I 
109TH CONGRESS 
2D SESSION 
H. R. 4722 
To amend title XVIII of the Social Security Act to eliminate cost-sharing 
under part D of such title for certain full-benefit dual eligible individuals. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 8, 2006 
Mr. ENGEL (for himself, Mr. BROWN of Ohio, Mr. WAXMAN, Mr. BOUCHER, 
Mr. TOWNS, Mr. PALLONE, Mr. RUSH, Mr. STUPAK, Mr. STRICKLAND, 
Ms. DEGETTE, Mrs. CAPPS, Mr. ALLEN, Ms. SCHAKOWSKY, Mr. MCNUL-
TY, Mr. JEFFERSON, Mr. EMANUEL, and Mr. KENNEDY of Rhode Island) 
introduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to eliminate 
cost-sharing under part D of such title for certain full- 
benefit 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. ELIMINATION OF PART D COST-SHARING FOR 
CERTAIN FULL-BENEFIT DUAL ELIGIBLE IN-
DIVIDUALS. 
(a) IN GENERAL.—Section 1860D–14(a)(1)(D)(i) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395w– 
114(a)(1)(D)(i)) is amended— 
(1) in the heading, by striking ‘‘INSTITU-
TIONALIZED
INDIVIDUALS.—In’’ 
and 
inserting 
‘‘ELIMINATION
OF
COST-SHARING
FOR
CERTAIN 
FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS.—’’ 
‘‘(I) INSTITUTIONALIZED
INDI-
VIDUALS.—In’’; and 
(2) by adding at the end the following new sub-
clauses: 
‘‘(II) CERTAIN
OTHER
INDIVID-
UALS.—In the case of an individual 
who is a full-benefit dual eligible indi-
vidual and who receives services from 
a facility or program described in sub-
clause (III), the elimination of any 
beneficiary coinsurance described in 
section 
1860D–2(b)(2) 
(for 
all 
amounts through the total amount of 
expenditures at which benefits are 
available 
under 
section 
1860D– 
2(b)(4)).
‘‘(III) FACILITY
DESCRIBED.— 
For purposes of subclause (II), a fa-
cility or program described in this 
subclause is a board and care facility, 
a custodial care facility, a group 
home, or an assisted living facility (as 
such terms are defined by the Sec-
retary), or any other facility or pro-
gram that the Secretary determines 
provides services without which the in-
dividual would require long-term care 
in a medical institution or nursing fa-
cility.’’. 
(b) EFFECTIVE DATE.— 
(1) IN GENERAL.—The amendments made by 
subsection (a) shall take effect as if included in the 
enactment of section 101 of the Medicare Prescrip-
tion Drug, Improvement, and Modernization Act of 
2003 (Public Law 108–173). 
(2) REIMBURSEMENT
OF
COST-SHARING
PAY-
MENTS.—The Secretary shall provide for reimburse-
ment of any beneficiary coinsurance described in sec-
tion 1860D–2(b)(2) of the Social Security Act (42 
U.S.C. 1395w–102(b)(2)) paid by or on behalf of an 
individual 
described 
in 
section 
1860D–
14(a)(1)(D)(i)(II) of such Act, as added by sub-
section (a), during the period beginning on January 
1, 2006, and ending on the date of enactment of this 
Act. 
Æ