I 

109TH CONGRESS 

2D SESSION H. R. 4665 

To amend title XIX of the Social Security Act to provide for an offset 

from the Medicaid clawback for State emergency prescription drug expenditures for Medicare dual-eligible individuals. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 31, 2006 

Mr. CARDIN (for himself, Ms. PELOSI, Mr. HOYER, Mr. RANGEL, Mr. STARK, 

Mr. WAXMAN, Mr. GEORGE MILLER of California, Ms. HOOLEY, Mrs. 

CAPPS, Mr. WEXLER, Ms. NORTON, Mr. THOMPSON of California, Mr. 

ROSS, Mr. DAVIS of Florida, Ms. MATSUI, Ms. WOOLSEY, Mr. SANDERS, 

Mr. MCDERMOTT, Ms. ESHOO, Ms. HARMAN, Mr. GUTIERREZ, Mr. 

HASTINGS of Florida, Mr. NADLER, Mr. ENGEL, Mr. VAN HOLLEN, Mrs. 

MALONEY, Ms. MOORE of Wisconsin, Mr. KANJORSKI, Mr. HIGGINS, Mr. 

JEFFERSON, Mr. BISHOP of New York, Mr. DELAHUNT, Ms. BALDWIN, 

Mr. HINCHEY, Mr. GRIJALVA, Ms. LEE, Mr. DEFAZIO, Mr. LANTOS, Mr. 

DOYLE, Ms. DEGETTE, Mr. FARR, Mr. MCGOVERN, Mr. ORTIZ, Ms. ZOE

LOFGREN of California, Mr. KILDEE, Mr. WYNN, Mr. CLEAVER, Mr. 

KENNEDY of Rhode Island, Mr. PAYNE, Mr. FILNER, Mr. MICHAUD, Mr. 

RUPPERSBERGER, Mr. FORD, Mr. CUMMINGS, Mr. CROWLEY, Mr. 

HONDA, Mr. BERRY, Mr. FRANK of Massachusetts, Ms. SCHAKOWSKY, 

and Mr. PRICE of North Carolina) 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 title XIX of the Social Security Act to provide 

for an offset from the Medicaid clawback for State emergency prescription drug expenditures for Medicare dualeligible individuals. 
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. FEDERAL RESPONSIBILITY FOR STATE EMER4 GENCY PRESCRIPTION DRUG EXPENDITURES 

5 FOR MEDICARE DUAL-ELIGIBLE INDIVID6 UALS. 

7 Section 1935(c) of the Social Security Act (42 U.S.C. 

8 1396v–5(c)) is amended— 

9 (1) in paragraph (1)(A), by striking ‘‘Each of 

10 the 50 States’’ and inserting ‘‘Subject to paragraph 

11 (7), each of the 50 States’’; and 

12 (2) by adding at the end the following new 

13 paragraph: 

14 ‘‘(7) OFFSET FOR EMERGENCY STATE PRE15 SCRIPTION DRUG EXPENDITURES.— 

16 ‘‘(A) IN GENERAL.—The amount of pay17 ment for a month (beginning with January 

18 2006 and ending with December 2007) under 

19 paragraph (1) shall be reduced by the amount 

20 (as documented by the State) that the State ex21 pended during the month for payment for part 

22 D covered drugs for part D eligible individuals 

23 who are entitled to benefits under the State 

24 plan (whether as full-benefit dual eligible indi25 viduals, qualified medicare beneficiaries, or oth-
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1 erwise) and who are enrolled in a prescription 

2 drug plan under part D of title XVIII, but were 

3 unable to access on a timely basis prescription 

4 drug benefits to which they were entitled under 

5 such prescription drug plan. 

6 ‘‘(B) RECOVERY OF AMOUNT OF OFFSET

7 FROM PRESCRIPTION DRUG PLANS.—The Sec8 retary shall provide for recovery of payment re9 ductions made under subparagraph (A) from 

10 those prescription drug plans under part D of 

11 title XVIII or MA–PD plans under part C of 

12 such title that would otherwise be responsible 

13 for the expenditures described in such subpara14 graph. Any such amounts recovered shall be de15 posited into the Medicare Prescription Drug Ac16 count in the Federal Supplementary Medical 

17 Insurance Trust Fund.’’. 

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