraph (A), in the matter following clause 
     (ii), by inserting the following sentence at the end: ``An 
     entity that engages in a business, trade, or profession shall 
     be deemed to have a self-insured plan if it carries its own 
     risk (whether by a failure to obtain insurance, or otherwise) 
     in whole or in part.'';
       (2) in subparagraph (B)(ii), as redesignated by subsection 
     (a)(2)(B)--
       (A) by striking the first sentence and inserting the 
     following: ``A primary plan, and an entity that receives 
     payment from a primary plan, shall reimburse the appropriate 
     Trust Fund for any payment made by the Secretary under this 
     title with respect to an item or service if it is 
     demonstrated that such primary plan has or had a 
     responsibility to make payment with respect to such item or 
     service. A primary plan's responsibility for such payment may 
     be demonstrated by a judgment, a payment conditioned upon the 
     recipient's compromise, waiver, or release (whether or not 
     there is a determination or admission of liability) of 
     payment for items or services included in a claim against the 
     primary plan or the primary plan's insured, or by other 
     means.''; and
       (B) in the final sentence, by striking ``on the date such 
     notice or other information is received'' and inserting ``on 
     the date notice of, or information related to, a primary 
     plan's responsibility for such payment or other information 
     is received''; and
       (3) in subparagraph (B)(iii), , as redesignated by 
     subsection (a)(2)(B), by striking the first sentence and 
     inserting the following:

[[Page 15646]]

     ``In order to recover payment made under this title for an 
     item or service, the United States may bring an action 
     against any or all entities that are or were required or 
     responsible (directly, as an insurer or self-insurer, as a 
     third-party administrator, as an employer that sponsors or 
     contributes to a group health plan, or large group health 
     plan, or otherwise) to make payment with respect to the same 
     item or service (or any portion thereof) under a primary 
     plan. The United States may, in accordance with paragraph 
     (3)(A) collect double damages against any such entity. In 
     addition, the United States may recover under this clause 
     from any entity that has received payment from a primary plan 
     or from the proceeds of a primary plan's payment to any 
     entity.''.
       (c) Clerical Amendments.--Section 1862(b) (42 U.S.C. 
     1395y(b)) is amended--
       (1) in paragraph (1)(A), by moving the indentation of 
     clauses (ii) through (v) 2 ems to the left; and
       (2) in paragraph (3)(A), by striking ``such'' before 
     ``paragraphs''.
                                 ______
                                 
  SA 964. Mr. BAUCUS (for Mr. Jeffords) proposed an amendment to the 
bill S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; as 
follows:
       Beginning on page 8, strike line 1 and all that follows 
     through page 9, line 2, and insert the following:
       ``(A) In general.--Except as provided in subparagraphs (B), 
     (C), and (D), the term `covered drug' means--
       ``(i) a drug that may be dispensed only upon a prescription 
     and that is described in clause (i) or (ii) of subparagraph 
     (A) of section 1927(k)(2);
       ``(ii) a smoking cessation agent that is approved under 
     section 505 of the Federal Food, Drug, and Cosmetic Act as a 
     non-prescription drug and is dispensed upon a prescription;
       ``(iii) a biological product described in clauses (i) 
     through (iii) of subparagraph (B) of section 1927(k)(2); or
       ``(iv) insulin described in subparagraph (C) of such 
     section;
     and such term includes a vaccine licensed under section 351 
     of the Public Health Service Act and any use of a covered 
     drug for a medically accepted indication (as defined in 
     section 1927(k)(6)).
       ``(B) Exclusions.--
       ``(i) In general.--The term `covered drug' 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 subparagraphs (E) and (G) 
     thereof insofar as they relate to smoking cessation agents, 
     or under section 1927(d)(3).
                                 ______
                                 
  SA 965. Mr. BAUCUS (for Mr. Jeffords) proposed an amendment to the 
bill S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; as 
follows:

       At the end of subtitle B of title IV, add the following:

     SEC. __. COUNCIL FOR TECHNOLOGY AND INNOVATION.

