I 

113TH CONGRESS 

1ST SESSION H. R. 1024 

To amend title XVIII of the Social Security Act to provide part D eligible 

individuals with single chronic diseases access to services under medication therapy management programs under the Medicare part D prescription drug program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 7, 2013 

Mrs. MCMORRIS RODGERS 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 

part D eligible individuals with single chronic diseases 

access to services under medication therapy management 

programs under the Medicare part D 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 ‘‘Medication Therapy 

5 Management Empowerment Act of 2013’’. 


tjames on DSK6SPTVN1PROD with BILLS
2 

•HR 1024 IH

1 SEC. 2. ACCESS TO SERVICES UNDER MEDICATION THER2 APY MANAGEMENT PROGRAMS FOR MEDI3 CARE PART D ELIGIBLE INDIVIDUALS WITH 

4 SINGLE CHRONIC DISEASES. 

5 Section 1860D–4(c)(2)(A) of the Social Security Act 

6 (42 U.S.C. 1395w–104(c)(2)(A)) is amended— 

7 (1) in clause (ii), by striking subclause (I) and 

8 inserting the following: 

9 ‘‘(I) have— 

10 ‘‘(aa) multiple chronic dis11 eases (such as diabetes, asthma, 

12 hypertension, hyperlipidemia, and 

13 congestive heart failure); or 

14 ‘‘(bb) subject to clause (iii), 

15 any single chronic disease, in16 cluding diabetes, hypertension, 

17 heart failure, dyslipidemia, res18 piratory disease (such as asthma, 

19 chronic obstructive pulmonary 

20 disease or chronic lung disorder), 

21 bone disease-arthritis (such as 

22 osteoporosis or osteoarthritis), 

23 rheumatoid arthritis, or mental 

24 health disorder (such as depres25 sion, schizophrenia, or bipolar 

26 disorder).’’; and 


tjames on DSK6SPTVN1PROD with BILLS
3 

•HR 1024 IH

1 (2) by adding at the end the following: 

2 ‘‘(iii) DETERMINATIONS RELATING TO

3 PROGRAM COSTS FOR INCLUDING INDIVID4 UALS WITH SINGLE CHRONIC DISEASES.— 

5 ‘‘(I) INITIAL DETERMINA6 TIONS.—With regard to any single 

7 chronic disease, clause (ii)(I)(bb) shall 

8 only be applied if the Chief Actuary 

9 for the Centers for Medicare & Med10 icaid Services determines that the ap11 plication of such clause with regard to 

12 such disease is not projected to in13 crease overall costs to the Medicare 

14 program under this title over the five 

15 year period beginning on the date of 

16 determination. 

17 ‘‘(II) REVIEW OF DETERMINA18 TIONS.—In the case that clause 

19 (ii)(I)(bb) is applied with respect to a 

20 single chronic disease pursuant to a 

21 determination under subclause (I), not 

22 later than five years after such date of 

23 determination, the Chief Actuary for 

24 the Centers for Medicare & Medicaid 

25 Services shall review the effect of the 


tjames on DSK6SPTVN1PROD with BILLS
4 

•HR 1024 IH

1 application of such clause with respect 

2 to such disease on the actual cost of 

3 the Medicare program under this title 

4 during such five years. Based on such 

5 review, if the Chief Actuary is unable 

6 to determine that, with regard to such 

7 single chronic disease, the application 

8 of such clause did not increase costs 

9 to the Federal government under the 

10 Medicare program under this title 

11 over such period, then the Secretary 

12 shall review the findings of the Chief 

13 Actuary and determine whether such 

14 clause shall continue to be applied 

15 with regard to such single chronic dis16 ease. In conducting such review and 

17 making such determination, the Sec18 retary shall consider the extent to 

19 which the application of such clause 

20 with regard to such single chronic dis21 ease effects the health outcomes of 

22 part D eligible individuals and any 

23 savings and costs to the Federal govVerDate Mar 15 2010 02:14 Mar 09, 2013 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1024.IH H1024

tjames on DSK6SPTVN1PROD with BILLS
5 

•HR 1024 IH

1 ernment under the Medicare program 

2 under this title.’’. 

Æ 


tjames on DSK6SPTVN1PROD with BILLS