I 
113TH CONGRESS 
1ST SESSION H. R. 1325 
To amend title XVIII of the Social Security Act to provide Medicare 
entitlement to immunosuppressive drugs for kidney transplant recipients. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 21, 2013 
Mr. BURGESS (for himself, Mrs. BLACKBURN, Mr. MARINO, Mr. CASSIDY, Mr. 
YOUNG of Florida, Mr. CRENSHAW, Mr. MCDERMOTT, Mr. BACHUS, Mr. 
GRIMM, Mr. WOLF, and Mr. TIBERI) 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 provide 
Medicare entitlement to immunosuppressive drugs for 
kidney transplant recipients. 
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 ‘‘Comprehensive Im-
munosuppressive Drug Coverage for Kidney Transplant 
Patients Act of 2013’’. 
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SEC. 
2. 
MEDICARE 
ENTITLEMENT 
TO 
IMMUNO-
SUPPRESSIVE DRUGS FOR KIDNEY TRANS-
PLANT RECIPIENTS. 
(a) KIDNEY
TRANSPLANT
RECIPIENTS.—Section 
226A(b)(2) of the Social Security Act (42 U.S.C. 426– 
1(b)(2)) is amended by inserting ‘‘(except for eligibility for 
enrollment under part B solely for purposes of coverage 
of 
immunosuppressive 
drugs 
described 
in 
section 
1861(s)(2)(J))’’ before ‘‘, with the thirty-sixth month’’. 
(b) INDIVIDUALS ELIGIBLE ONLY FOR COVERAGE OF 
IMMUNOSUPPRESSIVE DRUGS.— 
(1) IN GENERAL.—Section 1836 of the Social 
Security Act (42 U.S.C. 1395o) is amended— 
(A) by striking ‘‘Every’’ and inserting ‘‘(a) 
IN GENERAL.—Every’’; and 
(B) by inserting at the end the following 
new subsection: 
‘‘(b) 
INDIVIDUALS
ELIGIBLE
FOR
IMMUNO-
SUPPRESSIVE DRUG COVERAGE.—Beginning on January 
1, 2014, every individual whose insurance benefits under 
part A have ended (whether before, on, or after such date) 
by reason of section 226A(b)(2) is eligible for enrollment 
in the insurance program established by this part solely 
for purposes of coverage of immunosuppressive drugs.’’. 
(2) 
CONFORMING
AMENDMENT.—Sections 
1837, 1838, and 1839 of the Social Security Act (42 
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U.S.C. 1395(o), 42 U.S.C. 1395(p), 42 U.S.C. 
1395(q)) are each amended by striking ‘‘1836’’ and 
inserting ‘‘1836(a)’’ each place it appears. 
(c) ENROLLMENT FOR INDIVIDUALS ONLY ELIGIBLE 
FOR COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.—Sec-
tion 1837 of the Social Security Act (42 U.S.C. 1395(p)) 
is amended by adding at the end the following new sub-
section: 
‘‘(m)(1) Any individual who is eligible under section 
1836(b) to enroll in the medical insurance program estab-
lished under this part for purposes of coverage of immuno-
suppressive drugs may enroll only in such manner and 
form as may be prescribed by regulations, and only during 
an enrollment period described in this subsection. 
‘‘(2) An individual described in paragraph (1) may 
enroll beginning on the first day of the third month before 
the month in which the individual first satisfies section 
1836(b). 
‘‘(3) An individual described in paragraph (1) whose 
entitlement for hospital insurance benefits under part A 
ends by reason of section 226A(b)(2) on or after January 
1, 2014, shall be deemed to have enrolled in the medical 
insurance program established by this part for purposes 
of coverage of immunosuppressive drugs.’’. 
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(d) COVERAGE PERIOD FOR INDIVIDUALS ONLY ELI-
GIBLE
FOR
COVERAGE
OF
IMMUNOSUPPRESSIVE 
DRUGS.— 
(1) IN GENERAL.—Section 1838 of the Social 
Security Act (42 U.S.C. 1395(q)) is amended by 
adding at the end the following new subsection: 
‘‘(g) In the case of an individual described in section 
1836(b), the following rules shall apply: 
‘‘(1) In the case of such an individual who is 
deemed to have enrolled in part B for coverage of 
immunosuppressive drugs under section 1837(m)(3), 
such individual’s coverage period shall begin on the 
first day of the month in which the individual first 
satisfies section 1836(b). 
‘‘(2) In the case of such an individual who en-
rolls in part B for coverage of immunosuppressive 
drugs under section 1837(m)(2), such individual’s 
coverage period shall begin on the first day of the 
month in which the individual first satisfies section 
1836(b) or the month following the month in which 
the individual so enrolls, whichever is later. 
