I 
109TH CONGRESS 
1ST SESSION H. R. 2051
To amend title XVIII of the Social Security Act to provide continued entitle-
ment to coverage for immunosuppressive drugs furnished to beneficiaries 
under the Medicare Program that have received an organ transplant 
and whose entitlement to coverage would otherwise expire, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 3, 2005
Mr. CAMP (for himself and Mr. STRICKLAND) 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 
continued entitlement to coverage for immunosuppressive 
drugs furnished to beneficiaries under the Medicare Pro-
gram that have received an organ transplant and whose 
entitlement to coverage would otherwise expire, and for 
other purposes.
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 Transplant Patients 
Act of 2005’’. 
SEC. 2. PROVISION OF APPROPRIATE COVERAGE OF IM-
MUNOSUPPRESSIVE 
DRUGS 
UNDER 
THE 
MEDICARE PROGRAM FOR ORGAN TRANS-
PLANT RECIPIENTS. 
(a) 
CONTINUED
ENTITLEMENT
TO
IMMUNO-
SUPPRESSIVE DRUGS.—
(1) KIDNEY
TRANSPLANT
RECIPIENTS.—Sec-
tion 226A(b)(2) of the Social Security Act (42 
U.S.C. 426–1(b)(2)) is amended by inserting ‘‘(ex-
cept for coverage of immunosuppressive drugs under 
section 1861(s)(2)(J))’’ after ‘‘shall end’’. 
(2) OTHER
TRANSPLANT
RECIPIENTS.—The 
flush matter following paragraph (2)(C)(ii)(II) of 
section 226(b) of the Social Security Act (42 U.S.C. 
426(b)) is amended by striking ‘‘of this subsection)’’ 
and inserting ‘‘of this subsection and except for cov-
erage of immunosuppressive drugs under section 
1861(s)(2)(J))’’. 
(3) APPLICATION.—Section 1836 of the Social 
Security Act (42 U.S.C. 1395o) is amended—
(A) by striking ‘‘Every individual who’’ 
and inserting ‘‘(a) IN GENERAL.—Every indi-
vidual who’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(b) SPECIAL RULES APPLICABLE TO INDIVIDUALS 
ONLY ELIGIBLE FOR COVERAGE OF IMMUNOSUPPRESSIVE 
DRUGS.—
‘‘(1) IN GENERAL.—In the case of an individual 
whose eligibility for benefits under this title has 
ended except for the coverage of immunosuppressive 
drugs by reason of section 226(b) or 226A(b)(2), the 
following rules shall apply: 
‘‘(A) The individual shall be deemed to be 
enrolled under this part for purposes of receiv-
ing coverage of such drugs. 
‘‘(B) The individual shall be responsible 
for the full amount of the premium under sec-
tion 1839 in order to receive such coverage. 
‘‘(C) The provision of such drugs shall be 
subject to the application of—
‘‘(i) the deductible under section 
1833(b); and
‘‘(ii) the coinsurance amount applica-
ble for such drugs (as determined under 
this part). 
‘‘(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 
this part. 
‘‘(2) ESTABLISHMENT
OF
PROCEDURES
IN 
ORDER TO IMPLEMENT COVERAGE.—The Secretary 
shall establish procedures for—
‘‘(A) identifying beneficiaries that are enti-
tled to coverage of immunosuppressive drugs by 
reason of section 226(b) or 226A(b)(2); and 
‘‘(B) distinguishing such beneficiaries from 
beneficiaries that are enrolled under this part 
for the complete package of benefits under this 
part.’’. 
(4) TECHNICAL AMENDMENT.—Subsection (c) 
of section 226A of the Social Security Act (42 
U.S.C. 426–1), as added by section 201(a)(3)(D)(ii) 
of the Social Security Independence and Program 
Improvements Act of 1994 (Public Law 103–296; 
108 Stat. 1497), is redesignated 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 
Comprehensive Immunosuppressive Drug Coverage for 
Transplant Patients Act of 2005, 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 Comprehensive Immuno-
suppressive Drug Coverage for Transplant Patients Act 
of 2005, and such requirement shall be deemed to be in-
corporated 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 Comprehensive Immuno-
suppressive Drug Coverage for Transplant Patients Act
of 2005, and such requirement shall be deemed to be in-
corporated 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:
‘‘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:
‘‘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 Comprehensive Immuno-
suppressive Drug Coverage for Transplant Patients Act 
of 2005, and such requirement shall be deemed to be in-
corporated into this section.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to plan years beginning on or after 
January 1, 2006.
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