I 
110TH CONGRESS 
1ST SESSION H. R. 3025 
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 
JULY 12, 2007 
Mr. DOGGETT (for himself, Mr. ACKERMAN, Mr. ALLEN, Mr. BECERRA, Mr. 
BERMAN, Mrs. CAPPS, Mr. COHEN, Mr. DAVIS of Illinois, Ms. DELAURO, 
Ms. EDDIE BERNICE JOHNSON of Texas, Mr. ELLISON, Mr. EMANUEL, 
Mr. ENGEL, Mr. FRANK of Massachusetts, Mr. AL GREEN of Texas, Mr. 
GRIJALVA, Mr. GUTIERREZ, Mr. HINCHEY, Ms. JACKSON-LEE of Texas, 
Ms. KAPTUR, Mr. KENNEDY, Mr. LARSON of Connecticut, Mr. LEWIS of 
Georgia, Mrs. LOWEY, Mrs. MALONEY of New York, Ms. MATSUI, Ms. 
MCCOLLUM of Minnesota, Mr. MCDERMOTT, Mr. MCGOVERN, Mr. 
MCNULTY, Mr. MICHAUD, Ms. MOORE of Wisconsin, Mr. MORAN of Vir-
ginia, Mr. NADLER, Mr. NEAL of Massachusetts, Ms. NORTON, Mr. 
ORTIZ, Mr. RUPPERSBERGER, Ms. SCHAKOWSKY, Mr. SCOTT of Virginia, 
Mr. STARK, Mr. WEINER, and Mr. WYNN) 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 subse-
quently 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 2007’’. 
(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 part D cost-sharing for certain non-institutionalized 
full-benefit dual eligible individuals. 
Sec. 203. Expediting low-income subsidies under the Medicare Prescription 
Drug Program. 
Sec. 204. Modification of resource standards for determination of eligibility for 
low-income subsidy; simplification of income and asset rules. 
Sec. 205. Indexing deductible and cost-sharing above annual out-of-pocket 
threshold for individuals with income below 150 percent of pov-
erty line. 
Sec. 206. No impact on eligibility for benefits under other programs. 
Sec. 207. Screening by Commissioner of Social Security for eligibility under 
Medicare savings programs. 
Sec. 208. Special enrollment period for subsidy eligible individuals. 
Sec. 209. Waiver of late enrollment penalty for subsidy eligible individuals. 
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 
2007. 
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 
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Sec. 501. 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. 
Sec. 504. Removal of covered part D drugs from the prescription drug plan for-
mulary. 
Sec. 505. Special treatment under Medicare part D for drugs in 6 specified 
therapeutic categories. 
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. 
Sec. 509. Beneficiary complaints. 
Sec. 510. Fill of drugs for dual eligibles. 
TITLE W—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. 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 2008), in addition to any plans offered 
under section 1860D–11, the Secretary shall offer one or 
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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-
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 
(including discounts, rebates, and other price conces-
sions) that of covered part D drugs and shall en-
courage the use of more affordable therapeutic 
equivalents to the extent such practices do not over-
ride medical necessity as determined by the pre-
scribing physician. To the extent 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 cov-
ered part D drugs. 
‘‘(2) PERMITTING
APPLICATION
OF
SOME
OR 
ALL
OF
SAVINGS
TO
REDUCTION
IN
COVERAGE 
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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-
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 
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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-
tified by the chief actuary of the Centers for Medi-
care & Medicaid Services. 
‘‘(2) SUPPLEMENTAL PRESCRIPTION DRUG COV-
ERAGE.—Insofar as a Medicare operated prescrip-
tion drug plan offers supplemental prescription drug 
coverage, the Secretary may adjust the amount of 
the premium charged under paragraph (1).’’. 
(b) AUTO-ENROLLMENT OF SUBSIDY ELIGIBLE IN-
DIVIDUALS
IN
MEDICARE
OPERATED
PRESCRIPTION 
DRUG PLAN.—Section 1860D–1(b)(1)(C) of such Act (42 
U.S.C. 1395w–101(b)(1)(C)) is amended— 
(1) by designating the matter beginning with 
‘‘The process established’’ as a clause (i) with the 
heading ‘‘AUTO-ENROLLMENT FOR DUAL ELIGIBLES 
AND OTHER SUBSIDY ELIGIBLE INDIVIDUALS’’; 
(2) by inserting ‘‘or who is a subsidy eligible in-
dividual’’ after ‘‘section 1935(c)(6))’’; 
(3) by striking ‘‘for the enrollment in’’ and all 
that follows through ‘‘in the PDP region.’’ and in-
serting ‘‘for the enrollment in the Medicare operated 
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prescription drug plan (as defined in section 1860D– 
11A(c)).’’; and 
(4) by adding at the end the following new 
clauses: 
‘‘(ii) APPLICATION IN CASE OF PRE-
MIUM
INCREASES
OR
PLAN
DISCONTINU-
ATION.—The process under subparagraph 
(A) shall also provide for enrollment de-
scribed in clause (i) in the case of such an 
individual who is enrolled in a prescription 
drug plan that has a monthly beneficiary 
premium that does not exceed the premium 
assistance available under section 1860D– 
14(a)(1)(A)) if such plan is discontinued 
or the premium under such plan is in-
creased so it exceeds such available pre-
mium assistance. 
