I 
111TH CONGRESS 
1ST SESSION H. R. 2860 
To amend title XVIII of the Social Security Act to provide for a Medicare 
operated prescription drug plan option to deliver a meaningful drug 
benefit and lower prescription drug prices under the Medicare Program. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 12, 2009 
Mr. MURPHY of Connecticut (for himself and Mr. COURTNEY) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for a Medicare operated prescription drug plan option 
to deliver a meaningful drug benefit and lower prescrip-
tion drug prices under the Medicare Program. 
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 ‘‘Medicare Drug Savings 
Through Choice Act of 2009’’. 
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SEC. 2. ESTABLISHMENT OF MEDICARE OPERATED PRE-
SCRIPTION DRUG PLAN OPTION. 
(a) IN GENERAL.—Subpart 2 of part D of the Social 
Security Act is amended by inserting after section 1860D– 
11 (42 U.S.C. 1395w–111) the following new section: 
‘‘MEDICARE OPERATED PRESCRIPTION DRUG PLAN 
OPTION 
‘‘SEC. 1860D–11A. (a) IN
GENERAL.—Notwith-
standing any other provision of this part, for each year 
(beginning with 2010), in addition to any plans offered 
under section 1860D–11, the Secretary shall offer a Medi-
care operated prescription drug plan (as defined in sub-
section (b)) with a service area that consists of the entire 
United States. 
‘‘(b) MEDICARE OPERATED PRESCRIPTION DRUG 
PLAN DEFINED.—For purposes of this part, the term 
‘Medicare operated prescription drug plan’ means a pre-
scription drug plan that offers qualified prescription drug 
coverage and access described in section 1860D–2(d) to 
the prices negotiated under subsection (c)(1). Such plan 
may offer supplemental prescription drug coverage in the 
same manner as other qualified prescription drug coverage 
offered by other prescription drug plans. 
‘‘(c) ENHANCED AFFORDABILITY THROUGH NEGO-
TIATIONS.— 
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‘‘(1) IN
GENERAL.—Notwithstanding section 
1860D–11(i), for purposes of offering the Medicare 
operated prescription drug plan under this section, 
the Secretary shall negotiate with pharmaceutical 
manufacturers with respect to the purchase price of 
such covered part D drugs and shall encourage the 
use of more affordable therapeutic equivalents to the 
extent such practices do not override medical neces-
sity as determined by the prescribing physician. 
‘‘(2) IMPLEMENTATION OF OTHER COST SAV-
INGS STRATEGIES.—To the extent practicable and 
consistent with paragraph (1), the Secretary shall 
implement strategies similar to those used by the 
Department of Veterans Affairs or other Federal 
purchasers of prescription drugs, and other strate-
gies, to reduce the purchase cost of covered part D 
drugs. 
‘‘(3) CONDITIONING USE OF FORMULARIES.— 
Insofar as the Medicare operated prescription drug 
plan uses a formulary, such plan shall inform, con-
sistent with section 1860D–4(a)(3)(B), enrollees of 
changes in such formulary, including changes in cov-
ered drugs and the prices of such drugs. 
‘‘(4) SAVINGS
USED
TO
FILL
GAPS
IN
PRE-
SCRIPTION DRUG COVERAGE.—Any savings to the 
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Medicare operated prescription drug plan resulting 
from actions take under this subsection shall be used 
by the plan to extend coverage under the plan to in-
dividuals who have reached the initial coverage limit 
applicable under the plan but who have not reached 
the annual out-of-pocket threshold specified in sec-
tion 1860D–2(b)(4)(B). 
‘‘(d) MONTHLY PREMIUMS.— 
‘‘(1) FOR QUALIFIED PRESCRIPTION DRUG COV-
ERAGE.— 
‘‘(A) NATIONALLY
UNIFORM
MONTHLY 
BENEFICIARY
PREMIUM.—The monthly bene-
ficiary premium for qualified prescription drug 
coverage and access to negotiated prices de-
scribed in section 1860D–2(a)(1)(A) to be 
charged under the Medicare operated prescrip-
tion drug plan shall be uniform nationally. 
‘‘(B) BID BASED ON COSTS.—The bid sub-
mitted under section 1860D–11(b)(2)(C) for 
the Medicare operated prescription drug plan 
shall be based on the average monthly per cap-
ita actuarial cost of offering such plan for the 
year involved, including administrative ex-
penses. 
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‘‘(2) SUPPLEMENTAL PRESCRIPTION DRUG COV-
ERAGE.—Insofar as the Medicare operated prescrip-
tion drug plan offers supplemental prescription drug 
coverage, the Secretary shall adjust the amount of 
the bid submitted under section 1860D–11(b)(2)(C) 
(and the premium charged under paragraph (1)) to 
reflect the additional benefits offered under such 
coverage. 
‘‘(e) OPEN ENROLLMENT.—A part D eligible indi-
vidual may enroll in the Medicare operated prescription 
drug plan at any time.’’. 
(b) NO LATE ENROLLMENT PENALTY FOR INDIVID-
UALS ENROLLED IN MEDICARE OPERATED PRESCRIP-
TION DRUG PLAN.—Section 1860D–13(b)(2) of such Act 
(42 U.S.C. 1395w–113(b)(2)) is amended by adding at 
the end the following new sentence: ‘‘A part D eligible in-
dividual described in this paragraph does not include an 
individual enrolled in the Medicare operated prescription 
drug plan during the period in which the individual is so 
enrolled.’’. 
(c) CONFORMING AMENDMENTS.— 
(1) Section 1860D–1(b)(1)(B)(iii) of the Social 
Security Act (42 U.S.C. 1395w–101(b)(1)(B)(iii)) is 
amended by inserting ‘‘and section 1860D–11A(e)’’ 
after ‘‘paragraphs (2) and (3) of this subsection’’. 
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