I 
109TH CONGRESS 
2D SESSION 
H. R. 6281 
To amend title XVIII of the Social Security Act to provide comprehensive 
improvements to the Medicare prescription drug program, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 29, 2006 
Mr. DOGGETT (for himself, Mr. RANGEL, Mr. STARK, Mr. MCDERMOTT, Mr. 
LEWIS of Georgia, Mr. NEAL of Massachusetts, Mr. MCNULTY, Mr. 
BECERRA, Mrs. JONES of Ohio, Mr. LARSON of Connecticut, Mr. EMAN-
UEL, Mr. ALLEN, Mrs. CAPPS, Mrs. DAVIS of California, Ms. DELAURO, 
Mr. FRANK of Massachusetts, Mr. AL GREEN of Texas, Mr. GENE 
GREEN of Texas, Mr. GRIJALVA, Mr. HINCHEY, Ms. JACKSON-LEE of 
Texas, Ms. EDDIE BERNICE JOHNSON of Texas, Ms. KAPTUR, Mr. KEN-
NEDY of Rhode Island, Ms. KILPATRICK of Michigan, Mr. LANGEVIN, 
Mrs. LOWEY, Mrs. MALONEY, Ms. MCCOLLUM of Minnesota, Mr. 
MCGOVERN, Mr. MEEHAN, Ms. MOORE of Wisconsin, Mr. MORAN of Vir-
ginia, Mr. NADLER, Mr. OBERSTAR, Mr. ORTIZ, Mr. REYES, Ms. 
SCHAKOWSKY, Mr. WAXMAN, Mr. WEINER, and Ms. WOOLSEY) intro-
duced 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 provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
comprehensive improvements to the Medicare prescrip-
tion drug program, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Medicare Prescription Drug Savings for Our Seniors 
(Medicare Prescription Drug SOS) Act of 2006’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—MEDICARE OPERATED PRESCRIPTION DRUG PLAN 
OPTION 
Sec. 101. Establishment of medicare operated prescription drug plan option. 
TITLE II—MEDICAID AND LOW-INCOME IMPROVEMENTS 
Sec. 201. Change in base used in computing State clawback provision. 
Sec. 202. Elimination of cost-sharing for certain full-benefit dual eligibles. 
Sec. 203. Elimination of the indexing on the price-sharing for dual-eligibles and 
qualifying low income beneficiaries. 
Sec. 204. Expediting low-income subsidies under the Medicare prescription 
drug program. 
Sec. 205. Increase in permitted resources to obtain low-income subsidies. 
Sec. 206. Waiver of late enrollment penalty for subsidy eligible individuals for 
first 24 months of non-enrollment. 
TITLE III—FRAUD AND ABUSE PROVISIONS 
Sec. 301. Criminal penalty for fraud in connection with enrollment under an 
MA plan or prescription drug plan. 
Sec. 302. Recourse for slamming practices. 
Sec. 303. Protection from loss of employment-based retiree health coverage 
upon enrollment for medicare prescription drug benefit during 
2006. 
Sec. 304. Required application of intermediate sanctions to protect against 
fraud and abuse. 
Sec. 305. Repeal of special waiver authority for State licensure. 
TITLE IV—RELATION TO SOCIAL SECURITY BENEFITS 
Sec. 401. Protection of Social Security benefits against decrease due to part D 
medicare premium increases. 
TITLE V—BENEFICIARY PROTECTION PROVISIONS 
Sec. 501. Extension of open enrollment period; suspension of late enrollment 
penalties; allowing one-time change in plan during first year of 
enrollment. 
Sec. 502. Counting expenditures under State drug assistance programs against 
true out-of-pocket costs. 
Sec. 503. Price disclosure. 
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Sec. 504. Removal of covered part D drugs from the prescription drug plan for-
mulary. 
Sec. 505. Codification of requirement for coverage of all or substantially all of 
drugs within six categories of drugs. 
Sec. 506. Removal of exclusion of benzodiazepines from required coverage 
under the medicare prescription drug program. 
Sec. 507. Standardized forms and procedures for reconsiderations and appeals. 
Sec. 508. Elimination of MA Regional Stabilization Fund (Slush Fund); elimi-
nation of certain MA overpayments. 
TITLE VI—FAIR AND SPEEDY TREATMENT OF MEDICARE 
PRESCRIPTION DRUG CLAIMS 
Sec. 601. Prompt payment by Medicare prescription drug plans and MA–PD 
plans under part D. 
Sec. 602. Restriction on co-branding. 
Sec. 603. Minimum dispensing fees for generic covered part D drugs. 
Sec. 604. Provision of medication therapy management services under part D. 
TITLE I—MEDICARE OPERATED 
PRESCRIPTION DRUG PLAN 
OPTION 
SEC. 101. 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 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 2007), in addition to any plans offered 
under section 1860D–11, the Secretary shall offer one or 
more medicare operated prescription drug plans (as de-
fined in subsection (c)) with a service area that consists 
of the entire United States and shall enter into negotia-
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tions with pharmaceutical manufacturers to reduce the 
purchase cost of covered part D drugs for eligible part 
D individuals in accordance with subsection (b). 
‘‘(b) NEGOTIATIONS.— 
‘‘(1) IN
GENERAL.—Notwithstanding section 
1860D–11(i), for purposes of offering a medicare 
operated prescription drug plan under this section, 
the Secretary shall negotiate with pharmaceutical 
manufacturers with respect to the purchase price of 
covered part D drugs and shall encourage the use of 
more affordable therapeutic equivalents to the extent 
such practices do not override medical necessity as 
determined by the prescribing physician. To the ex-
tent practicable and consistent with the previous 
sentence, the Secretary shall implement strategies 
similar to those used by other Federal purchasers of 
prescription drugs, and other strategies, to reduce 
the purchase cost of covered part D drugs. 
‘‘(2) PERMITTING
APPLICATION
OF
SOME
OR 
ALL
OF
SAVINGS
TO
REDUCTION
IN
COVERAGE 
GAP.—Notwithstanding any other provision of this 
part, the Secretary may increase the initial coverage 
limit under section 1860D–2(b)(3) for a year, but 
only with respect to the medicare operated prescrip-
tion drug plan, by an amount not to exceed the actu-
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arial value of the reductions in expenditures during 
such year resulting from the application of para-
graph (1). 
‘‘(c) 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 to negotiated prices described in sec-
tion 1860D–2(a)(1)(A). Such a plan may offer supple-
mental prescription drug coverage in the same manner as 
other qualified prescription drug coverage offered by other 
prescription drug plans. 
‘‘(d) MONTHLY BENEFICIARY PREMIUM.— 
‘‘(1) QUALIFIED
PRESCRIPTION
DRUG
COV-
ERAGE.—The monthly beneficiary premium for 
qualified prescription drug coverage and access to 
negotiated prices described in section 1860D– 
2(a)(1)(A) to be charged under a medicare operated 
prescription drug plan shall be uniform nationally. 
Such premium for months in a year shall be based 
on the average monthly per capita actuarial cost of 
offering the medicare operated prescription drug 
plan for the year involved, including administrative 
expenses, as determined by the Secretary and as cer-
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