I 
108TH CONGRESS 
1ST SESSION H. R. 2223
To amend title XVIII of the Social Security Act to provide adequate coverage 
for immunosuppressive drugs furnished to beneficiaries under the Medi-
care Program that have received an organ transplant. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 22, 2003
Mr. CAMP introduced the following bill; which was referred to the Committee 
on Ways and Means, and in addition to the Committees on Energy, and 
Commerce, and Education and the Workforce, for a period to be subse-
quently 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 
adequate coverage for immunosuppressive drugs fur-
nished to beneficiaries under the Medicare Program that 
have received an organ transplant.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Comprehensive Im-
munosuppressive Drug Coverage for Transplant Patients 
Act of 2003’’.
SEC. 
2. 
COMPREHENSIVE 
COVERAGE 
OF 
IMMUNO-
SUPPRESSIVE DRUGS UNDER THE MEDICARE 
PROGRAM. 
(a) IN GENERAL.—Section 1861(s)(2)(J) of the So-
cial Security Act (42 U.S.C. 1395x(s)(2)(J)) is amended 
by striking ‘‘, to an individual who receives’’ and all that 
follows before the semicolon at the end and inserting ‘‘to 
an individual who has received an organ transplant’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to drugs furnished on or after the 
date of enactment of this Act. 
SEC. 3. PROVISION OF APPROPRIATE COVERAGE OF IM-
MUNOSUPPRESSIVE 
DRUGS 
UNDER 
THE 
MEDICARE PROGRAM FOR ORGAN TRANS-
PLANT RECIPIENTS. 
(a) 
CONTINUED
ENTITLEMENT
TO
IMMUNO-
SUPPRESSIVE DRUGS.—
(1) KIDNEY
TRANSPLANT
RECIPIENTS.—Sec-
tion 226A(b)(2) of the Social Security Act (42 
U.S.C. 426–1(b)(2)) is amended by inserting ‘‘(ex-
cept for coverage of immunosuppressive drugs under 
section 1861(s)(2)(J))’’ after ‘‘shall end’’. 
(2) OTHER
TRANSPLANT
RECIPIENTS.—The 
flush matter following paragraph (2)(C)(ii)(II) of 
section 226(b) of the Social Security Act (42 U.S.C. 
426(b)) is amended by striking ‘‘of this subsection)’’
and inserting ‘‘of this subsection and except for cov-
erage of immunosuppressive drugs under section 
1861(s)(2)(J))’’. 
(3) APPLICATION.—Section 1836 of the Social 
Security Act (42 U.S.C. 1395o) is amended—
(A) by striking ‘‘Every individual who’’ 
and inserting ‘‘(a) IN GENERAL.—Every indi-
vidual who’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(b) SPECIAL RULES APPLICABLE TO INDIVIDUALS 
ONLY ELIGIBLE FOR COVERAGE OF IMMUNOSUPPRESSIVE 
DRUGS.—
‘‘(1) IN GENERAL.—In the case of an individual 
whose eligibility for benefits under this title has 
ended except for the coverage of immunosuppressive 
drugs by reason of section 226(b) or 226A(b)(2), the 
following rules shall apply: 
‘‘(A) The individual shall be deemed to be 
enrolled under this part for purposes of receiv-
ing coverage of such drugs. 
‘‘(B) The individual shall be responsible 
for the full amount of the premium under sec-
tion 1839 in order to receive such coverage.
‘‘(C) The provision of such drugs shall be 
subject to the application of—
‘‘(i) the deductible under section 
1833(b); and 
‘‘(ii) the coinsurance amount applica-
ble for such drugs (as determined under 
this part). 
‘‘(D) If the individual is an inpatient of a 
hospital or other entity, the individual is enti-
tled to receive coverage of such drugs under 
this part. 
‘‘(2) ESTABLISHMENT
OF
PROCEDURES
IN 
ORDER TO IMPLEMENT COVERAGE.—The Secretary 
shall establish procedures for—
‘‘(A) identifying beneficiaries that are enti-
tled to coverage of immunosuppressive drugs by 
reason of section 226(b) or 226A(b)(2); and 
‘‘(B) distinguishing such beneficiaries from 
beneficiaries that are enrolled under this part 
for the complete package of benefits under this 
part.’’.
(4) TECHNICAL AMENDMENT.—Subsection (c) 
of section 226A of the Social Security Act (42 
U.S.C. 426–1), as added by section 201(a)(3)(D)(ii) 
of the Social Security Independence and Program
Improvements Act of 1994 (Public Law 103–296; 
108 Stat. 1497), is redesignated as subsection (d). 
(b) EXTENSION OF SECONDARY PAYER REQUIRE-
MENTS
FOR
ESRD 
BENEFICIARIES.—Section 
1862(b)(1)(C) of the Social Security Act (42 U.S.C. 
1395y(b)(1)(C)) is amended by adding at the end the fol-
lowing new sentence: ‘‘With regard to immunosuppressive 
drugs furnished on or after the date of enactment of the 
Comprehensive Immunosuppressive Drug Coverage for 
Transplant Patients Act of 2003, this subparagraph shall 
be applied without regard to any time limitation.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to drugs furnished on or after the 
date of enactment of this Act. 
SEC. 4. PLANS REQUIRED TO MAINTAIN COVERAGE OF IM-
MUNOSUPPRESSIVE DRUGS. 
(a) APPLICATION TO CERTAIN HEALTH INSURANCE 
COVERAGE.—
(1) IN GENERAL.—Subpart 2 of part A of title 
XXVII of the Public Health Service Act (42 U.S.C. 
300gg–4 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 2707. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS. 
‘‘A group health plan (and a health insurance issuer 
offering health insurance coverage in connection with a
‘‘SEC. 9813. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS. 
‘‘A group health plan shall provide coverage of im-
munosuppressive drugs that is at least as comprehensive 
as the coverage provided by such plan on the day before 
the date of enactment of the Comprehensive Immuno-
suppressive Drug Coverage for Transplant Patients Act 
of 2003, and such requirement shall be deemed to be in-
corporated into this section.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to plan years beginning on or after 
January 1, 2004.
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