I 

116TH CONGRESS 

1ST SESSION H. R. 4669 

To amend title XVIII of the Social Security Act to provide for intelligent 

assignment of certain subsidy eligible individuals auto-enrolled under 

Medicare prescription drug plans and MA–PD plans. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 11, 2019 

Ms. STEVENS (for herself, Mrs. HAYES, Ms. KUSTER of New Hampshire, and 

Ms. SEWELL of Alabama) 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 XVIII of the Social Security Act to provide 

for intelligent assignment of certain subsidy eligible individuals auto-enrolled under Medicare prescription drug 

plans and MA–PD plans. 

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 ‘‘Maximizing Drug Cov5 erage for Low-Income Seniors Act of 2019’’. 


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1 SEC. 2. PROVIDING FOR INTELLIGENT ASSIGNMENT OF 

2 CERTAIN SUBSIDY ELIGIBLE INDIVIDUALS 

3 AUTO-ENROLLED UNDER MEDICARE PRE4 SCRIPTION DRUG PLANS AND MA–PD PLANS. 

5 (a) IN GENERAL.—Section 1860D–1(b)(1) of the So6 cial Security Act (42 U.S.C. 1395w–101(b)(1)) is amend7 ed— 

8 (1) in subparagraph (C)— 

9 (A) by inserting after ‘‘PDP region’’ the 

10 following: ‘‘or through use of an intelligent as11 signment process that is designed to maximize 

12 the access of such individual to necessary pre13 scription drugs while minimizing costs to such 

14 individual and to the program under this part 

15 to the greatest extent possible. In the case the 

16 Secretary enrolls such individuals through use 

17 of an intelligent assignment process, such proc18 ess shall take into account the extent to which 

19 prescription drugs necessary for the individual 

20 are covered in the case of a PDP sponsor of a 

21 prescription drug plan that uses a formulary, 

22 the use of prior authorization or other restric23 tions on access to coverage of such prescription 

24 drugs by such a sponsor, and the overall quality 

25 of a prescription drug plan as measured by 


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1 quality ratings established by the Secretary’’; 

2 and 

3 (B) by striking ‘‘Nothing in the previous 

4 sentence’’ and inserting ‘‘Nothing in this sub5 paragraph’’; and 

6 (2) in subparagraph (D)— 

7 (A) by inserting after ‘‘PDP region’’ the 

8 following: ‘‘or through use of an intelligent as9 signment process that is designed to maximize 

10 the access of such individual to necessary pre11 scription drugs while minimizing costs to such 

12 individual and to the program under this part 

13 to the greatest extent possible. In the case the 

14 Secretary enrolls such individuals through use 

15 of an intelligent assignment process, such proc16 ess shall take into account the extent to which 

17 prescription drugs necessary for the individual 

18 are covered in the case of a PDP sponsor of a 

19 prescription drug plan that uses a formulary, 

20 the use of prior authorization or other restric21 tions on access to coverage of such prescription 

22 drugs by such a sponsor, and the overall quality 

23 of a prescription drug plan as measured by 

24 quality ratings established by the Secretary’’; 

25 and 


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1 (B) by striking ‘‘Nothing in the previous 

2 sentence’’ and inserting ‘‘Nothing in this sub3 paragraph’’. 

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

5 subsection (a) shall apply with respect to plan years begin6 ning with plan year 2022. 

Æ 


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