II 

109TH CONGRESS 

2D SESSION S. 2240 

To amend title XVIII to reform the Medicare prescription drug program. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 2, 2006 

Mr. LEVIN (for himself and Ms. STABENOW) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII to reform the Medicare prescription 

drug program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Part D Re5 form Act of 2006’’. 

6 SEC. 2. REMOVAL OF COVERED PART D DRUGS FROM THE 

7 PRESCRIPTION DRUG PLAN FORMULARY. 

8 Section 1860D–4(b)(3)(E) of the Social Security Act 

9 (42 U.S.C. 1395w–104(b)(3)(E)) is amended to read as 

10 follows: 
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1 ‘‘(E) REMOVING DRUG FROM FORMULARY

2 OR CHANGING PREFERRED OR TIER STATUS OF

3 DRUG.— 

4 ‘‘(i) LIMITATION ON REMOVAL OR

5 CHANGE.—Beginning with 2006, the PDP 

6 sponsor of a prescription drug plan may 

7 not remove a covered part D drug from the 

8 plan formulary or change the preferred or 

9 tiered cost-sharing status of such a drug 

10 other than during the period beginning on 

11 September 1 and ending on October 31. 

12 Subject to clause (ii), such removal or 

13 change shall only be effective beginning on 

14 January 1 of the immediately succeeding 

15 calendar year. 

16 ‘‘(ii) NOTICE.—Any removal or 

17 change under this subparagraph shall not 

18 take effect unless appropriate notice is 

19 made available (such as under subsection 

20 (a)(3)) to the Secretary, affected enrollees, 

21 physicians, pharmacies, and pharmacists. 

22 Such notice shall ensure that such infor23 mation is made available prior to the an24 nual, coordinated open election period de25 scribed in section 1851(e)(3)(B)(iii), as ap-
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1 plied under section 1860D– 

2 1(b)(1)(B)(iii).’’. 

3 SEC. 3. PHARMACEUTICAL PATIENT ASSISTANCE PRO4 GRAMS. 

5 (a) PROVIDING A SAFE HARBOR FOR PHARMA6 CEUTICAL PATIENT ASSISTANCE PROGRAMS.—Section 

7 1128B(b)(3) of the Social Security Act (42 U.S.C. 1320a– 

8 7b(b)(3)) is amended— 

9 (1) in subparagraph (G)— 

10 (A) by inserting ‘‘or under a patient assist11 ance program (including a pharmaceutical man12 ufacturer patient assistance program)’’ after 

13 ‘‘Indian organizations)’’; and 

14 (B) by striking ‘‘and’’ at the end; 

15 (2) in subparagraph (H), as added by section 

16 237(d) of the Medicare Prescription Drug, Improve17 ment, and Modernization Act of 2003 (Public Law 

18 108–173; 117 Stat. 2213)— 

19 (A) by moving such subparagraph 2 ems to 

20 the left; and 

21 (B) by striking the period at the end and 

22 inserting ‘‘; and’’; and 

23 (3) by redesignating subparagraph (H), as 

24 added by section 431(a) of the Medicare Prescrip25 tion Drug, Improvement, and Modernization Act of 
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1 2003 (Public Law 108–173; 117 Stat. 2287), as 

2 subparagraph (I) and moving such subparagraph 2 

3 ems to the left. 

4 (b) EXCLUSION OF EXPENDITURES UNDER CERTAIN

5 PHARMACY ASSISTANCE PROGRAMS FROM TROOP.— 

6 Section 1860D–2(b)(4)(C)(ii) of such Act (42 U.S.C. 

7 1395w–102(b)(4)(C)(ii)) is amended by inserting ‘‘under 

8 a pharmaceutical manufacturer patient assistance pro9 gram,’’ after ‘‘a group health plan,’’. 

10 (c) EFFECTIVE DATE.—The amendments made by 

11 this section shall take effect on the date of enactment of 

12 this Act. 

13 SEC. 4. PROTECTION AGAINST COST-SHARING FOR FULL14 BENEFIT DUAL ELIGIBLE INDIVIDUALS. 

15 (a) IN GENERAL.—Section 1860D–14(a)(1)(D)(ii) of 

16 the Social Security Act (42 U.S.C. 1395w– 

17 114(a)(1)(D)(ii)) is amended— 

18 (1) in the heading, by striking ‘‘LOWEST IN19 COME’’; 

20 (2) by striking ‘‘and whose income does not ex21 ceed 100 percent of the poverty line applicable to a 

22 family of the size involved’’; and 

23 (3) by adding at the end the following new sen24 tence: ‘‘In the case of an individual who is unable 
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1 to pay the copayment applicable under the preceding 

2 sentence, such copayment shall be waived.’’. 

3 (b) EFFECTIVE DATE.—The amendments made by 

4 this section shall apply to drugs dispensed on or after the 

5 date of enactment of this Act. 

6 SEC. 5. NEGOTIATING FAIR PRICES FOR MEDICARE PRE7 SCRIPTION DRUGS. 

8 (a) IN GENERAL.—Section 1860D–11 of the Social 

9 Security Act (42 U.S.C. 1395w–111) is amended by strik10 ing subsection (i) (relating to noninterference) and by in11 serting the following new subsection: 

12 ‘‘(i) AUTHORITY TO NEGOTIATE PRICES WITH MAN13 UFACTURERS.—In order to ensure that beneficiaries en14 rolled under prescription drug plans and MA–PD plans 

15 pay the lowest possible price, the Secretary shall have au16 thority similar to that of other Federal entities that pur17 chase prescription drugs in bulk to negotiate contracts 

18 with manufacturers of covered part D drugs, consistent 

19 with the requirements and in furtherance of the goals of 

20 providing quality care and containing costs under this 

21 part.’’. 

22 (b) EFFECTIVE DATE.—The amendment made by 

23 this section shall take effect on the date of enactment of 

24 this Act. 

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