II 

109TH CONGRESS 

1ST SESSION S. 614 

To amend title 38, United States Code, to permit medicare-eligible veterans 

to receive an out-patient medication benefit, to provide that certain 

veterans who receive such benefit are not otherwise eligible for medical 

care and services from the Department of Veterans Affairs, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 14, 2005 

Mr. SPECTER introduced the following bill; which was read twice and referred 

to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to permit medicareeligible veterans to receive an out-patient medication benefit, to provide that certain veterans who receive such 

benefit are not otherwise eligible for medical care and 

services from the Department of Veterans Affairs, and 

for other purposes. 

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 ‘‘Veterans Prescription 

5 Drugs Assistance Act’’. 
2 

•S 614 IS 

1 SEC. 2. ELIGIBILITY OF MEDICARE-ELIGIBLE VETERANS 

2 FOR OUT-PATIENT MEDICATION BENEFIT. 

3 (a) RESTATEMENT OF CURRENT LAW ON DRUGS

4 AND MEDICATIONS AND PROVISION OF OUT-PATIENT

5 MEDICATION BENEFIT.—Chapter 17 of title 38, United 

6 States Code, is amended by inserting after section 1710B 

7 the following new section: 

8 ‘‘§ 1710C. Drugs and medications; vaccines 

9 ‘‘(a)(1) The Secretary shall furnish to each veteran 

10 who is receiving additional compensation or allowance 

11 under chapter 11 of this title, or increased pension as a 

12 veteran of a period of war, by reason of being permanently 

13 housebound or in need of regular aid and attendance, such 

14 drugs and medicines as may be ordered on prescription 

15 of a duly licensed physician as specific therapy in the 

16 treatment of any illness or injury suffered by such veteran. 

17 ‘‘(2) The Secretary shall continue to furnish such 

18 drugs and medicines ordered under paragraph (1) to any 

19 such veteran in need of regular aid and attendance whose 

20 pension payments have been discontinued solely because 

21 such veteran’s annual income is greater than the applica22 ble maximum annual income limitation, but only so long 

23 as such veteran’s annual income does not exceed such 

24 maximum annual income limitation by more than $1,000. 

25 ‘‘(b)(1) Any medicare-eligible veteran may elect to be 

26 furnished by the Secretary, on an out-patient basis, such 
3 

•S 614 IS 

1 drugs and medicines as may be ordered on prescription 

2 of a duly licensed physician as specific therapy in the 

3 treatment of any illness or injury suffered by such veteran. 

4 ‘‘(2) In this subsection, the term ‘medicare-eligible 

5 veteran’ means any veteran who— 

6 ‘‘(A) is entitled to or enrolled in hospital insur7 ance benefits under part A of title XVIII of the So8 cial Security Act (42 U.S.C. 1395 et seq.); or 

9 ‘‘(B) is enrolled in the supplementary medical 

10 insurance program under part B of such title (42 

11 U.S.C. 1395j et seq.). 

12 ‘‘(3) The Secretary shall furnish to any veteran who 

13 makes an election under paragraph (1), on an out-patient 

14 basis, such drugs and medicines as may be ordered on pre15 scription of a duly licensed physician as specific therapy 

16 in the treatment of any illness or injury suffered by such 

17 veteran. 

18 ‘‘(4)(A) Notwithstanding any other provision of law 

19 and except as provided in subparagraph (B), a veteran 

20 who makes an election under paragraph (1) shall not be 

21 eligible for care and services under this chapter during the 

22 year covered by the election. 

23 ‘‘(B) Subparagraph (A) shall not apply with respect 

24 to any veteran who has a compensable service-connected 

25 disability. 
4 

•S 614 IS 

1 ‘‘(5) The furnishing of drugs and medicines under 

2 this subsection shall be subject to the provisions of section 

3 1722A(b) of this title. 

4 ‘‘(6)(A) An election under paragraph (1) shall be for 

5 a calendar year, and shall be irrevocable for the year cov6 ered by such election. An election may be renewed. 

7 ‘‘(B) The Secretary shall prescribe the form, manner, 

8 and timing of an election. 

9 ‘‘(7) Before permitting a veteran to make an election 

10 under paragraph (1), the Secretary shall provide the vet11 eran such educational materials and other information on 

12 the furnishing and receipt of drugs and medicines under 

13 this subsection as the Secretary considers appropriate to 

14 inform the veteran of the benefits and costs of being fur15 nished drugs and medicines under this subsection, includ16 ing materials and information on the consequences of 

17 making an election under paragraph (1) and on the fees, 

18 copayments, or other amounts required under section 

19 1722A(b) of this title for drugs and medicines furnished 

20 under this subsection. 

21 ‘‘(c)(1) In order to assist the Secretary of Health and 

22 Human Services in carrying out national immunization 

23 programs under other provisions of law, the Secretary may 

24 authorize the administration of immunizations to eligible 

25 veterans who voluntarily request such immunizations in 
5 

•S 614 IS 

1 connection with the provision of care for a disability under 

2 this chapter in any Department health care facility. 

