I 

109TH CONGRESS 

2D SESSION H. R. 4685 

To amend titles XVIII and XIX of the Social Security Act to assure uninterrupted access to necessary medicines under the Medicare prescription 

drug program. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 1, 2006 

Mr. DINGELL (for himself, Mr. RANGEL, Mr. SPRATT, Mr. WAXMAN, Mr. 

BROWN of Ohio, Mr. STARK, Ms. PELOSI, Mr. MARKEY, Mrs. CAPPS, Mr. 

BOUCHER, Ms. SCHAKOWSKY, Ms. DEGETTE, Mr. PALLONE, Ms. SOLIS, 

Ms. BALDWIN, Mr. GENE GREEN of Texas, Mr. GORDON, Mr. ALLEN, 

Mr. INSLEE, Mr. CLEAVER, Ms. SLAUGHTER, Mr. EMANUEL, Mr. NEAL

of Massachusetts, Mr. DELAHUNT, Mr. DOGGETT, Mr. CONYERS, Ms. 

MATSUI, Mr. BERMAN, Mr. LARSON of Connecticut, Mr. CARDIN, Mr. 

MCNULTY, Mr. HOLDEN, Mr. OWENS, Ms. HERSETH, and Mrs. MCCARTHY) 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 

A BILL 

To amend titles XVIII and XIX of the Social Security Act 

to assure uninterrupted access to necessary medicines 

under 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, 
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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

2 (a) SHORT TITLE.—This Act may be cited as the 

3 ‘‘Medicare Prescription Drug Emergency Guarantee Act 

4 of 2006’’. 

5 (b) TABLE OF CONTENTS.—The table of contents of 

6 this Act is as follows: 

Sec. 1. Short title; table of contents 

Sec. 2. Protections to provide for uninterrupted access to medicines 

Sec. 3. Required application of intermediate sanctions to protect against fraud 

and abuse 

Sec. 4. Changes of enrollment in prescription drug plans and MA–PD plans allowed twice during year 

Sec. 5. Prohibiting additional restrictions or limitations on coverage during year 

Sec. 6. MedPAC study on appropriate enrollment of dual eligible individuals 

Sec. 7. Prohibition on conditioning Medicaid eligibility on enrollment in Medicare part D coverage or other creditable coverage 

Sec. 8. Reimbursement of third parties for 2006 transition costs 

7 SEC. 2. PROTECTIONS TO PROVIDE FOR UNINTERRUPTED 

8 ACCESS TO MEDICINES. 

9 (a) MINIMUM STANDARD TRANSITION COVERAGE.— 

10 (1) IN GENERAL.—Section 1860D–4(b) of the 

11 Social Security Act (42 U.S.C. 1395w–104(b)) is 

12 amended by adding at the end the following new 

13 paragraph: 

14 ‘‘(4) UNINTERRUPTED ACCESS TO MEDI15 CINES.— 

16 ‘‘(A) MINIMUM STANDARD TRANSITION

17 COVERAGE.—A PDP sponsor offering a pre18 scription drug plan under this part or an MA– 

19 PD plan under part C shall provide minimum 
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1 standard transition coverage in accordance with 

2 subparagraph (B). 

3 ‘‘(B) REQUIREMENTS.—The minimum 

4 standard transition coverage under this sub5 paragraph, with respect to a part D eligible in6 dividual who is enrolled in a prescription drug 

7 plan (or an individual who is presumed to be 

8 such an individual pursuant to subparagraph 

9 (F)) who presents a prescription for a drug at 

10 a pharmacy, is the following: 

11 ‘‘(i) GUARANTEED INITIAL SUPPLY, 

12 REGARDLESS OF COVERAGE LIMITATIONS

13 OR RESTRICTIONS.—In the case that the 

14 PDP sponsor of such plan uses a for15 mulary that does not cover the drug or 

16 otherwise imposes a restriction on the cov17 erage of the drug (such as through the ap18 plication of a preferred status, usage re19 striction, step therapy, prior authorization 

20 or a quantity limits) and during the period 

21 in which such individual has been enrolled 

22 in such plan the individual has not pre23 viously sought coverage under the plan for 

24 such drug the plan shall provide for the 

25 following: 
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1 ‘‘(I) MINIMUM SUPPLY OF PRE2 SCRIPTION DRUG.—The plan must 

3 provide for coverage for at least a 60- 

4 day supply (or a 90-day supply in the 

5 case of an individual who is a resident 

6 of a long-term care facility) of the 

7 drug, or, if less, a supply of the drug 

8 that is the full amount of the pre9 scription. 

