I

107TH CONGRESS

1ST SESSION H. R. 121

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

under the Medicare Program of oral drugs to treat low blood calcium

levels or elevated parathyroid hormone levels for patients with end stage

renal disease.

IN THE HOUSE OF REPRESENTATIVES

JANUARY 3, 2001

Mr. HOLT introduced the following bill; which was referred to the Committee

on Ways and Means, and in addition to the Committee on Energy and

Commerce, 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 coverage under the Medicare Program of oral drugs

to treat low blood calcium levels or elevated parathyroid

hormone levels for patients with end stage renal disease.

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 ‘‘Medicare Coverage of

5 Replacement Calcitriol Act of 2001’’.
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1 SEC. 2. MEDICARE COVERAGE OF ORAL DRUGS USED TO

2 TREAT LOW BLOOD CALCIUM LEVELS OR

3 ELEVATED PARATHYROID HORMONE LEVELS

4 FOR END STAGE RENAL DISEASE PATIENTS.

5 (a) COVERAGE.—Section 1861(s)(2) of the Social Se6 curity Act (42 U.S.C. 1395x(s)(2)), as amended by sec7 tions 102(a) and 105(a) of the Medicare, Medicaid, and

8 SCHIP Benefits Improvement and Protection Act of 2000

9 (as enacted into law by section 1(a)(6) of Public Law 106–

10 554), is amended—

11 (1) in subparagraph (U), by striking ‘‘and’’ at

12 the end;

13 (2) in subparagraph (V), by inserting ‘‘and’’ at

14 the end; and

15 (3) by inserting after subparagraph (V) the fol16 lowing new subparagraph:

17 ‘‘(W) an oral drug (which is approved by the

18 Food and Drug Administration) that—

19 ‘‘(i) is prescribed for use in the treatment

20 of low blood calcium levels or elevated parathy21 roid hormone levels in patients medically deter22 mined to have end stage renal disease;

23 ‘‘(ii) is a full replacement for such treat24 ment which would otherwise be administered in25 travenously; and
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1 ‘‘(iii) the Secretary determines results in

2 overall cost savings for such treatment which

3 would otherwise be administered intra4 venously;’’.

5 (b) INTERIM PAYMENT PENDING PUBLICATION OF

6 FINAL RULE.—For the period beginning 30 days after the

7 date of the enactment of this Act and ending on the date

8 the Secretary of Health and Human Services publishes a

9 final regulation to carry out section 1861(s)(2)(W) of the

10 Social Security Act, as added by subsection (a)—

11 (1) oral drugs furnished under such section are

12 deemed to result in the overall cost savings described

13 in clause (iii) of such section, and

14 (2) the Secretary shall provide for payment for

15 oral drugs furnished under such section during such

16 period, and assign such temporary HCPCS code as

17 is necessary to provide for such payment.

18 (c) EFFECTIVE DATE.—The amendments made by

19 subsection (a) shall apply to oral drugs furnished on or

20 after the date of the enactment of this Act.

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