I 

108TH CONGRESS 

2D SESSION H. R. 5144 

To amend title XVIII of the Social Security Act to preserve access to cancer 

care under the Medicare Program. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 23, 2004 

Mr. NORWOOD (for himself, Mrs. CAPPS, Mr. BURNS, Mr. BURTON of Indiana, Mr. FRANK of Massachusetts, Mr. FROST, Mr. HALL, Mr. 

HOEFFEL, Mr. OWENS, Mr. SANDLIN, Mr. TERRY, Mr. WALSH, and Mr. 

WELDON of Florida) 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 preserve 

access to cancer care under the Medicare 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 ‘‘Cancer Care Preserva5 tion Act of 2004’’. 
2 

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1 SEC. 2. ESTABLISHMENT OF MINIMUM PAYMENT AMOUNTS 

2 FOR ONCOLOGY DRUGS FURNISHED TO 

3 MEDICARE BENEFICIARIES. 

4 (a) IN GENERAL.—Section 1847A of the Social Secu5 rity Act (42 U.S.C. 1395w–3a), as added by section 

6 303(c)(1) of the Medicare Prescription Drug, Improve7 ment, and Modernization Act of 2003 (Public Law 108– 

8 173; 117 Stat. 2239), is amended— 

9 (1) in subsection (b)(1), by striking ‘‘Subject to 

10 subsections (d)(3)(C) and (e)’’ and inserting ‘‘Sub11 ject to subsections (d)(3)(C), (e), and (g)’’; 

12 (2) by redesignating subsection (g) as sub13 section (h); and 

14 (3) by inserting after subsection (f) the fol15 lowing new subsection: 

16 ‘‘(g) ALTERNATIVE MINIMUM PAYMENT AMOUNT

17 FOR ONCOLOGY DRUGS.— 

18 ‘‘(1) IN GENERAL.—In no case may the amount 

19 of payment determined under this section for the 

20 billing and payment code for a drug or biological 

21 (based on a minimum dosage unit) for an oncology 

22 drug furnished in 2005 or 2006 be less than 95 per23 cent of such amount of payment for that oncology 

24 drug furnished in the preceding year. 

25 ‘‘(2) ESTABLISHMENT OF CODE.—The Sec26 retary shall make such modifications to billing and 
3 

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1 payment codes, including the establishment of a 

2 temporary billing and payment code, to carry out 

3 this subsection.’’. 

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

5 subsection (a) shall take effect as if included in the enact6 ment of section 301(c)(1) of the Medicare Prescription 

7 Drug, Improvement, and Modernization Act of 2003 (Pub8 lic Law 108–173; 117 Stat. 2239). 

9 SEC. 3. ESTABLISHMENT OF MINIMUM PAYMENT AMOUNTS 

10 FOR DRUG ADMINISTRATION SERVICES. 

11 (a) IN GENERAL.—Section 303(a)(4) of the Medicare 

12 Prescription Drug, Improvement, and Modernization Act 

13 of 2003 (Public Law 108–173; 117 Stat. 2237) is amend14 ed— 

15 (1) in subparagraph (A), by striking ‘‘and be16 fore January 1, 2006,’’ and inserting ‘‘and before 

17 January 1, 2007,’’; and 

18 (2) in subparagraph (B)— 

19 (A) by striking ‘‘and’’ at the end of clause 

20 (i); 

21 (B) in clause (ii), by striking ‘‘3 percent.’’ 

22 and inserting ‘‘27 percent; and’’; and 

23 (C) by inserting after clause (ii) the fol24 lowing new clause: 

25 ‘‘(iii) during 2006, is 22 percent.’’. 
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1 (b) EFFECTIVE DATE.—The amendments made by 

2 subsection (a) shall apply as if included in the enactment 

3 of section 303(a)(4) of the Medicare Prescription Drug, 

4 Improvement, and Modernization Act of 2003 (Public Law 

5 108–173; 117 Stat. 2237). 

Æ