       Section 1868 (42 U.S.C. 1395ee), as amended by section 534, 
     is amended--
       (1) by adding at the end of the heading the following: ``; 
     council for technology and innovation''; and
       (2) by adding at the end the following new subsection:
       ``(c) Council for Technology and Innovation.--
       ``(1) Establishment.--The Secretary shall establish a 
     Council for Technology and Innovation within the Centers for 
     Medicare & Medicaid Services (in this section referred to as 
     `CMS').
       ``(2) Composition.--The Council shall be composed of senior 
     CMS staff and clinicians and shall be chaired by the 
     Executive Coordinator for Technology and Innovation (as 
     appointed or designated under paragraph (4)).
       ``(3) Duties.--The Council shall coordinate the activities 
     of coverage, coding, and payment processes with respect to 
     new technologies and procedures, including new drug 
     therapies, under this title in order to expedite patient 
     access to new technologies and therapies.
       ``(4) Executive Coordinator for technology and 
     innovation.--The Secretary shall appoint (or designate) a 
     noncareer appointee (as defined in section 3132(a)(7) of 
     title 5, United States Code) who shall serve as the Executive 
     Coordinator for Technology and Innovation. Such executive 
     coordinator shall report to the Administrator of CMS, shall 
     chair the Council, shall oversee the execution of its duties, 
     shall serve as a single point of contact for outside groups 
     and entities regarding the coverage, coding, and payment 
     processes under this title, and shall prepare reports to 
     Congress required under section 1869(f)(7).''.
                                 ______
                                 
  SA 966. Mr. CRAIG submitted an amendment intended to be proposed by 
him to the bill S. 1, to amend title XVIII of the Social Security Act 
to make improvements in the medicare program, to provide prescription 
drug coverage under the medicare program, and for other purposes; as 
follows:

       At the appropriate place in title VI, insert the following:

     SEC. __. RESTORATION OF FEDERAL HOSPITAL INSURANCE TRUST 
                   FUND.

       (a) Definitions.--In this section:
       (1) Clerical error.--The term ``clerical error'' means the 
     failure that occurred on April 15, 2001, to have transferred 
     the correct amount from the general fund of the Treasury to 
     the Trust Fund.
       (2) Trust fund.--The term ``Trust Fund'' means the Federal 
     Hospital Insurance Trust Fund established under section 1817 
     of the Social Security Act (42 U.S.C. 1395i).
       (b) Correction of Trust Fund Holdings.--
       (1) In general.--Not later than 120 days after the date of 
     enactment of this Act, the Secretary of the Treasury shall 
     take the actions described in paragraph (2) with respect to 
     the Trust Fund with the goal being that, after such actions 
     are taken, the holdings of the Trust Fund will replicate, to 
     the extent practicable in the judgment of the Secretary of 
     the Treasury, in consultation with the Secretary of Health 
     and Human Services, the holdings that would have been held by 
     the Trust Fund if the clerical error had not occurred.
       (2) Obligations issued and remedied.--The Secretary of the 
     Treasury shall--
       (A) issue to the Trust Fund obligations under chapter 31 of 
     title 31, United States Code, that bear issue dates, interest 
     rates, and maturity dates that are the same as those for the 
     obligations that--
       (i) would have been issued to the Trust Fund if the 
     clerical error had not occurred; or
       (ii) were issued to the Trust Fund and were redeemed by 
     reason of the clerical error; and
       (B) redeem from the Trust Fund obligations that would have 
     been redeemed from the Trust Fund if the clerical error had 
     not occurred.
       (c) Appropriation.--Not later than 120 days after the date 
     of enactment of this Act, there is appropriated to the Trust 
     Fund, out of any money in the Treasury not otherwise 
     appropriated, an amount determined by the Secretary of the 
     Treasury, in consultation with the Secretary of Health and 
     Human Services, to be equal to the interest income lost by 
     the Trust Fund through the date on which the appropriation is 
     being made as a result of the clerical error.
                                 ______
                                 
  SA 967. Mr. BAUCUS (for Mr. Harkin) proposed an amendment to the bill 
S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; as 
follows:

       At the end of subtitle B of title IV, add the following:

     SEC. __. IMPROVED PAYMENT FOR CERTAIN MAMMOGRAPHY SERVICES.