10 ‘‘(II) INFORMATION ON FOR11 MULARY, PRESCRIPTION DRUG PLANS, 

12 AND APPEAL RIGHTS.—The plan must 

13 provide the individual with a standard 

14 notice developed by the Secretary that 

15 informs the individual about the limi16 tations and restrictions of the cov17 erage of the drug, that describes the 

18 rights of the individual with respect to 

19 requesting a determination under sub20 section (g)(2) or an appeal of such a 

21 determination under subsection (h), 

22 that describes any ability of the indi23 vidual to change the election of such 

24 plan under section 1860D–1(b)(1)(B), 

25 and that informs the individual about 
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1 sources of information on prescription 

2 drug plans to make such a change in 

3 plans. 

4 ‘‘(III) REFILLS DURING PENDING

5 APPEAL.—In the case of such an indi6 vidual who brings an appeal under 

7 subsection (h), with respect to the 

8 prescription drug involved, an addi9 tional supply of the drug (for the 

10 amount of days provided to the indi11 vidual under subclause (I)) during the 

12 period ending on the date on which a 

13 final determination is made on the ap14 peal. 

15 ‘‘(ii) GUARANTEED SUPPLY WHEN UN16 ABLE TO VERIFY PLAN ENROLLMENT.—In 

17 the case that the pharmacy is unable to lo18 cate or verify the individual’s enrollment in 

19 such plan through a reasonable effort: 

20 ‘‘(I) MINIMUM SUPPLY OF PRE21 SCRIPTION DRUG.—The plan must 

22 provide for coverage for at least a 60- 

23 day supply (or a 90-day supply in the 

24 case of an individual who is a resident 

25 of a long-term care facility) of the 
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1 drug, or, if less, a supply of the drug 

2 that is the full amount of the pre3 scription. 

4 ‘‘(II) REFILLS.—The plan must 

5 provide an additional 60-day supply 

6 (or a 90-day supply in the case of an 

7 individual who is a resident of a long8 term care facility) of the drug, or if 

9 less, a supply of the drug that is the 

10 full amount of the prescription, if the 

11 pharmacy continues to be unable to 

12 locate the individual’s enrollment 

13 through such reasonable efforts when 

14 a prescription is presented on or after 

15 the date that a prescription refill is 

16 appropriate. 

17 ‘‘(C) REIMBURSEMENTS.— 

18 ‘‘(i) REIMBURSEMENTS TO PHAR19 MACIES.— 

20 ‘‘(I) IN GENERAL.—If a phar21 macy provides prescription drugs for 

22 which the minimum standard transi23 tion coverage is required under sub24 paragraph (B), the Secretary shall re25 imburse the pharmacy for the costs 
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1 incurred in providing the prescription 

2 drugs, including acquisition costs, dis3 pensing costs, and other overhead 

4 costs. The Secretary shall provide 

5 prompt payment (consistent with the 

6 provisions of section 1842(c)(2)) of 

7 such reimbursements from the Medi8 care Prescription Drug Account under 

9 section 1860D–16 of the Social Secu10 rity Act (42 U.S.C. 1395w–116). 

11 Such reimbursements shall be deemed 

12 to be payments from such Account 

13 under subsection (b) of such section. 

14 ‘‘(II) SANCTIONS FOR FRAUDU15 LENT CLAIMS.—In the case of a phar16 macy that knowingly provides to the 

17 Secretary false information in connec18 tion with a claim for reimbursement 

19 under subclause (I), the Secretary 

20 may impose a civil money penalty in 

21 an amount not to exceed $10,000 for 

22 each such claim. The provisions of 

23 section 1128A (other than subsections 

24 (a) and (b) and the second sentence of 

25 subsection (f)) shall apply to a civil 
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1 money penalty under the previous sen2 tence in the same manner as such 

3 provisions apply to a penalty or pro4 ceeding under section 1128A(a). 

