II 

111TH CONGRESS 

1ST SESSION S. 1201 

To amend title XVIII of the Social Security Act to include costs incurred 

by the Indian Health Service, a federally qualified health center, an 

AIDS drug assistance program, certain hospitals, or a pharmaceutical 

manufacturer patient assistance program in providing prescription drugs 

toward the annual out-of-pocket threshold under part D of the Medicare 

program. 

IN THE SENATE OF THE UNITED STATES 

JUNE 8, 2009 

Mr. BINGAMAN (for himself, Mr. BEGICH, and Ms. STABENOW) 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 include 

costs incurred by the Indian Health Service, a federally 

qualified health center, an AIDS drug assistance program, certain hospitals, or a pharmaceutical manufacturer patient assistance program in providing prescription drugs toward the annual out-of-pocket threshold 

under part D of the Medicare 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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•S 1201 IS

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Helping Fill the Medi3 care Rx Gap Act of 2009’’. 

4 SEC. 2. INCLUDING COSTS INCURRED BY THE INDIAN 

5 HEALTH SERVICE, A FEDERALLY QUALIFIED 

6 HEALTH CENTER, AN AIDS DRUG ASSISTANCE 

7 PROGRAM, CERTAIN HOSPITALS, OR A PHAR8 MACEUTICAL MANUFACTURER PATIENT AS9 SISTANCE PROGRAM IN PROVIDING PRE10 SCRIPTION DRUGS TOWARD THE ANNUAL 

11 OUT-OF-POCKET THRESHOLD UNDER PART D. 

12 (a) IN GENERAL.—Section 1860D–2(b)(4)(C) of the 

13 Social Security Act (42 U.S.C. 1395w–102(b)(4)(C)) is 

14 amended— 

15 (1) in clause (i), by striking ‘‘and’’ at the end; 

16 (2) in clause (ii)— 

17 (A) by striking ‘‘such costs shall be treated 

18 as incurred only if’’ and inserting ‘‘subject to 

19 clause (iii), such costs shall be treated as in20 curred if’’; 

21 (B) by striking ‘‘, under section 1860D– 

22 14, or under a State Pharmaceutical Assistance 

23 Program’’; 

24 (C) by striking ‘‘(other than under such 

25 section or such a Program)’’; and 

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•S 1201 IS

1 (D) by striking the period at the end and 

2 inserting ‘‘; and’’; and 

3 (3) by inserting after clause (ii) the following 

4 new clause: 

5 ‘‘(iii) such costs shall be treated as in6 curred and shall not be considered to be 

7 reimbursed under clause (ii) if such costs 

8 are borne or paid— 

9 ‘‘(I) under section 1860D–14; 

10 ‘‘(II) under a State Pharma11 ceutical Assistance Program; 

12 ‘‘(III) by the Indian Health Serv13 ice, an Indian tribe or tribal organiza14 tion, or an urban Indian organization 

15 (as defined in section 4 of the Indian 

16 Health Care Improvement Act); 

17 ‘‘(IV) by a federally qualified 

18 health center (as defined in section 

19 1861(aa)(4)); 

20 ‘‘(V) under an AIDS Drug As21 sistance Program under part B of 

22 title XXVI of the Public Health Serv23 ice Act; 

24 ‘‘(VI) by a subsection (d) hos25 pital (as defined in section 

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•S 1201 IS

1 1886(d)(1)(B)) that meets the re2 quirements of clauses (i) and (ii) of 

3 section 340B(a)(4)(L) of the Public 

4 Health Service Act; or 

5 ‘‘(VII) by a pharmaceutical man6 ufacturer patient assistance program, 

7 either directly or through the distribu8 tion or donation of covered part D 

9 drugs, which shall be valued at the 

10 negotiated price of such covered part 

11 D drug under the enrollee’s prescrip12 tion drug plan or MA–PD plan as of 

13 the date that the drug was distributed 

14 or donated.’’. 

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

16 subsection (a) shall apply to costs incurred on or after 

17 January 1, 2010. 

Æ 

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