       (a) Exclusion From OPD Fee Schedule.--Section 
     1833(t)(1)(B)(iv) (42 U.S.C. 13951(t)(1)(B)(iv)) is amended 
     by inserting before the period at the end the following: 
     ``and does not include screening mammography (as defined in 
     section 1861(jj)) and unilateral and bilateral diagnostic 
     mammography''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to mammography performed on or after January 1, 
     2004.
                                 ______
                                 
  SA 968. Mr. BAUCUS (for Mr. Harkin) proposed an amendment to the bill 
S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; as 
follows:

       At the end of subtitle B of title IV, add the following:

     SEC. __. REIMBURSEMENT FOR TOTAL BODY ORTHOTIC MANAGEMENT FOR 
                   CERTAIN NURSING HOME PATIENTS.

       (a) In General.--Not later than 60 days after the date of 
     the enactment of this Act, the Secretary shall issue product 
     codes that qualified practioners and suppliers may use to 
     receive reimbursement under section 1834(h) of the Social 
     Security Act (42 U.S.C. 1395m(h)) for qualified total body 
     orthotic management devices used for the treatment of 
     nonambulatory individuals with severe musculoskeletal 
     conditions who are in the full-time care of skilled nursing 
     facilities (as defined in section 1861(j) of such Act (42 
     U.S.C. 1395x(j))). In issuing such codes, the Secretary shall 
     take all steps necessary to prevent fraud and abuse.
       (b) Qualified Total Body Orthotic Management Device.--For 
     purposes of this section, the term ``qualified total body 
     orthotic management device'' means a medically-prescribed 
     device which--
       (1) consists of custom fitted individual braces with 
     adjustable points at the hips, knee, ankle, elbow, and wrist, 
     but only if--
       (A) the individually adjustable braces are attached to a 
     frame which is an integral

[[Page 15647]]

     component of the device and cannot function or be used apart 
     from the frame; and
       (B) the frame is designed such that it serves no purpose 
     without the braces; and
       (2) is designed to--
       (A) improve function;
       (B) retard progression of musculoskeletal deformity; or
       (C) restrict, eliminate, or assist in the functioning of 
     lower and upper extremities and pelvic, spinal, and cervical 
     regions of the body affected by injury, weakness, or 
     deformity,

     of an individual for whom stabilization of affected areas of 
     the body, or relief of pressure points, is required for 
     medical reasons.
                                 ______
                                 
  SA 969. Mr. BAUCUS (for Mr. Dodd) proposed an amendment to the bill 
S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; as 
follows:

       At the end of subtitle C of title II, add the following:

     SEC. __. PERMITTING CONTINUOUS OPEN ENROLLMENT AND 
                   DISENROLLMENT UNDER MEDICARE PARTS C AND D 
                   UNTIL 2008.

       (a) Under Medicare Prescription Drug Plans.--Subclause (II) 
     of section 1860D-3(a)(1)(A)(i), as added by section 101, is 
     amended to read as follows:

       ``(II)(aa) during 2006 and 2007, may change an election 
     under this clause at any time; and
       ``(bb) during 2008 or a subsequent year, may make an annual 
     election to change the election under this clause.''.

       (b) Under MedicareAdvantage Plans.--Section 1851(e) (42 
     U.S.C. 1395w-21(e)), as amended by section 201, is amended--
       (1) in paragraph (2)(A), by striking ``through 2005'' and 
     ``December 31, 2005'' and inserting ``through 2007'' and 
     ``December 31, 2007'', respectively;
       (2) in the heading of paragraph (2)(B), by striking 
     ``during 2006'' and inserting ``during 2008'';
       (3) in paragraph (2)(B)(i), by striking ``2006'' and 
     inserting ``2008'' each place it appears;
       (4) in paragraph (2)(C)(i), by striking ``2007'' and 
     inserting ``2009'' each place it appears;
       (5) in paragraph (2)(D), by striking ``2006'' and inserting 
     ``2008''; and
       (6) in paragraph (4), by striking ``2006'' and inserting 
     ``2008'' each place it appears.
                                 ______
                                 