5 ‘‘(ii) RECOVERY FROM PLANS OF

6 PHARMACY REIMBURSEMENTS.—The Sec7 retary shall establish a process for recov8 ering the reimbursements made to phar9 macies under clause (i) from prescription 

10 drug plans and MA–PD plans if the Sec11 retary determines that such plans should 

12 have incurred such costs. Amounts recov13 ered pursuant to the preceding sentence 

14 shall be deposited in the Medicare Pre15 scription Drug Account. 

16 ‘‘(iii) APPLICATION OF INTERMEDIATE

17 SANCTIONS.—In the case of a failure of a 

18 prescription drug plan under this part or 

19 an MA–PD plan under part C to provide 

20 for the minimum coverage required under 

21 subparagraph (B), the failure shall be 

22 treated as a failure to provide medically 

23 necessary items and services under section 

24 1857(g)(1)(A), as applied by section 

25 1860D–12(b)(3)(E), and the Secretary 
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1 shall impose intermediate sanctions under 

2 such section 1857(g). 

3 ‘‘(D) COST-SHARING.—The cost-sharing 

4 for a prescription filled pursuant to subpara5 graph (B) for an individual shall be in accord6 ance with the prescription drug plan in which 

7 the individual attests to be enrolled and the 

8 class of individual (such as subsidy-eligible indi9 viduals) to which the individual so attests. 

10 ‘‘(E) REFUNDS TO INDIVIDUALS WITH IN11 APPROPRIATE CHARGES.—If the Secretary de12 termines, in accordance with a method deter13 mined by the Secretary, that an individual was 

14 inappropriately charged for a prescription drug 

15 dispensed to such individual under this part or 

16 part C, the Secretary shall— 

17 ‘‘(i) reduce payments to the sponsor 

18 of the prescription drug plan under section 

19 1860D–15 or to the organization offering 

20 the MA–PD plan under section 1853 that 

21 inappropriately charged the individual by 

22 an amount equal to the amount the indi23 vidual was inappropriately charged; and 

24 ‘‘(ii) refund such amount to the indi25 vidual within 30 days of the date of the de-
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1 termination that the individual was inap2 propriately charged. 

3 ‘‘(F) PRESUMPTIVE ELIGIBILITY.— 

4 ‘‘(i) SUBSIDY-ELIGIBLE INDIVID5 UALS.—For purposes of this paragraph, an 

6 individual shall be presumed to be a dual 

7 eligible individual or subsidy-eligible indi8 vidual if the individual self attests to being 

9 such an individual, respectively. 

10 ‘‘(ii) PLAN ENROLLMENT.—For pur11 poses of this paragraph, an individual shall 

12 be presumed to be enrolled in a prescrip13 tion drug plan under this part or an MA– 

14 PD plan under part C if the individual self 

15 attests to being enrolled under such plan. 

16 ‘‘(iii) INDIVIDUAL LIABLE FOR COSTS

17 OF FALSE ATTESTATION.— 

18 ‘‘(I) IN GENERAL.—If the Sec19 retary, as the result of verification ac20 tivities conducted by the Secretary, 

21 determines after a fair hearing that 

22 an individual has knowingly made a 

23 false self-attestation described in 

24 clause (i) or (ii) or in subparagraph 

25 (D), the Secretary may, subject to 
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1 subclause (II), seek recovery from the 

2 individual for the full amount of the 

3 cost of benefits provided to the indi4 vidual under this paragraph as a re5 sult of such self attestation. 

6 ‘‘(II) EXCEPTION.—The Sec7 retary shall at its discretion not seek 

8 recovery under subclause (I) if the 

9 Secretary determines that it would not 

10 be cost-effective to do so. 

11 ‘‘(III) REIMBURSEMENTS TO

12 FEDERAL GOVERNMENT.—Any 

13 amounts recovered by the Secretary in 

14 accordance with this clause shall be 

15 returned to the prescription drug plan 

16 or MA–PD plan if the Secretary has 

17 previously recovered payment from 

18 such plan. 

19 ‘‘(iv) REQUIREMENTS FOR SELF AT20 TESTATION.—The Secretary shall promul21 gate requirements for self attestations 

22 under this subparagraph, but the failure of 

23 the Secretary to promulgate such require24 ments shall not preclude the applications 
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1 of the previous provisions of this subpara2 graph.’’. 

3 (2) EFFECTIVE DATE.—The amendment made 

4 by paragraph (1) shall take effect on the date of the 

5 enactment of this Act, but shall apply to prescription 

6 drugs dispensed on and after January 1, 2006. 

