II 

109TH CONGRESS 

2D SESSION S. 2184 

To amend title XVIII of the Social Security Act to provide residents of 

long-term care facilities with assistance with respect to prescription drug 

coverage under part D of such title for the resident. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 25, 2006 

Mr. SCHUMER introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to provide 

residents of long-term care facilities with assistance with 

respect to prescription drug coverage under part D of 

such title for the resident. 

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 ‘‘Long-Term Care Resi5 dent Part D Assistance Act of 2006’’. 
2 

•S 2184 IS

1 SEC. 2. PART D ASSISTANCE FOR RESIDENTS OF LONG2 TERM CARE FACILITIES. 

3 (a) IN GENERAL.—Section 1860D–42 of the Social 

4 Security Act (42 U.S.C. 1395w–152) is amended by add5 ing at the end the following new subsection: 

6 ‘‘(c) ASSISTANCE FOR RESIDENTS OF LONG-TERM

7 CARE FACILITIES.— 

8 ‘‘(1) PROCEDURES AND WAIVER OF REQUIRE9 MENTS.— 

10 ‘‘(A) IN GENERAL.—The Secretary shall 

11 establish procedures and may waive require12 ments of this part as necessary to provide as13 sistance to residents of long-term care facilities 

14 with respect to coverage under this part for the 

15 resident. 

16 ‘‘(B) REQUIREMENTS.—The procedures 

17 under subparagraph (A) shall include at least 

18 the following: 

19 ‘‘(i) DEDICATED TOLL-FREE NUM20 BER.—The establishment of a toll-free tele21 phone number for staff members of long22 term care facilities to request information 

23 regarding coverage under this part for the 

24 resident. 

25 ‘‘(ii) ASSISTANCE IN SELECTING A

26 PLAN RATHER THAN AUTO ENROLLMENT
3 

•S 2184 IS

1 IN A RANDOM PLAN.—Notwithstanding 

2 section 1860D–1(b)(1)(C), in the case of a 

3 part D eligible individual who is a full-ben4 efit dual eligible individual (as defined in 

5 section 1935(c)(6)), who is a resident of a 

6 long-term care facility, and who has failed 

7 to enroll in a prescription drug plan or an 

8 MA–PD plan, rather than randomly enroll9 ing such an individual in a plan pursuant 

10 to such section, the Secretary shall coordi11 nate with the resident and the long-term 

12 care facility to facilitate selection of and 

13 enrollment in the most appropriate plan 

14 under this part for the resident. 

15 ‘‘(iii) REIMBURSEMENT OF CERTAIN

16 COSTS.—The provision of reimbursement 

17 to long-term care facilities for the following 

18 costs: 

19 ‘‘(I) COSTS ASSOCIATED WITH

20 NEW REQUIREMENTS.—Costs associ21 ated with the requirements under 

22 paragraph (2). 

23 ‘‘(II) PRESCRIPTION DRUG EX24 PENDITURES FOR COVERED PART D

25 DRUGS.—The amount that the long- 
4 

•S 2184 IS

1 term care facility expends for payment 

2 for covered part D drugs for residents 

3 of the long-term care facility who are 

4 part D eligible individuals enrolled in 

5 a prescription drug plan under this 

6 part but were unable to access on a 

7 timely basis prescription drug benefits 

8 to which they were entitled under 

9 such plan. 

10 ‘‘(III) PROVIDING PART D AS11 SISTANCE FOR RESIDENTS OF LONG12 TERM CARE FACILITIES.—Costs asso13 ciated with providing part D assist14 ance for residents of long-term care 

15 facilities (including technical assist16 ance in filling prescriptions, time 

17 spent waiting on the telephone or on18 line to determine what plan a resident 

19 is enrolled in, and costs associated 

20 with advocating for residents by filing 

21 appeals or facilitating plan changes). 

22 ‘‘(2) REQUIREMENTS FOR LONG-TERM CARE

23 FACILITIES.— 

24 ‘‘(A) IN GENERAL.—In the case of a long25 term care facility receiving reimbursement 
5 

•S 2184 IS

1 under this title, the facility shall have in place 

2 procedures for— 

3 ‘‘(i) educating residents who are part 

4 D eligible individuals about the prescrip5 tion drug coverage available through plans 

6 under this part; and 

7 ‘‘(ii) providing technical assistance, 

8 phone support, and counseling for such 

9 residents to facilitate selection of and en10 rollment in the most appropriate plan 

11 under this part for the resident. 

12 ‘‘(B) REQUIREMENT.—The procedures 

13 under subparagraph (A) shall include a require14 ment that the facility periodically ascertain 

15 (and inform the resident regarding) whether or 

16 not the plan in which the resident is enrolled 

17 in— 

18 ‘‘(i) provides coverage of the covered 

19 part D drugs that the resident requires; 

20 and 

21 ‘‘(ii) has a contract with a pharmacy 

22 that supports the facility.’’. 
6 

•S 2184 IS

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

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

3 this Act. 

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