‘‘(iii) NOTICE.— 
‘‘(I) IN
GENERAL.—The Sec-
retary shall provide for notice to each 
individual auto-enrolled under clause 
(i) or (ii) that the individual has the 
right and the opportunity to select an-
other prescription drug plan (or MA– 
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PD plan) through which to obtain 
prescription drug coverage. 
‘‘(II) ADDITIONAL
NOTICE.—In 
the case of an individual described in 
clause (ii), both the sponsor of the 
plan in which the individual is en-
rolled and the Secretary shall provide 
notice to the individual that enroll-
ment in the plan will be discontinued 
or have a premium above the bench-
mark and, as a result, the individual 
will be enrolled in the Medicare oper-
ated prescription drug plan for the 
following year unless the individual af-
firmatively acts otherwise.’’. 
(c) APPLICATION OF MONTHLY PREMIUM FOR PRE-
MIUM SUBSIDY PURPOSES.—Section 1860D–14(b)(1) of 
such Act (42 U.S.C. 1395ww–114(b)(1)) is amended by 
striking ‘‘the amount specified in paragraph (3)’’ and in-
serting ‘‘the greater of the amount specified in paragraph 
(3) or the monthly premium amount specified in section 
1860D–11A(d)(1)’’. 
(d) CONFORMING AMENDMENTS, INCLUDING ELIMI-
NATION
OF UNNECESSARY PLAN REQUIREMENT
AND 
FALLBACK PLAN PROVISIONS.— 
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(1) Section 1860D–3 of such Act (42 U.S.C. 
1395w–103) is repealed. 
(2) Section 1860D–11 of such Act (42 U.S.C. 
1395w–111) is amended— 
(A) by striking subsection (f), (g), and (h); 
and 
(B) in subsection (i), by inserting ‘‘except 
as provided in section 1860D–11A(b),’’ after 
‘‘in carrying out this part,’’. 
(3) Section 1860D–12(b) of such Act (42 
U.S.C. 1395w–112(b)) is amended by striking para-
graph (2). 
(4) Section 1860D–13(c) of such Act (42 
U.S.C. 1395w–113(c)) is amended by striking para-
graph (3). 
(5) Section 1860D–15 of such Act (42 U.S.C. 
1395w–115) is amended by striking subsection (g). 
(6) Section 1860D–16(b)(1) of such Act (42 
U.S.C. 1395w–116(b)(1)) is amended by striking 
subparagraph (B) and inserting the following: 
‘‘(B) payments for expenses incurred with 
respect to the operation of Medicare operated 
prescription drug plans under section 1860D– 
11A.’’. 
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(7) Section 1860D–41(a) of such Act (42 
U.S.C. 1395ww–141(a)) is amended by striking 
paragraph (5) and inserting the following: 
‘‘(5) 
MEDICARE
OPERATED
PRESCRIPTION 
DRUG PLAN.—The term ‘Medicare operated prescrip-
tion drug plan’ has the meaning given such term in 
section 1860D–11A(c).’’. 
(8) Section 1860D–42(a) of such Act (42 
U.S.C. 1395w–142(a)) is amended by striking ‘‘, in-
cluding section 1860D–3(a)(1),’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of the enactment 
of this Act and shall apply to enrollments effective for pe-
riods occurring on or after January 1, 2008. 
TITLE II—MEDICAID AND LOW- 
INCOME IMPROVEMENTS 
SEC. 201. CHANGE IN BASE USED IN COMPUTING STATE 
CLAWBACK PROVISION. 
(a) IN GENERAL.—Section 1935(c) of the Social Se-
curity Act (42 U.S.C. 1936u–5(c)) is amended— 
(1) in paragraph (2)(A)(ii), by inserting ‘‘, sub-
ject to paragraph (7),’’ after ‘‘increased for each 
year (’’; 
(2) in paragraph (3), by inserting ‘‘Subject to 
paragraph (7)—’’ after ‘‘DUAL ELIGIBLE INDIVID-
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UALS.—’’ in the matter before subparagraph (A); 
and 
(3) by adding at the end the following new 
paragraph: 
‘‘(7) USE OF 2005 AS BASE.—This subsection 
shall be applied by substituting ‘2005’ for ‘2003’ 
each place it appears in paragraph (3) if such sub-
stitution results in a reduced amount under para-
graph (1)(A) of this subsection and, in the case of 
such substitution, the reference in paragraph 
(2)(A)(ii) to ‘2004’ is deemed a reference to 
‘2006.’ ’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to payments for calendar quar-
ters beginning on or after January 1, 2008. 