7 (b) NOTICE FOR CHANGE IN FORMULARY AND

8 OTHER RESTRICTIONS OR LIMITATIONS ON COVERAGE.— 

9 (1) IN GENERAL.—Section 1860D–4(a) of such 

10 Act (42 U.S.C. 1395w–104(a)) is amended by add11 ing at the end the following new paragraph: 

12 ‘‘(5) ANNUAL NOTICE OF CHANGES IN FOR13 MULARY AND OTHER RESTRICTIONS OR LIMITATIONS

14 ON COVERAGE.—Each PDP sponsor offering a pre15 scription drug plan (and each MA organization of16 fering an MA–PD plan) shall furnish to each en17 rollee at the time of each annual coordinated election 

18 period (referred to in section 1860D–1(b)(1)(B)(iii)) 

19 for a plan year a notice of any changes in the for20 mulary or other restrictions or limitations on cov21 erage of a covered part D drug under the plan that 

22 will take effect for the plan year.’’. 

23 (2) EFFECTIVE DATE.—The amendment made 

24 by paragraph (1) shall apply to annual coordinated 
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1 election periods beginning after the date of the en2 actment of this Act. 

3 (c) STANDARDIZED FORMS AND PROCEDURES FOR

4 RECONSIDERATIONS AND APPEALS.— 

5 (1) IN GENERAL.—Section 1860D–4 of such 

6 Act (42 U.S.C. 1395w–104) is amended by adding 

7 at the end the following new subsection: 

8 ‘‘(l) STANDARDIZED FORMS AND PROCEDURES FOR

9 RECONSIDERATIONS AND APPEALS.— 

10 ‘‘(1) STANDARD ENROLLEE NOTICE.—The Sec11 retary shall develop a standard notice to be distrib12 uted by a prescription drug plan (or an MA–PD 

13 plan) to an enrollee when a covered part D drug pre14 scribed for the enrollee is not covered, or the cov15 erage of such drug is otherwise restricted, by the 

16 plan. 

17 ‘‘(2) STANDARDIZED PROCESS FOR RECONSID18 ERATIONS AND APPEALS.—The Secretary shall re19 quire prescription drug plans and MA–PD plans to 

20 follow the same standardized process for reconsider21 ations and redeterminations under subsections (g) 

22 and (h). Such process shall require that determina23 tions regarding medical necessity are based on pro24 fessional medical judgement, the medical condition 
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1 of the enrollee, the treating physician’s recommenda2 tion, and other medical evidence.’’. 

3 (2) EFFECTIVE DATE.—The Secretary of 

4 Health and Human Services shall provide for the 

5 standard notice and the standardized process, and 

6 the application of such notice and process, under the 

7 amendment made by paragraph (1) by not later 

8 than January 1, 2007. 

9 SEC. 3. REQUIRED APPLICATION OF INTERMEDIATE SANC10 TIONS TO PROTECT AGAINST FRAUD AND 

11 ABUSE. 

12 (a) IN GENERAL.—Section 1860D–12(b)(3)(E) of 

13 the Social Security Act (42 U.S.C. 1395w–112(b)(3)(E)) 

14 is amended by inserting ‘‘and the reference to ‘may pro15 vide’ in section 1857(g)(1) is deemed a reference to ‘shall 

16 provide’ ’’ after ‘‘this part’’. 

17 (b) APPLICATION TO MA–PD PLANS.—Section 

18 1857(g)(1) of such Act (42 U.S.C. 1395w–27(g)(1)) is 

19 amended by inserting ‘‘(or in the case of an MA–PD plan 

20 or a prescription drug plan under part D, the Secretary 

21 shall provide)’’ after ‘‘may provide’’. 
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1 SEC. 4. CHANGES OF ENROLLMENT IN PRESCRIPTION 

2 DRUG PLANS AND MA–PD PLANS ALLOWED 

3 TWICE DURING YEAR. 

4 (a) ADDITIONAL ELECTION PERMITTED ONCE EACH

5 YEAR OUTSIDE OF ANNUAL COORDINATED ELECTION

6 PERIOD.—Section 1851(e)(4) of the Social Security Act 

7 (42 U.S.C. 1395w–21(e)(4)) is amended by inserting 

8 ‘‘once every year, and in addition,’’ after ‘‘make a new 

9 election under this section’’. 

