I 
116TH CONGRESS 
1ST SESSION H. R. 4669 
To amend title XVIII of the Social Security Act to provide for intelligent 
assignment of certain subsidy eligible individuals auto-enrolled under 
Medicare prescription drug plans and MA–PD plans. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 11, 2019 
Ms. STEVENS (for herself, Mrs. HAYES, Ms. KUSTER of New Hampshire, and 
Ms. SEWELL of Alabama) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined 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 
for intelligent assignment of certain subsidy eligible indi-
viduals auto-enrolled under Medicare prescription drug 
plans and MA–PD plans. 
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 ‘‘Maximizing Drug Cov-
erage for Low-Income Seniors Act of 2019’’. 
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SEC. 2. PROVIDING FOR INTELLIGENT ASSIGNMENT OF 
CERTAIN SUBSIDY ELIGIBLE INDIVIDUALS 
AUTO-ENROLLED 
UNDER 
MEDICARE 
PRE-
SCRIPTION DRUG PLANS AND MA–PD PLANS. 
(a) IN GENERAL.—Section 1860D–1(b)(1) of the So-
cial Security Act (42 U.S.C. 1395w–101(b)(1)) is amend-
ed— 
(1) in subparagraph (C)— 
(A) by inserting after ‘‘PDP region’’ the 
following: ‘‘or through use of an intelligent as-
signment process that is designed to maximize 
the access of such individual to necessary pre-
scription drugs while minimizing costs to such 
individual and to the program under this part 
to the greatest extent possible. In the case the 
Secretary enrolls such individuals through use 
of an intelligent assignment process, such proc-
ess shall take into account the extent to which 
prescription drugs necessary for the individual 
are covered in the case of a PDP sponsor of a 
prescription drug plan that uses a formulary, 
the use of prior authorization or other restric-
tions on access to coverage of such prescription 
drugs by such a sponsor, and the overall quality 
of a prescription drug plan as measured by 
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quality ratings established by the Secretary’’; 
and 
(B) by striking ‘‘Nothing in the previous 
sentence’’ and inserting ‘‘Nothing in this sub-
paragraph’’; and 
(2) in subparagraph (D)— 
(A) by inserting after ‘‘PDP region’’ the 
following: ‘‘or through use of an intelligent as-
signment process that is designed to maximize 
the access of such individual to necessary pre-
scription drugs while minimizing costs to such 
individual and to the program under this part 
to the greatest extent possible. In the case the 
Secretary enrolls such individuals through use 
of an intelligent assignment process, such proc-
ess shall take into account the extent to which 
prescription drugs necessary for the individual 
are covered in the case of a PDP sponsor of a 
prescription drug plan that uses a formulary, 
the use of prior authorization or other restric-
tions on access to coverage of such prescription 
drugs by such a sponsor, and the overall quality 
of a prescription drug plan as measured by 
quality ratings established by the Secretary’’; 
and 
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(B) by striking ‘‘Nothing in the previous 
sentence’’ and inserting ‘‘Nothing in this sub-
paragraph’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply with respect to plan years begin-
ning with plan year 2022. 
Æ 
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