  SA 970. Mr. BAUCUS (for Mr. Dodd) proposed an amendment to the bill 
S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; as 
follows:

       Section 1860D-19(a) of the Social Security Act, as added by 
     section 101, is amended by adding at the end the following 
     new paragraph:
       ``(5) Reduction of cost-sharing for additional low-income 
     beneficiaries.--
       ``(A) In general.--In the case of an additional low-income 
     beneficiary (as defined in subparagraph (B)), such individual 
     shall be responsible for cost-sharing for the cost of any 
     covered drug provided in the year (after the individual has 
     reached the initial coverage limit described in section 
     1860D-6(c)(3) and before the individual has reached the 
     annual out-of-pocket limit under section 1860D-6(c)(4)(A)), 
     that is equal to 50.0 percent.
       ``(B) Additional low-income beneficiary.--Subject to 
     subparagraph (H), the term `additional low-income 
     beneficiary' means an individual--
       ``(i) who is enrolled under this part, including an 
     individual who is enrolled under a MedicareAdvantage plan;
       ``(ii) whose income is at least 160 percent, but not more 
     than 250 percent, of the poverty line; and
       ``(iii) who is not--

       ``(I) a qualified medicare beneficiary;
       ``(II) a specified low-income medicare beneficiary;
       ``(III) a qualifying individual;
       ``(IV) a subsidy-eligible individual; or
       ``(V) a dual eligible individual.

                                 ______
                                 
  SA 971. Mr. BINGAMAN submitted an amendment intended to be proposed 
by him to the bill S. 1, to amend title XVIII of the Social Security 
Act to make improvements in the medicare program, to provide 
prescription drug coverage under the medicare program, and for other 
purposes; which was ordered to lie on the table; as follows:

       At the end of subtitle C of title II, add the following:

     SEC. __. CARVING OUT DSH PAYMENTS FROM PAYMENTS TO 
                   MEDICARE+CHOICE AND MEDICAREADVANTAGE 
                   ORGANIZATIONS AND PAYING THE AMOUNTS DIRECTLY 
                   TO DSH HOSPITALS ENROLLING MEDICARE+CHOICE AND 
                   MEDICAREADVANTAGE ENROLLEES.

       (a) Removal of DSH Payments From Calculation of Adjusted 
     Average Per Capita Cost.--
       (1) Under medicare+choice.--Section 1853(c)(3) (42 U.S.C. 
     1395w-23(c)(3) and as amended by section 203) is amended--
       (A) in subparagraph (A), by striking ``subparagraph (B)'' 
     and inserting ``subparagraphs (B) and (E)'',
       (B) by adding at the end the following new subparagraph:
       ``(E) Removal of payments attributable to disproportionate 
     share payments from calculation of adjusted average per 
     capita cost.--For each year (beginning with 2004), the area-
     specific Medicare+Choice capitation rate under subparagraph 
     (A)(ii) shall be adjusted to exclude from such rate the 
     portion of such rate that the Secretary estimates is 
     attributable to additional payment amounts described in 
     section 1886(d)(5)(F) (treating hospitals reimbursed under 
     section 1814(b)(3) as if such hospitals were reimbursed under 
     section 1886).''.
       (2) Under medicareadvantage.--Section 1853(a)(5) (as 
     amended by section 203) is amended by adding at the end the 
     following new subparagraph:
       ``(C) Removal of payments attributable to disproportionate 
     share payments from calculation of adjusted average per 
     capita cost.--For each year (beginning with 2004), the area-
     specific Medicare+Choice capitation rate under subparagraph 
     (A)(ii) shall be adjusted to exclude from such rate the 
     portion of such rate that the Secretary estimates is 
     attributable to additional payment amounts described in 
     section 1886(d)(5)(F) (treating hospitals reimbursed under 
     section 1814(b)(3) as if such hospitals were reimbursed under 
     section 1886).''.
       (3) Effective dates.--The amendments made--
       (A) by paragraph (1) shall apply to plan years beginning on 
     and after January 1, 2004 and shall continue to apply to plan 
     years beginning on and after January 1, 2006; and
       (B) by paragraph (2) shall apply to plan years beginning on 
     and after January 1, 2006.
       (b) Additional DSH Payments for Managed Care Enrollees.--
     Section 1886(d)(5)(F) ((42 U.S.C. 1395ww(d)(5)(F)) is 
     amended--
       (1) in clause (ii), by striking ``clause (ix)'' and 
     inserting ``clauses (ix) and (xvi)''; and
       (2) by adding at the end the following new clause:
       ``(xvi)(I) For portions of cost reporting periods occurring 
     on or after January 1, 2004, the Secretary shall provide for 
     an additional payment amount for each applicable discharge of 
     any subsection (d) hospital that is a disproportionate share 
     hospital (as described in clause (i)).
       ``(II) For purposes of this clause the term `applicable 
     discharge' means the discharge of any individual who is 
     enrolled under a risk-sharing contract with a eligible 
     organization under section 1876 and who is entitled to 
     benefits under part A and any individual who is enrolled with 
     a Medicare+Choice organization or a MedicareAdvantage 
     organization under part C.
       ``(III) The amount of the payment under this clause with 
     respect to any applicable discharge shall be equal to the 
     estimated average per discharge amount that would otherwise 
     have been paid under this subparagraph if the individuals had 
     not been enrolled as described in subclause (II).
       ``(IV) The Secretary shall establish rules for paying an 
     additional amount for any hospital reimbursed under a 
     reimbursement system authorized under 1814(b)(3) if such 
     hospital would qualify as a disproportionate share hospital 
     under clause (i) were it not so reimbursed. Such payment 
     shall be determined in the same manner as the amount of 
     payment is determined under this clause for disproportionate 
     share hospitals.''.
                                 ______
                                 
