[House Report 106-705]
[From the U.S. Government Publishing Office]



106th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     106-705

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 PROVIDING FOR THE CONSIDERATION OF H.R. 4680, THE MEDICARE RX 2000 ACT

                                _______
                                

   June 28, 2000.--Referred to the House Calendar and ordered to be 
                                printed

                                _______
                                

     Mr. Goss, from the Committee on Rules, submitted the following

                              R E P O R T

                       [To accompany H. Res 539]

    The Committee on Rules, having had under consideration 
House Resolution 539, by a record vote of 7 of 1, report the 
same to the House with the recommendation that the resolution 
be adopted.

                summary of provisions of the resolution

    The resolution provides for the consideration in the House 
of H.R. 4680, the Medicare Rx 2000 Act, under a closed rule. 
The rule provides two hours of debate equally divided among and 
controlled by the chairmen and ranking minority members of the 
Committees on Ways and Means and Commerce.
    The rule waives all points of order against consideration 
of the bill. The waiver of all points of order against 
consideration of the bill includes a waiver of clause 4(a) of 
rule XIII (requiring the three-day availability of the report), 
and sections 303 (prohibiting consideration of legislation, as 
reported, providing new budget authority, changes in revenues, 
or changes in the public debt for a fiscal year until the 
budget resolution for that year has been agreed to) and 401 of 
the Congressional Budget Act of 1974 (prohibiting consideration 
of legislation providing new entitlement authority which 
becomes effective during the current fiscal year).
    The rule provides that the amendment recommended by the 
Committee on Ways and Means now printed in the bill, modified 
by the amendment printed in the report, shall be considered as 
adopted. The rule further provides that the Chair may postpone 
further consideration of the bill until a time designated by 
the Speaker. The rule provides one motion to recommit, with or 
without instructions.
    The rule also provides that, at any time on or before the 
legislative day of Friday, June 30, 2000, it shall be in order 
for the Speaker to entertain motions to suspend the rules with 
respect to H.R. 3240 and H. Res. 535.

                            committee votes

    Pursuant to clause 3(b) of House rule XIII the results of 
each record vote on an amendment or motion to report, together 
with the names of those voting for and against, are printed 
below:

Rules Committee record vote No. 112

    Date: June 27, 2000.
    Measure: H.R. 4680, the Medicare Rx 2000 Act.
    Motion by: Mr. Frost.
    Summary of motion: To make in order the amendment in the 
nature of a substitute offered by Representatives Rangel and 
Stark which provides that, starting in 2003, Medicare 
beneficiaries have a choice between traditional Medicare or 
Medicare HMO with defined benefit and provides that the defined 
benefit is available everywhere in the country, and costs an 
estimated $40 billion over 5 years.
    Results: Defeated 1 to 7.
    Vote by Members: Goss--Nay; Pryce--Nay; Diaz-Balart--Nay; 
Hastings--Nay; Sessions--Nay; Reynolds--Nay; Frost--Yea; 
Dreier--Nay.

Rules Committee record vote No. 113

    Date: June 27, 2000.
    Measure: H.R. 4680, the Medicare Rx 2000 Act.
    Motion by: Mr. Frost.
    Summary of motion: To make in order the amendment in the 
nature of a substitute offered by Representatives Dingell and 
Stark which provides that, starting in 2003, Medicare 
beneficiaries have a choice of traditional Medicare or Medicare 
HMO with defined benefit (or can keep current employer-provided 
retiree coverage), and costs an estimated $100 billion over 5 
years.
    Results: Defeated 1 to 7.
    Vote by Members: Goss--Nay; Pryce--Nay; Diaz-Balart--Nay; 
Hastings--Nay; Sessions--Nay; Reynolds--Nay; Frost--Yea; 
Dreier--Nay.

Rules Committee record vote No. 114

    Date: June 27, 2000.
    Measure: H.R. 4680, the Medicare Rx 2000 Act.
    Motion by: Mr. Frost.
    Summary of motion: To make in order en bloc: an amendment 
by Representatives Allen, Thurman, Berry, Weygand, and 
Schakowsky; an amendment by Representative Baldwin; two 
amendments by Representative Capuano; an amendment by 
Representative Cardin; an amendment by Representatives Emerson, 
Berry, and Sanders; an amendment by Representative Sanders; an 
amendment by Representative Tanner; and two amendments by 
Representative Weygand.
    Results: Defeated 1 to 7.
    Vote by Members: Goss--Nay; Pryce--Nay; Diaz-Balart--Nay; 
Hastings--Nay; Sessions--Nay; Reynolds--Nay; Frost--Yea; 
Dreier--Nay.

Rules Committee record vote No. 115

    Date: June 27, 2000.
    Measure: H.R. 4680, the Medicare Rx 2000 Act.
    Motion by: Mr. Goss.
    Summary of motion: To report the rule providing for 
consideration of H.R. 4680.
    Results: Adopted 7 to 1.
    Vote by Members: Goss--Yea; Price--Yea; Diaz-Balart--Yea; 
Hastings--Yea; Sessions--Yea; Reynolds--Yea; Frost--Nay; 
Dreier--Yea.

 summary of amendment to be considered as adopted upon adoption of the 
                                  rule

    Clarifies that covered prescription drugs include vaccines, 
and the Medicare Benefits Administrator may provide for 
coverage of specified drugs in classes that are otherwise 
excluded (such as weight gain or loss drugs).
    Makes technical amendments correcting cross-ference errors.
    Limits to 30,000 the number of participants in the 
demonstration project for disease management for severely 
chronically ill medicare beneficiaries.
    Adds a new section providing for a State Pharmaceutical 
Assistance Transition Commission to develop a proposal to 
respond to transitional issues confronting State pharmaceutical 
assistance programs for low-income medicare beneficiaries.
    Adds a new section that clarifies that the coverage and 
appeals provisions in substitle C of title II do not take 
effect until fiscal year 2001.
    Adds a new section delaying from July to October, 2000 the 
deadline for offering and withdrawing Medicare+Choice plans for 
2001.

