United States Government Publishing Office publisher pbl distributor dst United States National Archives and Records Administration Office of the Federal Register author aut Government Organization text government publication eng FR Regulatory Information 2003_register executive 2010-09-23 article Part III Rules and Regulations D09002ee1c816bf78 D09002ee1c816c04b United States Department of Health and Human Services originator org United States Government Agency or Subagency United States Centers for Medicare & Medicaid Services originator org United States Government Agency or Subagency Section 101, subpart 4 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, codified in section 1860D- 31 of the Social Security Act, provides for a voluntary prescription drug discount card program for Medicare beneficiaries entitled to benefits, or enrolled, under Part A or enrolled under Part B, excluding beneficiaries entitled to medical assistance for outpatient prescription drugs under Medicaid, including section 1115 waiver demonstrations. Eligible beneficiaries may access negotiated prices on prescription drugs by enrolling in drug discount card programs offered by Medicare-endorsed sponsors. Eligible beneficiaries may enroll in the Medicare drug discount card program beginning no later than 6 months after the date of enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and ending December 31, 2005. After December 31, 2005, beneficiaries enrolled in the program may continue to use their drug discount card during a short transition period beginning January 1, 2006 and ending upon the effective date of a beneficiary's outpatient drug coverage under Medicare Part D, but no later than the last day of the initial open enrollment period under Part D. Beneficiaries with incomes no more than 135 percent of the poverty line applicable to their family size who do not have outpatient prescription drug coverage under certain programs--Medicaid, certain health insurance coverage or group health insurance (such as retiree coverage), TRICARE, and Federal Employees Health Benefits Program (FEHBP)--also are eligible for transitional assistance, or payment of $600 in 2004 and up to $600 in 2005 of the cost of covered discount card drugs obtained under the program. In most cases, any transitional assistance remaining available to a beneficiary on December 31, 2004 may be rolled over to 2005 and applied toward the cost of covered discount card drugs obtained under the program during 2005. Similarly, in most cases, any transitional assistance remaining available to a beneficiary on December 31, 2005 may be applied toward the cost of covered discount card drugs obtained under the program during the transition period. The Centers for Medicare & Medicaid Services will solicit applications from entities seeking to offer beneficiaries negotiated prices on covered discount card drugs. Those meeting the requirements described in the authorizing statute and this rule, including administration of transitional assistance, will be permitted to offer a Medicare-endorsed drug discount card program to eligible beneficiaries. Endorsed sponsors may charge beneficiaries enrolling in their endorsed programs an annual enrollment fee for 2004 and 2005 of no more than $30; CMS will pay this fee on behalf of enrollees entitled to transitional assistance. To ensure that eligible Medicare beneficiaries take full advantage of the Medicare drug discount card program and make informed choices, CMS will educate beneficiaries about the existence and features of the program and the availability of transitional assistance for certain low-income beneficiaries; and publicize information that will allow Medicare beneficiaries to compare the various Medicare-endorsed drug discount card programs. 68 FR 69840 https://www.govinfo.gov/app/details/FR-2003-12-15/03-30753 03-30753 fr15de03-20 RIN 0938-AM71 4120-01-P CMS-4063-IFC https://www.govinfo.gov/app/details/FR-2003-12-15/03-30753 https://www.govinfo.gov/content/pkg/FR-2003-12-15/html/03-30753.htm https://www.govinfo.gov/content/pkg/FR-2003-12-15/pdf/03-30753.pdf Grant Programs-Health Health Insurance Hospitals Intergovernmental Relations Medicare Reporting and Recordkeeping Requirements 88 p. 69840 69927 68 FR 69840 Title 42 Part 403 42 CFR Part 403 Title 42 Part 408 42 CFR Part 408 RIN 0938-AM71 Medicare Program; Medicare Prescription Drug Discount Card; Federal Register Vol. 68, Issue RULE 03-30753 III DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services CMS-4063-IFC 4120-01-P 03-30753 Interim final rule with comment period.