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

11 subsection (a) shall take effect as of the date of the enact12 ment of this Act. 

13 SEC. 5. PROHIBITING ADDITIONAL RESTRICTIONS OR LIMI14 TATIONS ON COVERAGE DURING YEAR. 

15 (a) IN GENERAL.—Section 1860D–4(b)(4) of the So16 cial Security Act (42 U.S.C. 1395w–104(b)(4)) is amend17 ed by inserting after subparagraph (F) the following new 

18 subparagraph: 

19 ‘‘(G) PROHIBITING ADDITIONAL RESTRIC20 TIONS OR LIMITATIONS ON COVERAGE DURING

21 YEAR.—A prescription drug plan and an MA– 

22 PD plan may only impose a restriction or limi23 tation on the coverage of a covered part D drug 

24 (such as through the application of a formulary, 

25 preferred status, usage restriction, step therapy, 

26 prior authorization, or a quantity limitation) 
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1 only at the beginning of a plan year, except in 

2 the case that the Commissioner of Food and 

3 Drugs issues a clinical warning during a year 

4 that imposes such a restriction or limitation on 

5 the drug.’’. 

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

7 subsection (a) shall take effect on the date of the enact8 ment of this Act and shall apply to the removal of a drug 

9 or a change in the status of such drug on and after such 

10 date. 

11 SEC. 6. MEDPAC STUDY ON APPROPRIATE ENROLLMENT 

12 OF DUAL ELIGIBLE INDIVIDUALS. 

13 (a) STUDY.—The Medicare Payment Advisory Com14 mission shall conduct a study to determine the extent to 

15 which full-benefit dual eligible individuals (as defined in 

16 section 1935(c)(6) of the Social Security Act (42 U.S.C. 

17 1396u5(c)(6)) were enrolled (by assignment or otherwise) 

18 in the most appropriate prescription drug plans under 

19 part D of title XVIII of such Act for such individuals. 

20 (b) REPORT.—The Commission shall submit a report 

21 to Congress on the study under subsection (a) not later 

22 than February 1, 2007. 
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1 SEC. 7. PROHIBITION ON CONDITIONING MEDICAID ELIGI2 BILITY ON ENROLLMENT IN MEDICARE PART 

3 D COVERAGE OR OTHER CREDITABLE COV4 ERAGE. 

5 (a) IN GENERAL.—Section 1935 of the Social Secu6 rity Act (42 U.S.C. 1396v) is amended by adding at the 

7 end the following new subsection: 

8 ‘‘(f) PROHIBITION ON CONDITIONING MEDICAID ELI9 GIBILITY ON ENROLLMENT IN MEDICARE PART D COV10 ERAGE OR OTHER CREDITABLE COVERAGE.— 

11 ‘‘(1) IN GENERAL.—A State shall not condition 

12 eligibility for medical assistance under the State 

13 plan for a part D eligible individual (as defined in 

14 section 1860D–1(a)(3)(A)) who is enrolled in cred15 itable prescription drug coverage described in any of 

16 subparagraphs (C) through (H) of section 1860D– 

17 13(b)(4) on the individual’s enrollment in a prescrip18 tion drug plan under part D of title XVIII or an 

19 MA–PD plan under part C of such title. 

20 ‘‘(2) COORDINATION OF BENEFITS WITH PART

21 D FOR OTHER INDIVIDUALS.—Nothing in this sub22 section shall be construed as prohibiting a State 

23 from coordinating medical assistance under the 

24 State plan with benefits under part D of title XVIII 

25 for individuals not described in paragraph (1).’’. 
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1 (b) TREATMENT OF STATE PLAN AMENDMENTS, RE2 DETERMINATION OF ELIGIBILITY.—In the case of a State 

3 that, as of the date of the enactment of this Act, has an 

4 approved amendment to its State plan under title XIX of 

5 the Social Security Act with a provision that conflicts with 

6 section 1935(f) of such Act (as added by subsection (a)), 

7 such provision is, as of such date of enactment, null and 

8 void. The State shall redetermine any applications for 

9 medical assistance that have been denied solely on the 

10 basis of such a State plan amendment not later than De11 cember 31, 2006. Such redetermination shall be effective 

12 as of the date of the individual’s application for medical 

13 assistance. 