  SA 972. Mr. BINGAMAN submitted an amendment intended to be proposed 
by him to the bill S. 1, to amend title XVIII of the Social Security 
Act to make improvements in the medicare program, to provide 
prescription drug coverage under the medicare program, and for other 
purposes; which was ordered to lie on the table; as follows:

       At the end of title VI, insert the following:

     SEC. __. REIMBURSEMENT FOR FEDERALLY QUALIFIED HEALTH CENTERS 
                   PARTICIPATING IN MEDICARE MANAGED CARE.

       (a) Reimbursement.--
       (1) In general.--Section 1833(a)(3) (42 U.S.C. 1395l(a)(3)) 
     is amended to read as follows:
       ``(3) in the case of services described in section 
     1832(a)(2)(D)--
       ``(A) except as provided in subparagraph (B), the costs 
     which are reasonable and related to the cost of furnishing 
     such services or which are based on such other tests of 
     reasonableness as the Secretary may prescribe in regulations, 
     including those authorized under section 1861(v)(1)(A), less 
     the amount a provider may charge as described in clause (ii) 
     of section 1866(a)(2)(A), but in no case may the payment for 
     such services (other than for items and services described in 
     section 1861(s)(10)(A)) exceed 80 percent of such costs; or
       ``(B) with respect to the services described in clause (ii) 
     of section 1832(a)(2)(D) that are furnished to an individual 
     enrolled with a MedicareAdvantage plan under part C pursuant 
     to a written agreement described in section 1853(j), the 
     amount by which--

[[Page 15648]]