Section 101, subpart 4 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, codified in section 1860D- 31 of the Social Security Act, provides for a voluntary prescription drug discount card program for Medicare beneficiaries entitled to benefits, or enrolled, under Part A or enrolled under Part B, excluding beneficiaries entitled to medical assistance for outpatient prescription drugs under Medicaid, including section 1115 waiver demonstrations. Eligible beneficiaries may access negotiated prices on prescription drugs by enrolling in drug discount card programs offered by Medicare-endorsed sponsors. Eligible beneficiaries may enroll in the Medicare drug discount card program beginning no later than 6 months after the date of enactment of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and ending December 31, 2005. After December 31, 2005, beneficiaries enrolled in the program may continue to use their drug discount card during a short transition period beginning January 1, 2006 and ending upon the effective date of a beneficiary's outpatient drug coverage under Medicare Part D, but no later than the last day of the initial open enrollment period under Part D. Beneficiaries with incomes no more than 135 percent of the poverty line applicable to their family size who do not have outpatient prescription drug coverage under certain programs--Medicaid, certain health insurance coverage or group health insurance (such as retiree coverage), TRICARE, and Federal Employees Health Benefits Program (FEHBP)--also are eligible for transitional assistance, or payment of $600 in 2004 and up to $600 in 2005 of the cost of covered discount card drugs obtained under the program. In most cases, any transitional assistance remaining available to a beneficiary on December 31, 2004 may be rolled over to 2005 and applied toward the cost of covered discount card drugs obtained under the program during 2005. Similarly, in most cases, any transitional assistance remaining available to a beneficiary on December 31, 2005 may be applied toward the cost of covered discount card drugs obtained under the program during the transition period. The Centers for Medicare & Medicaid Services will solicit applications from entities seeking to offer beneficiaries negotiated prices on covered discount card drugs. Those meeting the requirements described in the authorizing statute and this rule, including administration of transitional assistance, will be permitted to offer a Medicare-endorsed drug discount card program to eligible beneficiaries. Endorsed sponsors may charge beneficiaries enrolling in their endorsed programs an annual enrollment fee for 2004 and 2005 of no more than $30; CMS will pay this fee on behalf of enrollees entitled to transitional assistance. To ensure that eligible Medicare beneficiaries take full advantage of the Medicare drug discount card program and make informed choices, CMS will educate beneficiaries about the existence and features of the program and the availability of transitional assistance for certain low-income beneficiaries; and publicize information that will allow Medicare beneficiaries to compare the various Medicare-endorsed drug discount card programs.

Effective Date: The provisions of this interim final rule with comment period are effective December 15, 2003. Teresa DeCaro, (410) 786-6604. Grant Programs-Health Health Insurance Hospitals Intergovernmental Relations Medicare Reporting and Recordkeeping Requirements Medicare Prescription drug discount card, http://hhs.gov/ocr/hipaa http://www.access.gpo.gov/nara/index.html http://www.cms.hhs.gov/publications/trusteesreport/2003/ http://www.cms.hhs.gov/statistics/nhe/projections-2002/t11.asp http://www.medicare.gov http://www.nacds.org http://www.sba.gov/size/naicstb2-ret.html www.oig.hhs.gov/fraud/advisoryopinions.html Vol. 68, no. 240 Office of the Federal Register, National Archives and Records Administration 2003-12-15 continuing daily deposited born digital 369 p. Table of Contents: AE 2.7: GS 4.107: AE 2.106: KF70.A2 https://www.govinfo.gov/app/details/FR-2003-12-15 P0b002ee1809c5c24 0097-6326 0042-1219 0364-1406 769-004-00000-9 000582072 f:fr15de03 https://www.govinfo.gov/app/details/FR-2003-12-15 https://www.govinfo.gov/content/pkg/FR-2003-12-15/pdf/FR-2003-12-15.pdf https://www.govinfo.gov/content/pkg/FR-2003-12-15/xml/FR-2003-12-15.xml fdlp 69583 69939 DGPO 2010-09-23 2024-06-07 FR-2003-12-15 machine generated eng FR FR-2003-12-15 68 240