Medication Therapy Management Empowerment Act of 2013

Summary: Medication Therapy Management Empowerment Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to provide access to services under medication therapy management programs for Medicare part D (Voluntary Prescription Drug Program) eligible individuals with a single chronic disease. Allows the application of this Act only if the Chief Actuary for the Centers for Medicare &amp; Medicaid Services determines that such application with regard to a particular single chronic disease is not projected to increase overall costs to the Medicare program over the following five year period.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medication Therapy Management 
Empowerment Act of 2013''.

SEC. 2. ACCESS TO SERVICES UNDER MEDICATION THERAPY MANAGEMENT PROGRAMS 
              FOR MEDICARE PART D ELIGIBLE INDIVIDUALS WITH SINGLE 
              CHRONIC DISEASES.

    Section 1860D-4(c)(2)(A) of the Social Security Act (42 U.S.C. 
1395w-104(c)(2)(A)) is amended--
            (1) in clause (ii), by striking subclause (I) and inserting 
        the following:
                                    ``(I) have--
                                            ``(aa) multiple chronic 
                                        diseases (such as diabetes, 
                                        asthma, hypertension, 
                                        hyperlipidemia, and congestive 
                                        heart failure); or
                                            ``(bb) subject to clause 
                                        (iii), any single chronic 
                                        disease, including diabetes, 
                                        hypertension, heart failure, 
                                        dyslipidemia, respiratory 
                                        disease (such as asthma, 
                                        chronic obstructive pulmonary 
                                        disease or chronic lung 
                                        disorder), bone disease-
                                        arthritis (such as osteoporosis 
                                        or osteoarthritis), rheumatoid 
                                        arthritis, or mental health 
                                        disorder (such as depression, 
                                        schizophrenia, or bipolar 
                                        disorder).''; and
            (2) by adding at the end the following:
                            ``(iii) Determinations relating to program 
                        costs for including individuals with single 
                        chronic diseases.--
                                    ``(I) Initial determinations.--With 
                                regard to any single chronic disease, 
                                clause (ii)(I)(bb) shall only be 
                                applied if the Chief Actuary for the 
                                Centers for Medicare & Medicaid 
                                Services determines that the 
                                application of such clause with regard 
                                to such disease is not projected to 
                                increase overall costs to the Medicare 
                                program under this title over the five 
                                year period beginning on the date of 
                                determination.
                                    ``(II) Review of determinations.--
                                In the case that clause (ii)(I)(bb) is 
                                applied with respect to a single 
                                chronic disease pursuant to a 
                                determination under subclause (I), not 
                                later than five years after such date 
                                of determination, the Chief Actuary for 
                                the Centers for Medicare & Medicaid 
                                Services shall review the effect of the 
                                application of such clause with respect 
                                to such disease on the actual cost of 
                                the Medicare program under this title 
                                during such five years. Based on such 
                                review, if the Chief Actuary is unable 
                                to determine that, with regard to such 
                                single chronic disease, the application 
                                of such clause did not increase costs 
                                to the Federal government under the 
                                Medicare program under this title over 
                                such period, then the Secretary shall 
                                review the findings of the Chief 
                                Actuary and determine whether such 
                                clause shall continue to be applied 
                                with regard to such single chronic 
                                disease. In conducting such review and 
                                making such determination, the 
                                Secretary shall consider the extent to 
                                which the application of such clause 
                                with regard to such single chronic 
                                disease effects the health outcomes of 
                                part D eligible individuals and any 
                                savings and costs to the Federal 
                                government under the Medicare program 
                                under this title.''.