‘‘(3) The provisions of subsections (b) and (d) 
shall apply with respect to an individual described in 
paragraph (1) or (2). 
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‘‘(4) In addition to the reasons for termination 
under subsection (b), the coverage period of an indi-
vidual described in paragraph (1) or (2) shall end 
when the individual becomes entitled to benefits 
under this title under section 226(a), 226(b), or 
226A.’’. 
(2) 
CONFORMING
AMENDMENTS.—Section 
1838(b) is amended in the matter following para-
graph (2) by adding ‘‘or section 1837(m)(3)’’ after 
‘‘section 1837(f)’’ each place it appears. 
(e) PREMIUMS FOR INDIVIDUALS ONLY ELIGIBLE 
FOR COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.—Sec-
tion 1839 of the Social Security Act (42 U.S.C. 1395r) 
is amended— 
(1) in subsection (b), by adding at the end the 
following new sentence: ‘‘No increase in the pre-
mium shall be effected for individuals who are en-
rolled pursuant to section 1836(b) for coverage only 
of immunosuppressive drugs.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(j) DETERMINATION OF PREMIUM FOR INDIVID-
UALS ONLY ELIGIBLE
FOR COVERAGE
OF IMMUNO-
SUPPRESSIVE DRUGS.—The Secretary shall, during Sep-
tember of each year, determine and promulgate a monthly 
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premium rate for the succeeding calendar year for individ-
uals who enroll only for the purpose of coverage of im-
munosuppressive drugs under section 1836(b). Such pre-
mium shall be equal to 35 percent of the monthly actuarial 
rate for enrollees age 65 and over, determined according 
to paragraph (1), for that succeeding calendar year. The 
monthly premium of each individual enrolled for coverage 
of immunosuppressive drugs under section 1836(b) for 
each month shall be the amount promulgated in this sub-
section. Such amount shall be adjusted in accordance with 
subsections (c) and (f).’’. 
(f) GOVERNMENT CONTRIBUTION.—Section 1844(a) 
of the Social Security Act (42 U.S.C. 1395(w)) is amend-
ed— 
(1) in paragraph (3), by striking the period at 
the end and inserting ‘‘; plus’’; 
(2) by adding at the end the following new 
paragraph: 
‘‘(4) a Government contribution equal to the es-
timated aggregate reduction in premiums payable 
under part B that results from establishing the pre-
mium at 35 percent of the actuarial rate under sec-
tion 1839(j) instead of 50 percent of the actuarial 
rate for individuals who enroll only for the purpose 
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of coverage of immunosuppressive drugs under sec-
tion 1836(b).’’; and 
(3) by adding at the end the following flush 
matter: 
‘‘The Government contribution under paragraph (4) 
shall be treated as premiums payable and deposited 
for purposes of subparagraphs (A) and (B) of para-
graph (1).’’. 
(g) EXTENSION OF SECONDARY PAYER REQUIRE-
MENTS FOR ESRD BENEFICIARIES ELIGIBLE FOR COV-
ERAGE
OF
IMMUNOSUPPRESSIVE
DRUGS.—Section 
1862(b)(1)(C) (42 U.S.C. 1395(y)(b)(1)) is amended by 
adding at the end the following new sentence: ‘‘With re-
gard to immunosuppressive drugs furnished to an indi-
vidual who enrolls for the purpose of coverage of immuno-
suppressive drugs under section 1836(b) on or after Janu-
ary 1, 2014, this subparagraph shall apply without regard 
to any time limitation, except that when such individual 
becomes entitled to benefits under this title under sections 
226(a) or 226(b), or entitled to or eligible for benefits 
under this title under section 226A, the provisions of sub-
paragraphs (A) and (B), and the time limitations under 
this subparagraph, respectively, shall apply.’’. 
(h) ENSURING COVERAGE UNDER THE MEDICARE 
SAVINGS PROGRAM.—Section 1905(p)(1)(A) of the Social 
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Security Act (42 U.S.C. 1396d(p)(1)(A)) is amended by 
inserting ‘‘or an individual who is enrolled under part B 
for the purpose of coverage of immunosuppressive drugs 
under section 1836(b)’’ after ‘‘section 1818’’. 
(i) PART D.—Section 1860D–1(a)(3)(A) of the So-
cial Security Act (42 U.S.C. 1395w–101(a)(3)(A)) is 
amended by inserting ‘‘(but not including an individual en-
rolled solely for coverage of immunosuppressive drugs 
under section 1836(b))’’ before the period at the end. 
Æ 
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