To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program of oral drugs to treat low blood calcium levels or elevated parathyroid hormone levels for patients with end stage renal disease.

January 7, 2003

Mr. HOLT introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

To amend title XVIII of the Social Security Act to provide for coverage under the Medicare Program of oral drugs to treat low blood calcium levels or elevated parathyroid hormone levels for patients with end stage renal disease.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Medicare Coverage of Replacement Calcitriol Act of 2003'.

SEC. 2. MEDICARE COVERAGE OF ORAL DRUGS USED TO TREAT LOW BLOOD CALCIUM LEVELS OR ELEVATED PARATHYROID HORMONE LEVELS FOR END STAGE RENAL DISEASE PATIENTS.

(a) COVERAGE- Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended--

(1) in subparagraph (U), by striking `and' at the end;

(2) in subparagraph (V), by inserting `and' at the end; and

(3) by inserting after subparagraph (V) the following new subparagraph:

`(W) an oral drug (which is approved by the Food and Drug Administration) that--

`(i) is prescribed for use in the treatment of low blood calcium levels or elevated parathyroid hormone levels in patients medically determined to have end stage renal disease;

`(ii) is a full replacement for such treatment which would otherwise be administered intravenously; and

`(iii) the Secretary determines results in overall cost savings for such treatment which would otherwise be administered intravenously;'.

(b) INTERIM PAYMENT PENDING PUBLICATION OF FINAL RULE- For the period beginning 30 days after the date of the enactment of this Act and ending on the date the Secretary of Health and Human Services publishes a final regulation to carry out section 1861(s)(2)(W) of the Social Security Act, as added by subsection (a)--

(1) oral drugs furnished under such section are deemed to result in the overall cost savings described in clause (iii) of such section, and

(2) the Secretary shall provide for payment for oral drugs furnished under such section during such period, and assign such temporary HCPCS code as is necessary to provide for such payment.

(c) EFFECTIVE DATE- The amendments made by subsection (a) shall apply to oral drugs furnished on or after the date of the enactment of this Act.

END