I 
109TH CONGRESS 
2D SESSION 
H. R. 4796 
To amend title XVIII of the Social Security Act to improve implementation 
of the Medicare prescription drug benefit. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 16, 2006 
Mr. MORAN of Kansas (for himself, Mr. JONES of North Carolina, and Mrs. 
EMERSON) introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
implementation of the Medicare prescription drug benefit. 
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 Account-
ability, Bargaining, and Compassion for Part D (ABC for 
D) Act’’. 
SEC. 2. SENSE OF CONGRESS. 
It is the sense of Congress that— 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
(1) employees and volunteers of the Social Se-
curity Administration (SSA), Area Agencies on 
Aging (AAA), and the State Health Insurance As-
sistance Program (SHIP), who have gone above and 
beyond expectations, should be commended for mak-
ing great strides in outreach and education for the 
Medicare part D prescription drug program; 
(2) the Centers for Medicare & Medicaid Serv-
ices (CMS) should be encouraged to empower their 
outreach partners to share time and space in order 
to create (within existing office spaces) ‘‘one-stop lo-
cations’’ at which seniors can receive counseling on 
the low-income subsidy application, as well as plan 
selection, under such program; 
(3) decision-making at the local level relating to 
outreach and education for such program should be 
encouraged; and 
(4) if empowered by Centers for Medicare & 
Medicaid Services, personnel from the Social Secu-
rity Administration, Area Agencies on Aging, and 
the State Health Insurance Assistance Program will 
be able to coordinate better their efforts and there-
fore better serve seniors under such program. 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
SEC. 3. REQUIRING REGISTRATION OF PDP SPONSORS OF-
FERING PRESCRIPTION DRUG PLANS WITH 
STATE INSURANCE DEPARTMENT IN EACH 
STATE IN WHICH A PLAN IS OFFERED. 
(a) IN GENERAL.—Section 1860D–12(a) of the So-
cial Security Act (42 U.S.C. 1395w–112(a)) is amended 
by adding at the end the following new paragraph: 
‘‘(4) REGISTRATION IN EACH STATE IN WHICH 
PRESCRIPTION DRUG PLAN IS OFFERED.—The spon-
sor is registered with the State insurance depart-
ment in each State in which it offers a prescription 
drug plan under this part. Such registration shall 
consist of submitting to such department the fol-
lowing: 
‘‘(A) A certified copy of the sponsor’s char-
ter or deed of settlement. 
‘‘(B) A statement including the name of 
the sponsor, the place where it is located; and 
the amount of its capital. 
‘‘(C) A copy of its last annual report, if 
such a report was written.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to prescription drug plans of-
fered on or after January 1, 2007. 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
SEC. 4. IMPROVEMENTS IN MEDICARE PRESCRIPTION 
DRUG ENROLLMENT PROCESS. 
(a) EXTENDED PERIOD
OF OPEN ENROLLMENT 
DURING ALL OF 2006 FOR PRESCRIPTION DRUG PLANS 
AND MA PLANS WITHOUT LATE ENROLLMENT PEN-
ALTY.—Section 1851(e)(3)(B) of the Social Security Act 
(42 U.S.C. 1395w–21(e)(3)(B)) is amended— 
(1) in clause (iii), by striking ‘‘May 15, 2006’’ 
and inserting ‘‘December 31, 2006’’; and 
(2) by adding at the end the following new sen-
tence: ‘‘An individual making an election during the 
period beginning on November 15, 2006, and ending 
on December 31, 2006, shall specify whether the 
election is to be effective with respect to 2006 or 
with respect to 2007 (or both).’’. 
(b) PROVIDING PERIOD OF TIME BEFORE EFFEC-
TIVENESS OF ELECTIONS AND CHANGES OF ELECTIONS 
FOR PRESCRIPTION DRUG PLANS AND MA PLANS.— 
(1) FOR INITIAL ENROLLMENT PERIOD.—Sec-
tion 1851(f)(1) of such Act (42 U.S.C. 1395w– 
21(f)(1)) is amended— 
(A) by striking ‘‘except’’ and all that fol-
lows through ‘‘retroactive coverage.’’ and insert-
ing ‘‘except as follows:’’; and 
(B) by adding at the end the following new 
subparagraphs: 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
‘‘(A) Except as the Secretary may provide 
(consistent with section 1838 and subparagraph 
(B)) in order to prevent retroactive coverage. 
‘‘(B) Except such an election of coverage 
shall take effect not earlier than the date that 
is 14 days after the date on which such election 
is made.’’. 
(2) FOR
CONTINUOUS
ENROLLMENT
PERI-
ODS.—Section 1851(f)(2) of such Act (42 U.S.C. 
1395w–21(f)(2)) is amended by striking ‘‘following 
the date’’ and inserting ‘‘that begins at least 14 
days after the date’’. 