       ``(i) the amount of payment that would have otherwise been 
     provided under subparagraph (A) (calculated as if `100 
     percent' were substituted for `80 percent' in such 
     subparagraph) for such services if the individual had not 
     been so enrolled; exceeds
       ``(ii) the amount of the payments received under such 
     written agreement for such services (not including any 
     financial incentives provided for in such agreement such as 
     risk pool payments, bonuses, or withholds),
     less the amount the Federally qualified health center may 
     charge as described in section 1857(e)(3)(C);''.
       (b) Continuation of MedicareAdvantage Monthly Payments.--
       (1) In general.--Section 1853 (42 U.S.C. 1395w-23), as 
     amended by this Act, is amended by adding at the end the 
     following new subsection:
       ``(j) Payment Rule for Federally Qualified Health Center 
     Services.--If an individual who is enrolled with a 
     MedicareAdvantage plan under this part receives a service 
     from a Federally qualified health center that has a written 
     agreement with such plan for providing such a service 
     (including any agreement required under section 1857(e)(3))--
       ``(1) the Secretary shall pay the amount determined under 
     section 1833(a)(3)(B) directly to the Federally qualified 
     health center not less frequently than quarterly; and
       ``(2) the Secretary shall not reduce the amount of the 
     monthly payments to the MedicareAdvantage plan made under 
     section 1853(a) as a result of the application of paragraph 
     (1).''.
       (2) Conforming amendments.--
       (A) Paragraphs (1) and (2) of section 1851(i) (42 U.S.C. 
     1395w-21(i)(1)), as amended by this Act, are each amended by 
     inserting ``1853(j),'' after ``1853(i),''.
       (B) Section 1853(c)(5) is amended by striking ``subsections 
     (a)(3)(C)(iii) and (i)'' and inserting ``subsections 
     (a)(3)(C)(iii), (i), and (j)(1)''.
       (c) Additional MedicareAdvantage Contract Requirements.--
     Section 1857(e) (42 U.S.C. 1395w-27(e)) is amended by adding 
     at the end the following new paragraph:
       ``(3) Agreements with federally qualified health centers.--
       ``(A) Payment levels and amounts.--A contract under this 
     part shall require the MedicareAdvantage plan to provide, in 
     any contract between the plan and a Federally qualified 
     health center, for a level and amount of payment to the 
     Federally qualified health center for services provided by 
     such health center that is not less than the level and amount 
     of payment that the plan would make for such services if the 
     services had been furnished by a provider of services that 
     was not a Federally qualified health center.
       ``(B) Cost-sharing.--Under the written agreement described 
     in subparagraph (A), a Federally qualified health center must 
     accept the MedicareAdvantage contract price plus the Federal 
     payment provided for in section 1833(a)(3)(B) as payment in 
     full for services covered by the contract, except that such a 
     health center may collect any amount of cost-sharing 
     permitted under the contract under this part, so long as the 
     amounts of any deductible, coinsurance, or copayment comply 
     with the requirements under section 1854(e).''.
       (d) Safe Harbor From Antikickback Prohibition.--Section 
     1128B(b)(3) (42 U.S.C. 1320a-7b(b)(3)) is amended--
       (1) in subparagraph (E), by striking ``and'' after the 
     semicolon at the end;
       (2) in subparagraph (F), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following new subparagraph:
       ``(G) any remuneration between a Federally qualified health 
     center (or an entity controlled by such a health center) and 
     a MedicareAdvantage plan pursuant to the written agreement 
     described in section 1853(j).''.
       (e) Effective Date.--The amendments made by this section 
     shall apply to services provided on or after January 1, 2006, 
     and contract years beginning on or after such date.
                                 ______
                                 
  SA 973. Mr. BINGAMAN submitted an amendment to be proposed by him to 
the bill S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; which was 
ordered to lie on the table; as follows:

       At the end of subtitle B of title IV, insert the following:

     SEC. __. AUTHORIZATION OF REIMBURSEMENT FOR ALL MEDICARE PART 
                   B SERVICES FURNISHED BY CERTAIN INDIAN 
                   HOSPITALS AND CLINICS.

       (a) In General.--Section 1880(e) (42 U.S.C. 1395qq(e)) is 
     amended--
       (1) in paragraph (1)(A), by striking ``for services 
     described in paragraph (2)'' and inserting ``for all items 
     and services for which payment may be made under such part'';
       (2) by striking paragraph (2); and
       (3) by redesignating paragraph (3) as paragraph (2).
       (b) Effective Date.--The amendments made by this section 
     shall apply to items and services furnished on or after 
     October 1, 2004.
                                 ______
                                 
  SA 974. Mr. GRASSLEY (for himself, Mr. Leahy, Ms. Cantwell, Mr. 
Durbin, and Mr. Kohl) submitted an amendment to be proposed by him to 
the bill S. 1, to amend title XVIII of the Social Security Act to make 
improvements in the medicare program, to provide prescription drug 
coverage under the medicare program, and for other purposes; which was 
ordered to lie on the table; as follows:
       At the end of the amendment, insert the following:

                 TITLE __--DRUG COMPETITION ACT OF 2003

     SEC. __01. SHORT TITLE.

