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[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 137 Introduced in Senate (IS)]

110th CONGRESS
  1st Session
                                 S. 137

 To amend title XVIII of the Social Security Act to provide additional 
                        beneficiary protections.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            January 4, 2007

  Mr. Cardin 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 provide additional 
                        beneficiary protections.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Preserving 
Medicare for All Act of 2007''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Negotiation of prices for medicare prescription drugs.
Sec. 3. Guaranteed prescription drug benefits.
Sec. 4. Full reimbursement for qualified retiree prescription drug 
                            plans.
Sec. 5. Repeal of comparative cost adjustment (cca) program.
Sec. 6. Repeal of MA Regional Plan Stabilization Fund.
Sec. 7. Repeal of cost containment provisions.
Sec. 8. Removal of exclusion of benzodiazepines from required coverage 
                            under the Medicare prescription drug 
                            program.

SEC. 2. NEGOTIATION OF PRICES FOR MEDICARE PRESCRIPTION DRUGS.

    Section 1860D-11 of the Social Security Act (42 U.S.C. 1395w-111) 
is amended by striking subsection (i) (relating to noninterference) and 
inserting the following:
    ``(i) Negotiation; No National Formulary or Price Structure.--
            ``(1) Negotiation of prices with manufacturers.--In order 
        to ensure that beneficiaries enrolled under prescription drug 
        plans and MA-PD plans pay the lowest possible price, the 
        Secretary shall have and exercise authority similar to that of 
        other Federal entities that purchase prescription drugs in bulk 
        to negotiate contracts with manufacturers of covered part D 
        drugs, consistent with the requirements and in furtherance of 
        the goals of providing quality care and containing costs under 
        this part.
            ``(2) No national formulary or price structure.--In order 
        to promote competition under this part and in carrying out this 
        part, the Secretary may not require a particular formulary or 
        institute a price structure for the reimbursement of covered 
        part D drugs.''.

SEC. 3. GUARANTEED PRESCRIPTION DRUG BENEFITS.

    (a) In General.--Section 1860D-3 of the Social Security Act (42 
U.S.C. 1395w-103) is amended to read as follows:

      ``access to a choice of qualified prescription drug coverage

    ``Sec. 1860D-3.  (a) Assuring Access to a Choice of Coverage.--
            ``(1) Choice of at least three plans in each area.--
        Beginning on January 1, 2008, the Secretary shall ensure that 
        each part D eligible individual has available, consistent with 
        paragraph (2), a choice of enrollment in--
                    ``(A) a nationwide prescription drug plan offered 
                by the Secretary in accordance with subsection (b); and
                    ``(B) at least 2 qualifying plans (as defined in 
                paragraph (3)) in the area in which the individual 
                resides, at least one of which is a prescription drug 
                plan.
            ``(2) Requirement for different plan sponsors.--The 
        requirement in paragraph (1)(B) is not satisfied with respect 
        to an area if only one entity offers all the qualifying plans 
        in the area.
            ``(3) Qualifying plan defined.--For purposes of this 
        section, the term `qualifying plan' means--
                    ``(A) a prescription drug plan;
                    ``(B) an MA-PD plan described in section 
                1851(a)(2)(A)(i) that provides--
                            ``(i) basic prescription drug coverage; or
                            ``(ii) qualified prescription drug coverage 
                        that provides supplemental prescription drug 
                        coverage so long as there is no MA monthly 
                        supplemental beneficiary premium applied under 
                        the plan, due to the application of a credit 
                        against such premium of a rebate under section 
                        1854(b)(1)(C); or
                    ``(C) a nationwide prescription drug plan offered 
                by the Secretary in accordance with subsection (b).
    ``(b) HHS as PDP Sponsor for a Nationwide Prescription Drug Plan.--
            ``(1) In general.--The Secretary, acting through the 
        Administrator of the Centers for Medicare & Medicaid Services, 
        shall take such steps as may be necessary to qualify and serve 
        as a PDP sponsor and to offer a prescription drug plan that 
        offers basic prescription drug coverage throughout the United 
        States. Such a plan shall be in addition to, and not in lieu 
        of, other prescription drug plans offered under this part.
            ``(2) Premium; solvency; authorities.--In carrying out 
        paragraph (1), the Secretary--
                    ``(A) shall establish a premium in the amount of 
                $35 for months in 2008 and, for months in subsequent 
                years, in the amount specified in this paragraph for 
                months in the previous year increased by the annual 
                percentage increase described in section 1860D-2(b)(6) 
                (relating to growth in medicare prescription drug costs 
                per beneficiary) for the year involved;
                    ``(B) is deemed to have met any applicable solvency 
                and capital adequacy standards; and
                    ``(C) shall exercise such authorities (including 
                the use of regional or other pharmaceutical benefit 
                managers) as the Secretary determines necessary to 
                offer the prescription drug plan in the same or a 
                comparable manner as is the case for prescription drug 
                plans offered by private PDP sponsors.
    ``(c) Flexibility in Risk Assumed.--In order to ensure access 
pursuant to subsection (a) in an area the Secretary may approve limited 
risk plans under section 1860D-11(f) for the area.''.
    (b) Conforming Amendment.--Section 1860D-11(g) of the Social 
Security Act (42 U.S.C. 1395w-111(g)) is amended by adding at the end 
the following new paragraph:
            ``(8) Application.--This subsection shall not apply on or 
        after January 1, 2008.''.

