SEC. 2. EQUITABLE TREATMENT OF RESIDENTS OF TERRI-
TORIES UNDER MEDICARE PRESCRIPTION 
DRUG TRANSITIONAL ASSISTANCE PROGRAM. 
(a) IN GENERAL.—Subsection (b)(2)(A) of section 
1860D–31 of the Social Security Act (42 U.S.C. 1395w– 
141) is amended by inserting after ‘‘or the District of Co-
lumbia’’ the following: ‘‘or in Puerto Rico, the Virgin Is-
lands, Guam, American Samoa, or the Commonwealth of 
the Northern Mariana Islands’’. 
(b) CONFORMING CHANGE
IN AVAILABILITY
OF 
FUNDS.—Subsection (j)(2) of such section is amended— 
(1) by striking ‘‘for the entire period of the op-
eration of this section’’ and inserting ‘‘for 2004’’; 
and 
(2) by striking subparagraph (D). 
(c) ADDITIONAL CONFORMING AMENDMENTS.—(1) 
Subsection (b) of such section is amended— 
(A) by adding at the end of paragraph (2)(A) 
the following: ‘‘The poverty line to be applied under 
this subparagraph to an individual residing in a ter-
ritory shall be the same as the poverty line applica-
ble to individuals residing in the continental United 
States.’’; and 
(B) by adding at the end of paragraph (3) the 
following: ‘‘The poverty line to be applied under this 
paragraph to an individual residing in a territory
shall be the same as the poverty line applicable to 
individuals residing in the continental United 
States.’’. 
(2) Subsection (f)(3)(C)(ii) of such section is amend-
ed by striking ‘‘that is one of the 50 States or the District 
of Columbia’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on January 1, 2005. 
SEC. 3. EQUITABLE TREATMENT OF RESIDENTS OF TERRI-
TORIES IN PREMIUM AND COST-SHARING 
SUBSIDIES UNDER MEDICARE PRESCRIPTION 
DRUG PROGRAM. 
(a) IN GENERAL.—Section 1860D–14(a)(3) of the 
Social Security Act (42 U.S.C. 1395w–114(a)(3)) is 
amended by striking subparagraph (F). 
(b) CONFORMING AMENDMENTS.— 
(1) Section 1935 of such Act (42 U.S.C. 1396v) 
is amended— 
(A) in subsections (a) and (c)(1), by strik-
ing ‘‘subject to subsection (e)’’; 
(B) in subsection (c)(1)(A), by striking 
‘‘Each of the 50 States and the District of Co-
lumbia’’ and inserting ‘‘Each State’’; 
(C) in subsection (c)(2)(A)(i), by striking 
‘‘and’’ at the end of subclause (I), and by add-
ing after subclause (II) the following new sub-
clause: 
‘‘(III) in the case of a territory 
subject to a limitation on payments 
under this title under subsections (f) 
and (g) of section 1108, the ratio of 
the total amounts of the payment lim-
itations under such subsections for 
such territory for fiscal year 2003, to 
the total amounts that would be pay-
able to such territory under this title 
for such fiscal year but for such pay-
ment limitations; and’’; and 
(D) by striking subsection (e). 
(2) Section 1108(f) of such Act (42 U.S.C. 
1308(f)) is amended by striking ‘‘and section 
1935(e)(1)(B)’’. 
(3) Section 1860D–14(a)(3)(C) of such Act (42 
U.S.C. 1395w–114(a)(3)(C)) is amended by adding 
at the end the following: ‘‘The poverty line to be ap-
plied in the territories shall be the same as the pov-
erty line applied to States in the continental United 
States.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall be effective as if included in the enact-
ment of the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 (Public Law 108–173). 
SEC. 4. INSTITUTE OF MEDICINE REPORT ON ACCESS OF 
MEDICARE BENEFICIARIES IN TERRITORIES 
TO PRESCRIPTION DRUGS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall request the Institute of Medicine 
of the National Academy of Sciences to undertake a study 
that examines the access of medicare beneficiaries residing 
in the United States territories to prescription drugs dur-
ing each of 3 periods: 
(1) BEFORE MMA.—The period before the date 
of the enactment of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (Pub-
lic Law 108–173). 
(2) DISCOUNT
CARD
AND
TRANSITIONAL
AS-
SISTANCE.—The period during the implementation 
of the discount card and transitional assistance pro-
gram (under section 1860D–31 of the Social Secu-
rity Act). 
(3) IMPLEMENTATION OF PRESCRIPTION DRUG 
BENEFIT.—The period beginning on January 1, 
2006. 
(b) REPORT.—The study under subsection (a) shall 
include a report to the Secretary, the Committees on Ways