SEC. 202. ELIMINATION OF PART D COST-SHARING FOR 
CERTAIN 
NON-INSTITUTIONALIZED 
FULL- 
BENEFIT 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.— 
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‘‘(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) 
(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 
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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.’’. 
(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. 
SEC. 203. EXPEDITING LOW-INCOME SUBSIDIES UNDER THE 
MEDICARE PRESCRIPTION DRUG PROGRAM. 
(a) IN GENERAL.—Section 1860D–14 of the Social 
Security Act (42 U.S.C. 1395w–114) is amended by add-
ing at the end the following new subsection: 
‘‘(e) EXPEDITED APPLICATION
AND ELIGIBILITY 
PROCESS.— 
‘‘(1) EXPEDITED PROCESS.— 
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‘‘(A) IN
GENERAL.—The Secretary shall 
provide for an expedited process under this sub-
section for the qualification for low-income as-
sistance under this section through a request to 
the Secretary of the Treasury as provided in 
subparagraphs (B) and (C) for information suf-
ficient to identify whether the individual in-
volved is likely eligible for subsidies under this 
section based on such information and the 
amount of premium and cost-sharing subsidies 
for which they would qualify based on such in-
formation. Such process shall be conducted in 
cooperation with the Commissioner of Social 
Security. 
‘‘(B) OPT IN FOR NEWLY ELIGIBLE INDI-
VIDUALS.—Not later than 60 days after the 
date of the enactment of this subsection, the 
Secretary shall ensure that, as part of the 
Medicare enrollment process, enrolling individ-
uals— 
‘‘(i) receive information describing the 
low-income subsidy provided under this 
section; and 
‘‘(ii) are provided the opportunity to 
opt-in to the expedited process described in 
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this subsection by requesting that the 
Commissioner of Social Security screen the 
individual involved for eligibility for such 
subsidy through a request to the Secretary 
of the Treasury under section 6103(l)(21) 
of the Internal Revenue Code of 1986. 
‘‘(C) TRANSITION FOR CURRENTLY ELIGI-
BLE INDIVIDUALS.—In the case of any part D 
eligible individual to which subparagraph (B) 
did not apply at the time of such individual’s 
enrollment, the Secretary shall, not later than 
60 days after the date of the implementation of 
subparagraph (B), request that the Commis-
sioner of Social Security screen such individual 
for eligibility for the low-income subsidy pro-
vided under this section through a request to 
the Secretary of the Treasury under section 
6103(l)(21) of the Internal Revenue Code of 
1986. 
‘‘(2) NOTIFICATION OF POTENTIALLY ELIGIBLE 
INDIVIDUALS.—Under such process, in the case of 
each individual identified under paragraph (1) who 
has not otherwise applied for, or been determined el-
igible for, benefits under this section (or who has ap-
plied for and been determined ineligible for such 
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benefits based only on excess resources), the Sec-
retary shall send them a letter (using basic, uncom-
plicated language) containing the following: 
‘‘(A) ELIGIBILITY.—A statement that, 
based on the information obtained under para-
graph (1), the individual is likely eligible for 
low-income subsidies under this section. 
‘‘(B) AMOUNT OF SUBSIDIES.—A descrip-
tion of the amount of premium and cost-sharing 
subsidies under this section for which the indi-
vidual would likely be eligible based on such in-
formation. 
‘‘(C) 
ENROLLMENT
OPPORTUNITY.—In 
case the individual is not enrolled in a prescrip-
tion drug plan or MA–PD plan— 
‘‘(i) a statement that— 
‘‘(I) the individual has the oppor-
tunity to enroll in a prescription drug 
plan or MA–PD plan for benefits 
under this part, but is not required to 
be so enrolled; and 
‘‘(II) if the individual has cred-
itable prescription drug coverage, the 
individual need not so enroll; 
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‘‘(ii) a list of the prescription drug 
plans and MA–PD plans in which the indi-
vidual is eligible to enroll; 
‘‘(iii) an enrollment form that may be 
used to enroll in such a plan by mail and 
that provides that if the individual wishes 
to enroll but does not designate a plan, the 
Secretary is authorized to enroll the indi-
vidual in such a prescription drug plan se-
lected by the Secretary; and 
‘‘(iv) a statement that the individual 
may also enroll online or by telephone, but, 
in order to qualify for low-income sub-
sidies, the individual must complete the at-
testation described in subparagraph (D) or 
otherwise apply for such subsidies. 
‘‘(D) ATTESTATION.—A one-page applica-
tion form that provides for a signed attestation, 
under penalty of law, as to the amount of in-
come and assets of the individual and con-
stitutes an application for the low-income sub-
sidies described in subparagraph (B). Such 
form— 
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