       This title may be cited as the ``Drug Competition Act of 
     2003''.

     SEC. __02. FINDINGS.

       Congress finds that--
       (1) prescription drug prices are increasing at an alarming 
     rate and are a major worry of many senior citizens and 
     American families;
       (2) there is a potential for companies with patent rights 
     regarding brand name drugs and companies which could 
     manufacture generic versions of such drugs to enter into 
     financial deals that could tend to restrain trade and greatly 
     reduce competition and increase prescription drug 
     expenditures for American citizens; and
       (3) enhancing competition among these companies can 
     significantly reduce prescription drug expenditures for 
     Americans.

     SEC. __03. PURPOSES.

       The purposes of this title are--
       (1) to provide timely notice to the Department of Justice 
     and the Federal Trade Commission regarding agreements between 
     companies with patent rights regarding brand name drugs and 
     companies which could manufacture generic versions of such 
     drugs; and
       (2) by providing timely notice, to enhance the 
     effectiveness and efficiency of the enforcement of the 
     antitrust and competition laws of the United States.

     SEC. __04. DEFINITIONS.

       In this title:
       (1) ANDA.--The term ``ANDA'' means an Abbreviated New Drug 
     Application, as defined under section 201(aa) of the Federal 
     Food, Drug, and Cosmetic Act (21 U.S.C. 321(aa)).
       (2) Assistant attorney general.--The term ``Assistant 
     Attorney General'' means the Assistant Attorney General in 
     charge of the Antitrust Division of the Department of 
     Justice.
       (3) Brand name drug.--The term ``brand name drug'' means a 
     drug approved under section 505(c) of the Federal Food, Drug, 
     and Cosmetic Act (21 U.S.C. 355(c)).
       (4) Brand name drug company.--The term ``brand name drug 
     company'' means the party that received Food and Drug 
     Administration approval to market a brand name drug pursuant 
     to an NDA, where that drug is the subject of an ANDA, or a 
     party owning or controlling enforcement of any patent listed 
     in the Approved Drug Products With Therapeutic Equivalence 
     Evaluations of the Food and Drug Administration for that 
     drug, under section 505(b) of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 355(b)).
       (5) Commission.--The term ``Commission'' means the Federal 
     Trade Commission.
       (6) Generic drug.--The term ``generic drug'' means a 
     product that the Food and Drug Administration has approved 
     under section 505(j) of the Federal Food, Drug, and Cosmetic 
     Act (21 U.S.C. 355(j)).
       (7) Generic drug applicant.--The term ``generic drug 
     applicant'' means a person who has filed or received approval 
     for an ANDA under section 505(j) of the Federal Food, Drug, 
     and Cosmetic Act (21 U.S.C. 355(j)).
       (8) NDA.--The term ``NDA'' means a New Drug Application, as 
     defined under section 505(b) et seq. of the Federal Food, 
     Drug, and Cosmetic Act (21 U.S.C. 355(b) et seq.)

     SEC. __05. NOTIFICATION OF AGREEMENTS.

       (a) In General.--
       (1) Requirement.--A generic drug applicant that has 
     submitted an ANDA containing a certification under section 
     505(j)(2)(vii)(IV) of the Federal Food, Drug, and Cosmetic 
     Act (21 U.S.C. 355(j)(2)(vii)(IV)) and a brand name drug 
     company that enter into an agreement described in paragraph 
     (2), prior to the generic drug that is the subject of the 
     application entering the market, shall each file the 
     agreement as required by subsection (b).
       (2) Definition.--An agreement described in this paragraph 
     is an agreement regarding--
       (A) the manufacture, marketing or sale of the brand name 
     drug that is the subject of the generic drug applicant's 
     ANDA;
       (B) the manufacture, marketing or sale of the generic drug 
     that is the subject of the generic drug applicant's ANDA; or
       (C) the 180-day period referred to in section 
     505(j)(5)(B)(iv) of the Federal Food, Drug, and Cosmetic Act 
     (21 U.S.C. 355(j)(5)(B)(iv)) as it applies to such ANDA or to 
     any other ANDA based on the same brand name drug.
       (b) Filing.--

