SEC. 2. ACCESS TO SERVICES UNDER MEDICATION THER-
APY MANAGEMENT PROGRAMS FOR MEDI-
CARE PART D ELIGIBLE INDIVIDUALS WITH 
SINGLE CHRONIC DISEASES. 
Section 1860D–4(c)(2)(A) of the Social Security Act 
(42 U.S.C. 1395w–104(c)(2)(A)) is amended— 
(1) in clause (ii), by striking subclause (I) and 
inserting the following: 
‘‘(I) have— 
‘‘(aa) multiple chronic dis-
eases (such as diabetes, asthma, 
hypertension, hyperlipidemia, and 
congestive heart failure); or 
‘‘(bb) subject to clause (iii), 
any single chronic disease, in-
cluding diabetes, hypertension, 
heart failure, dyslipidemia, res-
piratory disease (such as asthma, 
chronic 
obstructive 
pulmonary 
disease or chronic lung disorder), 
bone disease-arthritis (such as 
osteoporosis 
or 
osteoarthritis), 
rheumatoid arthritis, or mental 
health disorder (such as depres-
sion, schizophrenia, or bipolar 
disorder).’’; and 
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(2) by adding at the end the following: 
‘‘(iii) DETERMINATIONS RELATING TO 
PROGRAM COSTS FOR INCLUDING INDIVID-
UALS WITH SINGLE CHRONIC DISEASES.— 
‘‘(I) 
INITIAL
DETERMINA-
TIONS.—With regard to any single 
chronic disease, clause (ii)(I)(bb) shall 
only be applied if the Chief Actuary 
for the Centers for Medicare & Med-
icaid Services determines that the ap-
plication of such clause with regard to 
such disease is not projected to in-
crease overall costs to the Medicare 
program under this title over the five 
year period beginning on the date of 
determination. 
‘‘(II) REVIEW
OF
DETERMINA-
TIONS.—In the case that clause 
(ii)(I)(bb) is applied with respect to a 
single chronic disease pursuant to a 
determination under subclause (I), not 
later than five years after such date of 
determination, the Chief Actuary for 
the Centers for Medicare & Medicaid 
Services shall review the effect of the 
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application of such clause with respect 
to such disease on the actual cost of 
the Medicare program under this title 
during such five years. Based on such 
review, if the Chief Actuary is unable 
to determine that, with regard to such 
single chronic disease, the application 
of such clause did not increase costs 
to the Federal government under the 
Medicare program under this title 
over such period, then the Secretary 
shall review the findings of the Chief 
Actuary and determine whether such 
clause shall continue to be applied 
with regard to such single chronic dis-
ease. In conducting such review and 
making such determination, the Sec-
retary shall consider the extent to 
which the application of such clause 
with regard to such single chronic dis-
ease effects the health outcomes of 
part D eligible individuals and any 
savings and costs to the Federal gov-
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ernment under the Medicare program 
under this title.’’. 
Æ 
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