I 
109TH CONGRESS 
2D SESSION 
H. R. 4665 
To amend title XIX of the Social Security Act to provide for an offset 
from the Medicaid clawback for State emergency prescription drug ex-
penditures for Medicare dual-eligible individuals. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 31, 2006 
Mr. CARDIN (for himself, Ms. PELOSI, Mr. HOYER, Mr. RANGEL, Mr. STARK, 
Mr. WAXMAN, Mr. GEORGE MILLER of California, Ms. HOOLEY, Mrs. 
CAPPS, Mr. WEXLER, Ms. NORTON, Mr. THOMPSON of California, Mr. 
ROSS, Mr. DAVIS of Florida, Ms. MATSUI, Ms. WOOLSEY, Mr. SANDERS, 
Mr. MCDERMOTT, Ms. ESHOO, Ms. HARMAN, Mr. GUTIERREZ, Mr. 
HASTINGS of Florida, Mr. NADLER, Mr. ENGEL, Mr. VAN HOLLEN, Mrs. 
MALONEY, Ms. MOORE of Wisconsin, Mr. KANJORSKI, Mr. HIGGINS, Mr. 
JEFFERSON, Mr. BISHOP of New York, Mr. DELAHUNT, Ms. BALDWIN, 
Mr. HINCHEY, Mr. GRIJALVA, Ms. LEE, Mr. DEFAZIO, Mr. LANTOS, Mr. 
DOYLE, Ms. DEGETTE, Mr. FARR, Mr. MCGOVERN, Mr. ORTIZ, Ms. ZOE 
LOFGREN of California, Mr. KILDEE, Mr. WYNN, Mr. CLEAVER, Mr. 
KENNEDY of Rhode Island, Mr. PAYNE, Mr. FILNER, Mr. MICHAUD, Mr. 
RUPPERSBERGER, Mr. FORD, Mr. CUMMINGS, Mr. CROWLEY, Mr. 
HONDA, Mr. BERRY, Mr. FRANK of Massachusetts, Ms. SCHAKOWSKY, 
and Mr. PRICE of North Carolina) 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 provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XIX of the Social Security Act to provide 
for an offset from the Medicaid clawback for State emer-
gency prescription drug expenditures for Medicare dual- 
eligible individuals.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. FEDERAL RESPONSIBILITY FOR STATE EMER-
GENCY PRESCRIPTION DRUG EXPENDITURES 
FOR 
MEDICARE 
DUAL-ELIGIBLE 
INDIVID-
UALS. 
Section 1935(c) of the Social Security Act (42 U.S.C. 
1396v–5(c)) is amended— 
(1) in paragraph (1)(A), by striking ‘‘Each of 
the 50 States’’ and inserting ‘‘Subject to paragraph 
(7), each of the 50 States’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(7) OFFSET
FOR
EMERGENCY
STATE
PRE-
SCRIPTION DRUG EXPENDITURES.— 
‘‘(A) IN GENERAL.—The amount of pay-
ment for a month (beginning with January 
2006 and ending with December 2007) under 
paragraph (1) shall be reduced by the amount 
(as documented by the State) that the State ex-
pended during the month for payment for part 
D covered drugs for part D eligible individuals 
who are entitled to benefits under the State 
plan (whether as full-benefit dual eligible indi-
viduals, qualified medicare beneficiaries, or oth-
erwise) and who are enrolled in a prescription 
drug plan under part D of title XVIII, but were 
unable to access on a timely basis prescription 
drug benefits to which they were entitled under 
such prescription drug plan. 
‘‘(B) RECOVERY OF AMOUNT OF OFFSET 
FROM PRESCRIPTION DRUG PLANS.—The Sec-
retary shall provide for recovery of payment re-
ductions made under subparagraph (A) from 
those prescription drug plans under part D of 
title XVIII or MA–PD plans under part C of 
such title that would otherwise be responsible 
for the expenditures described in such subpara-
graph. Any such amounts recovered shall be de-
posited into the Medicare Prescription Drug Ac-
count in the Federal Supplementary Medical 
Insurance Trust Fund.’’. 
Æ