SEC. 4. FULL REIMBURSEMENT FOR QUALIFIED RETIREE PRESCRIPTION DRUG 
              PLANS.

    (a) Elimination of True Out-of-Pocket Limitation.--Section 1860D-
2(b)(4)(C)(ii) of the Social Security Act (42 U.S.C. 1395w-
102(b)(4)(C)(ii) is amended--
            (1) by inserting ``under a qualified retiree prescription 
        drug plan (as defined in section 1860D-22(a)(2)),'' after 
        ``under section 1860D-14,''; and
            (2) by inserting ``, under such a qualified retiree 
        prescription drug plan,'' after ``(other than under such 
        section''.
    (b) Equalization of Subsidies.--Notwithstanding any other provision 
of law, the Secretary of Health and Human Services shall provide for 
such increase in the special subsidy payment amounts under section 
1860D-22(a)(3) of the Social Security Act (42 U.S.C. 1395w-132(a)(3)) 
as may be appropriate to provide for payments in the aggregate 
equivalent to the payments that would have been made under section 
1860D-15 of such Act (42 U.S.C. 1395w-115) if the individuals were not 
enrolled in a qualified retiree prescription drug plan. In making such 
computation, the Secretary shall not take into account the application 
of the amendments made by section 1202 of the Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 
117 Stat. 2480).
    (c) Effective Date.--This section, and the amendments made by this 
section, shall take effect on January 1, 2008.

SEC. 5. REPEAL OF COMPARATIVE COST ADJUSTMENT (CCA) PROGRAM.

    Subtitle E of title II of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 
Stat. 2214), and the amendments made by such subtitle, are repealed.

SEC. 6. REPEAL OF MA REGIONAL PLAN STABILIZATION FUND.

    (a) In General.--Subsection (e) of section 1858 of the Social 
Security Act (42 U.S.C. 1395w-27a) is repealed.
    (b) Conforming Amendment.--Section 1858(f)(1) of the Social 
Security Act (42 U.S.C. 1395w-27a(f)(1)) is amended by striking 
``subject to subsection (e),''.

SEC. 7. REPEAL OF COST CONTAINMENT PROVISIONS.

    Subtitle A of title VIII of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 
Stat. 2357) is repealed and any provisions of law amended by such 
subtitle are restored as if such subtitle had not been enacted.

SEC. 8. REMOVAL OF EXCLUSION OF BENZODIAZEPINES FROM REQUIRED COVERAGE 
              UNDER THE MEDICARE PRESCRIPTION DRUG PROGRAM.

    (a) Removal of Exclusion.--
            (1) In general.--Section 1860D-2(e)(2) of the Social 
        Security Act (42 U.S.C. 1395w-102(e)(2)) is amended--
                    (A) by striking ``subparagraph (E)'' and inserting 
                ``subparagraphs (E) and (J)''; and
                    (B) by inserting ``and benzodiazepines'' after 
                ``smoking cessation agents''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply to prescriptions dispensed on or after January 1, 
        2008.
    (b) Review of Benzodiazepine Prescription Policies to Assure 
Appropriateness and to Avoid Abuse.--The Secretary of Health and Human 
Services shall review the policies of Medicare prescription drug plans 
(and MA-PD plans) under parts C and D of title XVIII of the Social 
Security Act regarding the filling of prescriptions for benzodiazepine 
to ensure that these policies are consistent with accepted clinical 
guidelines, are appropriate to individual health histories, and are 
designed to minimize long term use, guard against over-prescribing, and 
prevent patient abuse.
    (c) Development by Medicare Quality Improvement Organizations of 
Educational Guidelines for Physicians Regarding Prescribing of 
Benzodiazepines.--The Secretary of Health and Human Services shall 
provide, in contracts entered into with Medicare quality improvement 
organizations under part B of title XI of the Social Security Act, for 
the development by such organizations of appropriate educational 
guidelines for physicians regarding the prescribing of benzodiazepines.
                                 <all>
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