text of amendment to be considered as adopted upon adoption of the rule

  Amend subparagraph (B) of section 1860B(f)(1) of the Social 
Security Act, as inserted by section 101(a)(2) of the bill, to 
read as follows:
                  ``(B) a biological product described in 
                clauses (i) through (iii) of subparagraph (B) 
                of such section or insulin described in 
                subparagraph (C) of such section;
  In section 1860B(f)(2)(A) of the Social Security Act, as 
inserted by section 101(a)(2) of the bill, insert before the 
period at the end the following: ``and except to the extent 
otherwise specifically provided by the Medicare Benefits 
Administrator with respect to a drug in any of such classes''.
  In section 1860G(b)(2)(B) of the Social Security Act, as 
inserted by section 101(a)(2) of the bill, strike 
``1851(j)(4)(A)(iii)'' and ``1851(j)(4)(B)'' and insert 
``1851(j)(5)(A)(iii)'' and ``1851(j)(5)(B)'', respectively.
  In section 1935(e)(3)(B)(ii) of the Social Security Act, as 
inserted by section 103(d)(1)(C) of the bill, strike 
``1860(b)(5)'' and inserting ``1860B(b)(5)''.
  In section 105(a) of the bill, add at the end the following: 
``In no case may the number of participants in the project 
exceed 30,000 at any time.''.
  Redesignate section 105 as section 106 and insert after 
section 104 the following new section (and conform the table of 
contents accordingly):

SEC. 105. STATE PHARMACEUTICAL ASSISTANCE TRANSITION COMMISSION.

  (a) Establishment.--
          (1) In general.--There is established as of October 
        1, 2000, a State Pharmaceutical Assistance Transition 
        Commission (in this section referred to as the 
        ``Commission'') to develop a proposal for addressing 
        the unique transitional issues facing State 
        pharmaceutical assistance programs, and program 
        participants, due to the implementation of the medicare 
        prescription drug program under part D of title XVIII 
        of the Social Security Act.
          (2) Definitions.--For purposes of this section:
                  (A) State pharmaceutical assistance program 
                defined.--The term ``State pharmaceutical 
                assistance program'' means a program (other 
                than the medicaid program) operated by a State 
                (or under contract with a State) that provides 
                as of the date of the enactment of this Act 
                assistance to low-income medicare beneficiaries 
                for the purchase of prescription drugs.
                  (B) Program participant.--The term ``program 
                participant'' means a low-income medicare 
                beneficiary who is a participant in a State 
                pharmaceutical assistance program.
  (b) Composition.--The Commission shall consist of the 
following:
          (1) A representative of each governor of each State 
        that the Secretary identifies as operating on a 
        statewide basis a State pharmaceutical assistance 
        program that provides for eligibility and benefits that 
        are comparable or more generous than the low-income 
        assistance eligibility and benefits offered under part 
        D of title XVIII of the Social Security Act.
          (2) Representatives from other States that the 
        Secretary identifies have in operation other State 
        pharmaceutical assistance programs, as appointed by the 
        Secretary.
          (3) Representatives of organizations that represent 
        the interests of program participants, as appointed by 
        the Secretary but not to exceed the number of 
        representatives under paragraphs (1) and (2).
          (4) The Secretary (or the Secretary's designee).
The Secretary shall designate a member to serve as chair of the 
Commission and the Commission shall meet at the call of the 
chair.
  (c) Development of Proposal.--The Commission shall develop 
the proposal described in subsection (a) in a manner consistent 
with the following principles:
          (1) Protection of the interests of program 
        participants in a manner that is the least disruptive 
        to such participants.
          (2) Protection of the financial interests of States 
        so that States are not financially worse off as a 
        result of the enactment of this title.
  (d) Report.--By not later than July 1, 2001, the Commission 
shall submit to the President and the Congress a report that 
contains a detailed proposal (including specific legislative or 
administrative recommendations, if any) and such other 
recommendations as the Commission deems appropriate.
  (e) Support.--The Secretary shall provide the Commission with 
the administrative support services necessary for the 
Commission to carry out its responsibilities under this 
section.
  (f) Termination.--The Commission shall terminate 30 days 
after the date of submission of the report under subsection 
(d).
  Add at the end of subtitle C of title II the following new 
section (and conform the table of contents accordingly):

SEC. 225. EFFECTIVE DATE OF SUBTITLE.

  In no case shall the amendments made by this subtitle apply 
before October 1, 2000.
  Add at the end of subtitle A of title III the following new 
section (and conform the table of contents accordingly):

SEC. 308. DELAY FROM JULY TO OCTOBER, 2000 IN DEADLINE FOR OFFERING AND 
                    WITHDRAWING MEDICARE+CHOICE PLANS FOR 2001.

  Notwithstanding any other provision of law, the deadline for 
a Medicare+Choice organization to withdraw the offering of a 
Medicare+Choice plan under part C of title XVIII of the Social 
Security Act (or otherwise to submit information required for 
the offering of such a plan) for 2001 is delayed from July 1, 
2000, to October 1, 2000, and any such organization that 
provided notice of withdrawal of such a plan during 2000 before 
the date of the enactment of this Act may rescind such 
withdrawal at any time before October 1, 2000.

                                  
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