[Congressional Record (Bound Edition), Volume 156 (2010), Part 7]
[Senate]
[Page 9823]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            MEDICARE PART D

  Mr. CARPER. Mr. President, while Medicare Part D has been a very 
popular program and has improved access to tens of millions of 
patients, the donut hole has been a continuing source of frustration 
for many beneficiaries. The Patient Protection and Affordable Care Act 
begins to fill in the ``donut hole'' with a 50 percent discount program 
that will begin in 2011. The purpose of the coverage gap discount was 
to provide relief for those beneficiaries who struggle with paying for 
medications in the coverage gap and, as a result, stop taking medicines 
as prescribed or cut back on their monthly medication use.
  The Centers for Medicare and Medicaid Services recently released 
guidance to Part D plans regarding the administration of the Part D 
coverage gap discount. In that guidance, CMS responded to comments that 
sought clarification on the relationship between the 50 percent 
discount program and existing Part D rebate contracts. Although the CMS 
guidance clarified that manufacturers would continue to negotiate with 
Part D plans to provide rebates, I feel the need to further clarify 
this issue.
  Any interference by CMS with price negotiations between manufacturers 
and Part D plans would be counter to the explicit intent of Congress 
through the government noninterference clause. With the passage of 
PPACA, and specifically the Part D Coverage Gap Discount Program, the 
government non-interference clause continues to be the existing law; 
therefore, CMS does not have the authority to require manufacturers to 
provide rebates at any particular level.

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