(3) CHANGE IN ANNUAL, COORDINATED ELEC-
TION PERIOD TO ALLOW FOR DELAY IN EFFECTIVE-
NESS.—Section 1851(e)(3)(B)(iv) of such Act (42 
U.S.C. 1395w–21(e)(3)(B)(iv)) is amended by strik-
ing ‘‘December 31’’ and inserting ‘‘December 15’’. 
(4) FOR SPECIAL ENROLLMENT PERIODS.—Sec-
tion 1851(f)(4) of such Act (42 U.S.C. 1395w– 
21(f)(4)) is amended by inserting before the period 
at the end the following: ‘‘and providing adequate 
notice to providers affected by such an election or 
change in election’’. 
(5) EFFECTIVE DATES.— 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
(A) INITIAL
AND
CONTINUOUS
ENROLL-
MENT
PERIODS.—The amendments made by 
paragraphs (1) and (2) shall not apply— 
(i) to elections of coverage made be-
fore the date of the enactment of this Act; 
and 
(ii) to elections of coverage made dur-
ing the month in which this Act is enacted 
if such date of enactment is within the last 
14 days of such month. 
(B) ANNUAL, COORDINATED ENROLLMENT 
PERIODS.—The amendment made by paragraph 
(3) shall apply to annual, coordinated election 
periods beginning on or after November 15, 
2006. 
(C) SPECIAL ENROLLMENT PERIODS.—The 
amendment made by paragraph (4) shall apply 
with respect to such special enrollment periods 
(beginning after the date of the enactment of 
this Act) as the Secretary of Health and 
Human Services shall specify. 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
SEC. 5. AUTHORIZING FEDERAL NEGOTIATION OF FAIR 
PRICES 
FOR 
MEDICARE 
PRESCRIPTION 
DRUGS ON BEHALF OF MEDICARE BENE-
FICIARIES. 
Section 1860D–11 of the Social Security Act (42 
U.S.C. 1395–111) is amended by striking subsection (i) 
(relating to noninterference) and by inserting the fol-
lowing: 
‘‘(i) AUTHORITY TO NEGOTIATE PRICES WITH MAN-
UFACTURERS.—In order to ensure that beneficiaries en-
rolled under prescription drug plans and MA–PD plans 
pay the lowest possible price, the Secretary shall have au-
thority similar to that of the Secretary of Veterans Affairs, 
Secretary of Defense, and the heads of other Federal 
agencies and departments that purchase prescription 
drugs in bulk to negotiate contracts with manufacturers 
of covered part D drugs, consistent with the requirements 
and in furtherance of the goals of providing quality care 
and containing costs under this part.’’. 
SEC. 6. INCREASED FUNDING FOR STATE HEALTH INSUR-
ANCE COUNSELING PROGRAMS AND SOCIAL 
SECURITY REGIONAL OFFICES FOR MEDI-
CARE PART D ENROLLMENT. 
(a) SHIP COUNSELING.—In addition to any amounts 
otherwise appropriated, there are appropriated out of any 
funds in the Treasury not otherwise appropriated 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
$100,000,000 for fiscal year 2006 to the Secretary of 
Health and Human Services for grants to States under 
section 4360 of the Omnibus Reconciliation Act of 1990 
for the purpose of providing outreach and information 
counseling and assistance with respect to enrollment of 
part D eligible individuals (as defined in section 1860D– 
1(a)(3) of the Social Security Act) under prescription drug 
plans and MA–PD plans under title XVIII of the Social 
Security Act. Funds appropriated under the preceding 
sentence shall remain available until expended. 
(b) SSA REGIONAL OFFICE OUTREACH.—In addition 
to any amounts otherwise appropriated, there are appro-
priated out of any funds in the Treasury not otherwise 
appropriated $100,000,000 for fiscal year 2006 to the Ad-
ministrator of Social Security for the purposes of con-
tinuing outreach and education efforts for the purpose of 
providing outreach and education by regional offices of the 
Social Security Administration with respect to enrollment 
of part D eligible individuals under prescription drug 
plans and MA–PD plans under title XVIII of the Social 
Security Act. Funds appropriated under the preceding 
sentence shall remain available until expended. 
(c) OFFSET.—Notwithstanding any other provision of 
law, the amount of funds available for obligation under 
section 1858(e)(2)(A)(i) of the Social Security Act (42 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS
U.S.C. 1395w–27a(e)(2)(A)(i)) are hereby reduced by the 
amount of funds appropriated under subsections (a) and 
(b). 
Æ 
VerDate Aug 31 2005 
07:05 Feb 22, 2006
Jkt 049196
PO 00000
Frm 00009
Fmt 6652
Sfmt 6301
E:\BILLS\H4796.IH
H4796
jcorcoran on PROD1PC62 with BILLS