[[Page 15649]]

       (1) Agreement.--The generic drug applicant and the brand 
     name drug company entering into an agreement described in 
     subsection (a)(2) shall file with the Assistant Attorney 
     General and the Commission the text of any such agreement, 
     except that the generic drug applicant and the brand-name 
     drug company shall not be required to file an agreement that 
     solely concerns--
       (A) purchase orders for raw material supplies;
       (B) equipment and facility contracts;
       (C) employment or consulting contracts; or
       (D) packaging and labeling contracts.
       (2) Other agreements.--The generic drug applicant and the 
     brand name drug company entering into an agreement described 
     in subsection (a)(2) shall file with the Assistant Attorney 
     General and the Commission the text of any other agreements 
     not described in subsection (a)(2) between the generic drug 
     applicant and the brand name drug company which are 
     contingent upon, provide a contingent condition for, or are 
     otherwise related to an agreement which must be filed under 
     this title.
       (3) Description.--In the event that any agreement required 
     to be filed by paragraph (1) or (2) has not been reduced to 
     text, both the generic drug applicant and the brand name drug 
     company shall file written descriptions of the non-textual 
     agreement or agreements that must be filed sufficient to 
     reveal all of the terms of the agreement or agreements.

     SEC. __06. FILING DEADLINES.

       Any filing required under section 5 shall be filed with the 
     Assistant Attorney General and the Commission not later than 
     10 business days after the date the agreements are executed.

     SEC. __07. DISCLOSURE EXEMPTION.

       Any information or documentary material filed with the 
     Assistant Attorney General or the Commission pursuant to this 
     title shall be exempt from disclosure under section 552 of 
     title 5, and no such information or documentary material may 
     be made public, except as may be relevant to any 
     administrative or judicial action or proceeding. Nothing in 
     this section is intended to prevent disclosure to either body 
     of Congress or to any duly authorized committee or 
     subcommittee of the Congress.

     SEC. __08. ENFORCEMENT.

       (a) Civil Penalty.--Any brand name drug company or generic 
     drug applicant which fails to comply with any provision of 
     this title shall be liable for a civil penalty of not more 
     than $11,000, for each day during which such entity is in 
     violation of this title. Such penalty may be recovered in a 
     civil action brought by the United States, or brought by the 
     Commission in accordance with the procedures established in 
     section 16(a)(1) of the Federal Trade Commission Act (15 
     U.S.C. 56(a)).
       (b) Compliance and Equitable Relief.--If any brand name 
     drug company or generic drug applicant fails to comply with 
     any provision of this title, the United States district court 
     may order compliance, and may grant such other equitable 
     relief as the court in its discretion determines necessary or 
     appropriate, upon application of the Assistant Attorney 
     General or the Commission.

     SEC. __09. RULEMAKING.

       The Commission, with the concurrence of the Assistant 
     Attorney General and by rule in accordance with section 553 
     of title 5 United States Code, consistent with the purposes 
     of this title--
       (1) may define the terms used in this title;
       (2) may exempt classes of persons or agreements from the 
     requirements of this title; and
       (3) may prescribe such other rules as may be necessary and 
     appropriate to carry out the purposes of this title.

     SEC. __10. SAVINGS CLAUSE.

       Any action taken by the Assistant Attorney General or the 
     Commission, or any failure of the Assistant Attorney General 
     or the Commission to take action, under this title shall not 
     bar any proceeding or any action with respect to any 
     agreement between a brand name drug company and a generic 
     drug applicant at any time under any other provision of law, 
     nor shall any filing under this title constitute or create a 
     presumption of any violation of any antitrust or competition 
     laws.

     SEC. __11. EFFECTIVE DATE.

       This title shall--
       (1) take effect 30 days after the date of enactment of this 
     title; and
       (2) shall apply to agreements described in section __05 
     that are entered into 30 days after the date of enactment of 
     this title.

                          ____________________