3 ‘‘(2) Any immunization under paragraph (1) shall be 

4 made using vaccine furnished by the Secretary of Health 

5 and Human Services at no cost to the Department. For 

6 such purpose, notwithstanding any other provision of law, 

7 the Secretary of Health and Human Services may provide 

8 such vaccine to the Department at no cost. 

9 ‘‘(3) Section 7316 of this title shall apply to claims 

10 alleging negligence or malpractice on the part of Depart11 ment personnel granted immunity under such section.’’. 

12 (b) COPAYMENT REQUIREMENTS.— 

13 (1) IN GENERAL.—Section 1722A of such title 

14 is amended— 

15 (A) in subsection (a)(1), by inserting 

16 ‘‘(other than a veteran covered by subsection 

17 (b))’’ after ‘‘require a veteran’’; 

18 (B) by redesignating subsections (b), (c), 

19 and (d), as subsections (c), (d), and (e), respec20 tively; 

21 (C) by inserting after subsection (a) the 

22 following new subsection (b): 

23 ‘‘(b)(1) In the case of a veteran who is furnished 

24 medications on an out-patient basis under section 

25 1710C(b) of this title, the Secretary shall require the vet-
6 

•S 614 IS 

1 eran to pay, at the election of the Secretary, one or more 

2 of the following: 

3 ‘‘(A) An annual enrollment fee in an amount 

4 determined appropriate by the Secretary. 

5 ‘‘(B) A copayment for each 30-day supply of 

6 such medications in an amount determined appro7 priate by the Secretary. 

8 ‘‘(C) An amount equal to the cost to the Sec9 retary of such medications, as determined by the 

10 Secretary. 

11 ‘‘(2)(A) In determining the amounts to be paid by 

12 a veteran under paragraph (1), and the basis of payment 

13 under one or more subparagraphs of that paragraph, the 

14 Secretary shall ensure that the total amount paid by vet15 erans for medications under that paragraph in a year is 

16 not less than the costs of the Department in furnishing 

17 medications to veterans under section 1710C(b) of this 

18 title during that year, including the cost of purchasing and 

19 furnishing medications, and other costs of administering 

20 that section. 

21 ‘‘(B) The Secretary shall take appropriate actions to 

22 ensure, to the maximum extent practicable, that amounts 

23 paid by veterans under paragraph (1) in a year are equal 

24 to the costs of the Department referred to in subpara25 graph (A) in that year. 
7 

•S 614 IS 

1 ‘‘(3) In determining amounts under paragraph (1), 

2 the Secretary may take into account the following: 

3 ‘‘(A) Whether or not the medications furnished 

4 are generic medications or brand name medications. 

5 ‘‘(B) Whether or not the medications are fur6 nished by mail. 

7 ‘‘(C) Whether or not the medications furnished 

8 are listed on the National Prescription Drug For9 mulary of the Department. 

10 ‘‘(D) Any other matters the Secretary considers 

11 appropriate. 

12 ‘‘(4) The Secretary may from time to time adjust any 

13 amount determined by the Secretary under paragraph (1), 

14 as previously adjusted under this paragraph, in order to 

15 meet the purpose specified in paragraph (2).’’; and 

16 (D) in subsection (d), as so redesignated— 

17 (i) by striking ‘‘subsection (a)’’ and 

18 inserting ‘‘subsections (a) and (b)’’; and 

19 (ii) by striking ‘‘subsection (b)’’ and 

20 inserting ‘‘subsection (c)’’. 

21 (2) DEPOSIT OF COLLECTIONS IN MEDICAL

22 CARE COLLECTIONS FUND.—Paragraph (4) of sec23 tion 1729A(b) of such title is amended to read as 

24 follows: 
8 

•S 614 IS 

1 ‘‘(4) Subsection (a) or (b) of section 1722A of 

2 this title.’’. 

3 (c) CONFORMING AMENDMENTS.—(1) Section 1707 

4 of such title is amended by adding at the end the following 

5 new subsection: 

6 ‘‘(c) Notwithstanding any other provision of law, a 

7 veteran who makes an election authorized by section 

8 1710C(b) of this title (other than a veteran covered by 

9 paragraph (4)(B) of that section) shall not, for the period 

10 of such election, be eligible for care and services under 

11 this chapter, except as provided in that section.’’. 

12 (2) Section 1712 of such title is amended by striking 

13 subsections (d) and (e). 

14 (d) CLERICAL AMENDMENTS.—(1) The heading for 

15 section 1712 of such title is amended to read as follows: 

16 ‘‘§ 1712. Dental care’’. 

17 (2) The table of sections at the beginning of chapter 

18 17 of such title is amended— 

19 (A) by inserting after the item relating to sec20 tion 1710B the following new item: 

‘‘1710C. Drugs and medications; vaccines.’’; 

21 and 

22 (B) by striking the item relating to section 

23 1712 and inserting the following new item: 

‘‘1712. Dental care.’’. 

Æ