I
107TH CONGRESS
1ST SESSION
H. R. 1839
To amend title XVIII of the Social Security Act to provide adequate coverage
for immunosuppressive drugs furnished to beneficiaries under the medi-
care program that have received an organ transplant, and for other
purposes.
IN THE HOUSE OF REPRESENTATIVES
MAY 15, 2001
Mr. CAMP (for himself and Mrs. THURMAN) introduced the following bill;
which was referred to the Committee on Ways and Means, and in addi-
tion to the Committees on Energy and Commerce and Education and the
Workforce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to provide
adequate coverage for immunosuppressive drugs fur-
nished to beneficiaries under the medicare program that
have received an organ transplant, and for other pur-
poses.
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 ‘‘Immunosuppressive
Drug Coverage Act of 2001’’.
SEC. 2. PROVISION OF APPROPRIATE COVERAGE OF IM-
MUNOSUPPRESSIVE 
DRUGS 
UNDER 
THE
MEDICARE PROGRAM.
(a) 
CONTINUED
ENTITLEMENT
TO
IMMUNO-
SUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT RECIPI-
ENTS.—
(1) IN GENERAL.—Section 226A(b)(2) of the
Social Security Act (42 U.S.C. 426–1(b)(2)) is
amended by inserting ‘‘(except for coverage of im-
munosuppressive 
drugs 
under 
section
1861(s)(2)(J))’’ after ‘‘shall end’’.
(2) APPLICATION.—In the case of an individual
whose eligibility for benefits under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.) has
ended except for the coverage of immunosuppressive
drugs by reason of the amendment made by para-
graph (1), the following rules shall apply:
(A) The individual shall be deemed to be
enrolled in part B of the original medicare fee-
for-service program under title XVIII of the So-
cial Security Act (42 U.S.C. 1395j et seq.) for
purposes of receiving coverage of such drugs.
(B) The individual shall be responsible for
the full part B premium under section 1839 of
such Act (42 U.S.C. 1395r) in order to receive
such coverage.
(C) The provision of such drugs shall be
subject to the application of—
(i) the part B deductible under section
1833(b) of such Act (42 U.S.C. 1395l(b));
and
(ii) the coinsurance amount applicable
for such drugs (as determined under such
part B).
(D) If the individual is an inpatient of a
hospital or other entity, the individual is enti-
tled to receive coverage of such drugs under
such part B.
(3) 
ESTABLISHMENT
OF
PROCEDURES
IN
ORDER TO IMPLEMENT COVERAGE.—The Secretary
of Health and Human Services shall establish proce-
dures for—
(A) identifying beneficiaries that are enti-
tled to coverage of immunosuppressive drugs by
reason of the amendment made by paragraph
(1); and
(B) distinguishing such beneficiaries from
beneficiaries that are enrolled under part B of
title XVIII of the Social Security Act for the
complete package of benefits under such part.
(4) TECHNICAL AMENDMENT.—Subsection (c)
of section 226A (42 U.S.C. 426–1), as added by sec-
tion 201(a)(3)(D)(ii) of the Social Security Inde-
pendence and Program Improvements Act of 1994
(Public Law 103–296; 108 Stat. 1497), is redesig-
nated as subsection (d).
(b) EXTENSION OF SECONDARY PAYER REQUIRE-
MENTS
FOR
ESRD 
BENEFICIARIES.—Section
1862(b)(1)(C) of the Social Security Act (42 U.S.C.
1395y(b)(1)(C)) is amended by adding at the end the fol-
lowing new sentence: ‘‘With regard to immunosuppressive
drugs furnished on or after the date of enactment of the
Immunosuppressive Drugs Coverage Act of 2001, this
subparagraph shall be applied without regard to any time
limitation.’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to drugs furnished on or after the
date of enactment of this Act.
SEC. 3. PLANS REQUIRED TO MAINTAIN COVERAGE OF IM-
MUNOSUPPRESSIVE DRUGS.
(a) APPLICATION TO CERTAIN HEALTH INSURANCE
COVERAGE.—
(1) IN GENERAL.—Subpart 2 of part A of title
XXVII of the Public Health Service Act (42 U.S.C.
300gg–4 et seq.) is amended by adding at the end
the following:
‘‘SEC. 2707. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.
‘‘A group health plan (and a health insurance issuer
offering health insurance coverage in connection with a
group health plan) shall provide coverage of immuno-
suppressive drugs that is at least as comprehensive as the
coverage provided by such plan or issuer on the day before
the date of enactment of the Immunosuppressive Drug
Coverage Act of 2001, and such requirement shall be
deemed to be incorporated into this section.’’.
(2) 
CONFORMING
AMENDMENT.—Section
2721(b)(2)(A) of the Public Health Service Act (42
U.S.C. 300gg–21(b)(2)(A)) is amended by inserting
‘‘(other than section 2707)’’ after ‘‘requirements of
such subparts’’.
(b) APPLICATION TO GROUP HEALTH PLANS AND
GROUP HEALTH INSURANCE COVERAGE UNDER THE EM-
PLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.—
(1) IN GENERAL.—Subpart B of part 7 of sub-
title B of title I of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1185 et seq.) is
amended by adding at the end the following new sec-
tion:
‘‘SEC. 714. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.
‘‘A group health plan (and a health insurance issuer
offering health insurance coverage in connection with a
group health plan) shall provide coverage of immuno-
suppressive drugs that is at least as comprehensive as the
coverage provided by such plan or issuer on the day before
the date of enactment of the Immunosuppressive Drug
Coverage Act of 2001, and such requirement shall be
deemed to be incorporated into this section.’’.
(2) CONFORMING AMENDMENTS.—
(A) Section 732(a) of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C.
1185(a)) is amended by striking ‘‘section 711’’
and inserting ‘‘sections 711 and 714’’.
(B) The table of contents in section 1 of
the Employee Retirement Income Security Act
of 1974 is amended by inserting after the item
relating to section 713 the following new item:
‘‘Sec. 714. Coverage of Immunosuppressive drugs.’’.
(c) APPLICATION TO GROUP HEALTH PLANS UNDER
THE INTERNAL REVENUE CODE OF 1986.—Subchapter B
of chapter 100 of the Internal Revenue Code of 1986 is
amended—
(1) in the table of sections, by inserting after
the item relating to section 9812 the following new
item:
‘‘Sec. 9813. Coverage of immunosuppressive drugs.’’;
and
(2) by inserting after section 9812 the fol-
lowing:
‘‘SEC. 9813. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.
‘‘A group health plan shall provide coverage of im-
munosuppressive drugs that is at least as comprehensive
as the coverage provided by such plan on the day before
the date of enactment of the Immunosuppressive Drug
Coverage Act of 2001, and such requirement shall be
deemed to be incorporated into this section.’’.
(d) EFFECTIVE DATE.—The amendments made by
this section shall apply to plan years beginning on or after
January 1, 2002.
Æ