I 
110TH CONGRESS 
2D SESSION 
H. R. 5604 
To amend title XVIII of the Social Security Act to reduce cost-sharing 
under part D of such title for certain non-institutionalized full-benefit 
dual eligible individuals. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 13, 2008 
Mr. DOGGETT (for himself, Mr. LINCOLN DIAZ-BALART of Florida, Mr. 
RAMSTAD, Mr. ALLEN, Mrs. CAPITO, Mr. COHEN, Mr. MARIO DIAZ- 
BALART of Florida, Mr. AL GREEN of Texas, Mr. HOLDEN, Mr. KEN-
NEDY, Mrs. MCCARTHY of New York, Ms. MCCOLLUM of Minnesota, Ms. 
MATSUI, Mr. MORAN of Virginia, Mr. PLATTS, Ms. ROS-LEHTINEN, and 
Ms. LINDA T. SA´NCHEZ of California) 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 XVIII of the Social Security Act to reduce 
cost-sharing under part D of such title for certain non- 
institutionalized 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. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Part D Home 
and Community Services Copayment Equity Act of 2008’’. 
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SEC. 2. ELIMINATION OF PART D COST-SHARING FOR CER-
TAIN 
NON-INSTITUTIONALIZED 
FULL-BEN-
EFIT DUAL ELIGIBLE INDIVIDUALS. 
(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 is a resident of a facil-
ity described in subclause (III) or who 
is receiving home and community- 
based services in a home setting pro-
vided under a home and community- 
based waiver approved for the State 
under section 1915 or 1115, the elimi-
nation of any beneficiary coinsurance 
described in section 1860D–2(b)(2) 
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(for all amounts through the total 
amount of expenditures at which ben-
efits are available under section 
1860D–2(b)(4)). 
‘‘(III) FACILITY
DESCRIBED.— 
For purposes of subclause (II), a fa-
cility described in this subclause is an 
assisted living facility or a resident 
care program facility (as such terms 
are defined by the Secretary), a board 
and care facility (as defined in section 
1903(q)(4)(B)), or any other facility 
that is licensed or certified by the 
State involved and is determined ap-
propriate by the Secretary, such as a 
community mental health center that 
meets the requirements of section 
1913(c) of the Public Health Service 
Act, a psychiatric health facility, a 
mental health rehabilitation center, 
and a mental retardation develop-
mental disability facility.’’. 
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(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to drugs dispensed on or after 
the date of the enactment of this Act. 
Æ 
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