To amend title XVIII of the Social Security Act to authorize the Secretary of Health and Human Services to endorse prescription drug discount cards for use by Medicare beneficiaries.

January 31, 2003

Mr. FOLEY introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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 authorize the Secretary of Health and Human Services to endorse prescription drug discount cards for use by Medicare beneficiaries.

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 Rx Drug Discount Act of 2003'.

SEC. 2. MEDICARE PRESCRIPTION DRUG DISCOUNT CARD ENDORSEMENT PROGRAM.

Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by inserting after section 1806 the following new sections:

`MEDICARE PRESCRIPTION DRUG DISCOUNT CARD ENDORSEMENT PROGRAM

`SEC. 1807. (a) IN GENERAL- The Secretary shall establish a program--

`(1) to endorse prescription drug discount card programs that meet the requirements of this section; and

`(2) to make available to medicare beneficiaries information regarding such endorsed programs.

`(b) REQUIREMENTS FOR ENDORSEMENT- The Secretary may not endorse a prescription drug discount card program under this section unless the program meets the following requirements:

`(1) SAVINGS TO MEDICARE BENEFICIARIES- The program passes on to medicare beneficiaries who enroll in the program discounts on prescription drugs, including discounts negotiated with manufacturers.

`(2) PROHIBITION ON APPLICATION ONLY TO MAIL ORDER- The program applies to drugs that are available other than solely through mail order.

`(3) BENEFICIARY SERVICES- The program provides pharmaceutical support services, such as education and counseling, and services to prevent adverse drug interactions.

`(4) INFORMATION- The program makes available to medicare beneficiaries through the Internet and otherwise information, including information on enrollment fees, prices charged to beneficiaries, and services offered under the program, that the Secretary identifies as being necessary to provide for informed choice by beneficiaries among endorsed programs.

`(5) DEMONSTRATED EXPERIENCE- The entity operating the program has demonstrated experience and expertise in operating such a program or a similar program.

`(6) QUALITY ASSURANCE- The entity has in place adequate procedures for assuring quality service under the program.

`(7) OPERATION OF ASSISTANCE PROGRAM- The entity meets such requirements relating to solvency, compliance with financial reporting requirements, audit compliance, and contractual guarantees as the Secretary finds necessary for participation.

`(8) ENROLLMENT FEES- The program may charge an annual enrollment fee, but the amount of such annual fee may not exceed $25.

`(9) ADDITIONAL BENEFICIARY PROTECTIONS- The program meets such additional requirements as the Secretary identifies to protect and promote the interest of medicare beneficiaries, including requirements that ensure that beneficiaries are not charged more than the lower of the negotiated retail price or the usual and customary price.

The prices negotiated by a prescription drug discount card program endorsed under this section shall (notwithstanding any other provision of law) not be taken into account for the purposes of establishing the best price under section 1927(c)(1)(C).

`(c) PROGRAM OPERATION- The Secretary shall operate the program under this section consistent with the following:

`(1) PROMOTION OF INFORMED CHOICE- In order to promote informed choice among endorsed prescription drug discount card programs, the Secretary shall provide for the dissemination of information which compares the prices and services of such programs in a manner coordinated with the dissemination of educational information on Medicare+Choice plans under part C.

`(2) OVERSIGHT- The Secretary shall provide appropriate oversight to ensure compliance of endorsed programs with the requirements of this section, including verification of the discounts and services provided.

`(3) USE OF MEDICARE TOLL-FREE NUMBER- The Secretary shall provide through the 1-800-medicare toll free telephone number for the receipt and response to inquiries and complaints concerning the program and programs endorsed under this section.

`(4) SANCTIONS FOR ABUSIVE PRACTICES- The Secretary may implement intermediate sanctions or may revoke the endorsement of a program in the case of a program that the Secretary determines no longer meets the requirements of this section or that has engaged in false or misleading marketing practices.

`(5) ENROLLMENT PRACTICES- A medicare beneficiary may not be enrolled in more than one endorsed program at any time. A medicare beneficiary may change the endorsed program in which the beneficiary is enrolled, but may not make such change until the beneficiary has been enrolled in a program for a minimum period of time specified by the Secretary.

`(d) TRANSITION- The Secretary shall provide for an appropriate transition and discontinuation of the program under this section at the time outpatient prescription drug benefits first become available under this title.

`(e) ENDORSEMENT CONDITION- The Secretary shall require, as condition of endorsement under of a prescription drug discount card program under this section that the program implement policies and procedures to safeguard the use and disclosure of program beneficiaries' individually identifiable health information in a manner consistent with the Federal regulations (concerning the privacy of individually identifiable health information) promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996.

`(f) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated such sums as may be necessary to carry out the program under this section.'.

END