14 SEC. 8. REIMBURSEMENT OF THIRD PARTIES FOR 2006 

15 TRANSITION COSTS. 

16 (a) REIMBURSEMENT.— 

17 (1) IN GENERAL.—Notwithstanding section 

18 1935(d) of the Social Security Act (42 U.S.C. 

19 1396u–5(d) or any other provision of law, the Sec20 retary of Health and Human Services shall reim21 burse covered third parties for 100 percent of the 

22 costs incurred by the covered third party during 

23 2006 for covered part D drugs for part D eligible in24 dividuals who are enrolled in a prescription drug 

25 plan under part D of title XVIII of such Act (or an 
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1 MA–PD plan under part C of such title) which the 

2 individual reasonably expected would have been cov3 ered under such part but were not because the indi4 vidual was unable to access on a timely basis pre5 scription drug benefits to which the individual was 

6 entitled under such part. Such payments shall be 

7 made from the Medicare Prescription Drug Account 

8 under section 1860D–16 of the Social Security Act 

9 (42 U.S.C. 1395w–116) and shall be deemed to be 

10 payments from such Account under subsection (b) of 

11 such section. The provisions of clauses (ii) through 

12 (iv) of subparagraph (F) of paragraph (4) of section 

13 1860D–4(b) of the Social Security Act, as added by 

14 section 2(a), shall apply under this paragraph in the 

15 same manner as they apply under such paragraph 

16 (4). 

17 (2) SANCTIONS FOR FRAUDULENT CLAIMS.— 

18 The provisions of subclause (II) of section 1860D– 

19 4(b)(4)(C)(i) of the Social Security Act, as added by 

20 section 2(a), shall apply to a covered third party 

21 with respect to a claim for reimbursement under 

22 paragraph (1) in the same manner that such provi23 sions apply to a pharmacy in connection with a 

24 claim for reimbursement under subclause (I) of such 

25 section 1860D–4(b)(4)(C)(i). 
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1 (3) RETROACTIVE APPLICATION TO BEGINNING

2 OF 2006.—The costs incurred by a third party which 

3 may be reimbursed under paragraph (1) shall in4 clude costs incurred during the period beginning on 

5 January 1, 2006, and before the date of enactment 

6 of this Act. 

7 (b) RECOVERY OF COSTS FROM PLANS BY SEC8 RETARY.—The Secretary of Health and Human Services 

9 shall establish a process for recovering the costs described 

10 in subsection (a)(1) from prescription drug plans and 

11 MA–PD plans if the Secretary determines that such plans 

12 should have incurred such costs. Amounts recovered pur13 suant to the preceding sentence shall be deposited in the 

14 Medicare Prescription Drug Account described in sub15 section (a)(1). 

16 (c) DEFINITIONS.—For purposes of this section: 

17 (1) COVERED PART D DRUG.—The term ‘‘cov18 ered part D drug’’ has the meaning given such term 

19 under section 1860D–2(e) of the Social Security Act 

20 (42 U.S.C. 1395w–102(e)). 

21 (2) COVERED THIRD PARTY.—The term ‘‘cov22 ered third party’’ means any individual or party 

23 (such as a State, charity, or family member of the 

24 part D eligible individual involved) other than a 

25 party that is obligated under part D of title XVIII 
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1 of the Social Security Act to incur the costs in2 volved. Such term shall not include a pharmaceutical 

3 company or an assistance program sponsored or as4 sisted (in whole or in part) by such company. 

5 (3) MA–PD PLAN.—The term ‘‘MA–PD plan’’ 

6 has the meaning given such term under section 

7 1860D–41(a)(14) of the Social Security Act (42 

8 U.S.C. 1395w–151(a)(14)). 

9 (4) PART D ELIGIBLE INDIVIDUAL.—The term 

10 ‘‘part D eligible individual’’ has the meaning given 

11 such term under section 1860D–1(a)(3)(A) of the 

12 Social Security Act (42 U.S.C. 1394w– 

13 101(a)(3)(A)). 

14 (5) PRESCRIPTION DRUG PLAN.—The term 

15 ‘‘prescription drug plan’’ has the meaning given 

16 such term under section 1860D–1(a)(3)(C) of the 

17 Social Security Act (42 U.S.C. 1394w– 

18 101(a)(3)(C)). 

19 (6) STATE.—The term ‘‘State’’ includes the 

20 District of Columbia. 

Æ