legislation: 106-s-3107
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| bill_id | congress | bill_type | bill_number | title | policy_area | introduced_date | latest_action_date | latest_action_text | origin_chamber | sponsor_name | sponsor_state | sponsor_party | sponsor_bioguide_id | cosponsor_count | summary_text | update_date | url |
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| 106-s-3107 | 106 | s | 3107 | Medicare Prescription Drug Coverage Act of 2000 | Health | 2000-09-26 | 2000-09-26 | Introduced in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time. | Senate | Sen. Graham, Bob [D-FL] | FL | D | G000352 | 4 | Medicare Prescription Drug Coverage Act of 2000 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to add a new part D (Outpatient Prescription Drug Benefit Program) to provide Medicare coverage of certain outpatient prescription drugs and biological products for individuals entitled to benefits under Medicare part A (Hospital Insurance) or enrolled under Medicare part B (Supplementary Medical Insurance).(Sec. 2) Directs the Secretary of Health and Human Services to provide for an outpatient prescription drug benefit program for eligible Medicare beneficiaries.Makes the cost of providing benefits under this part payable from the Federal Supplementary Medical Insurance Trust Fund.Directs the Secretary to establish a process for an eligible Medicare beneficiary (including one enrolled in a Medicare+Choice plan under Medicare part C (Medicare+Choice)) to elect to enroll under new SSA title XVIII part D. Requires an eligible Medicare beneficiary to enroll under new SSA title XVIII part D in order to be eligible for covered outpatient drugs under Medicare.Directs the Secretary to disseminate information to eligible and prospective eligible beneficiaries. Authorizes appropriations.Directs the Secretary to determine and promulgate a monthly premium rate for the succeeding year in accordance with specified guidelines. Requires monthly premiums to be credited to the Federal Supplementary Medical Insurance Trust Fund.Outlines cost-sharing provisions, including those for a $250 deductible waivable for generic drugs, coinsurance payments for the drug in an amount equal to the applicable percentage of the cost of the drug, and inflation adjustment.Directs the Secretary to establish procedures for accepting bids and awarding competitive contracts for benefit administration. Sets out patient protections. Provides for: (1) accessibility of outpatient drugs; (2) continuity of care; (3) medically necessary drugs; (4) denials of care; (5) procedures to ensure a timely internal and external review and resolution of denials of coverage and complaints regarding the use of formularies; (6) confidentiality; (7) transfer of medical records; and (8) medical errors. Requires the eligible entity, among other things, to have in place procedures to control fraud, abuse, and waste.Authorizes the Secretary to develop and implement an Employer Incentive Program, including incentive payments, that encourages employers and other sponsors of employment-based health care coverage to provide adequate prescription drug benefits to retired individuals by subsidizing, in part, the sponsor's cost of providing coverage under qualifying plans. Outlines sponsor requirements. Authorizes appropriations.Establishes a Medicare Pharmacy and Therapeutics Advisory Committee for development of: (1) guidelines for administration of the outpatient prescription drug benefit program; (2) standards for required pharmacy and therapeutics committees of eligible entities; (3) procedures for determining if a drug is medically necessary to prevent or to slow the deterioration of, or improve or maintain, the health of an eligible beneficiary; (4) standards for defining therapeutic classes and other specified matters; (5) procedures to evaluate the bids submitted by eligible entities under SSA title XVIII part D; and (6) procedures to ensure that eligible entities under contract are in compliance with requirements. Authorizes appropriations.Applies to SSA title XVIII part D the coverage exclusions under Medicare parts A or B for any expenses incurred for certain items or services. Provides that prescription drugs are not excluded from such coverage if reasonable and necessary.(Sec. 3) Amends SSA title XVIII part C to: (1) require each Medicare+Choice plan, with specified exceptions, to provide enrolled members items and services for which benefits are available under part D; (2) permit a Medicare+Choice organization offering a Medicare+Choice plan to elect a benefit provider as long as the organization complies with outpatient drug access requirements; (3) require the Secretary to determine a Medicare+Choice capitation rate for outpatient drug benefits for enrollees in accordance with specified payment rules; and (4) prohibit a Medicare+Choice organization from requiring an enrollee to pay an outpatient prescription drug benefit deductible or a coinsurance percentage exceeding the applicable amount.(Sec. 4) Amends SSA title XVIII part D to exclude Medicare part D costs from determination of the part B monthly premium.(Sec. 5) Amends SSA title XIX (Medicaid) to: (1) include in Medicare cost-sharing for qualified Medicare beneficiaries premiums under the Outpatient Prescription Drug Benefit Program; and (2) provide for expanding medical assistance with regard to the coinsurance and deductible under such Program. Sets at 100 percent the Federal Medicaid percentage with respect to such medical assistance. Provides for the nonapplicability of payment differential requirements to SSA title XVIII part D cost-sharing.Amends SSA title XI to increase according to a certain formula Medicaid payments to territories for FY 2002 and thereafter.(Sec. 6) Amends SSA title XVIII to revise requirements for benefit packages for Medicare supplemental (Medigap) policies.(Sec. 7) Directs the Secretary to study and report to Congress on the feasibility and advisability of: (1) establishing a uniform format for pharmacy benefit cards provided to beneficiaries by eligible entities under the Outpatient Prescription Drug Benefit Program; and (2) developing systems to transfer prescriptions electronically under such program from the prescriber to the pharmacist.(Sec. 8) Authorizes appropriations. | 2025-08-20T14:17:37Z |