automatically auto-enrolled to new benchmark pre-
scription drug plans under part D of the Medicare 
program between 2006 and 2007. 
(5) Community providers are at the front line 
of helping the most vulnerable dual eligible bene-
ficiaries obtain prescription drug coverage under the 
Medicare program and navigate complex enrollment 
and low-income subsidy eligibility requirements 
under such program. 
(b) PURPOSE.—It is the purpose of this bill to help 
low-income persons with cognitive impairments to enroll 
in and navigate the prescription drug benefit under the 
Medicare program by providing front line community pro-
viders who serve the population daily with financial assist-
ance to conduct vigorous education and outreach and di-
rect case management. 
SEC. 3. MEDICARE PRESCRIPTION DRUG OUTREACH DEM-
ONSTRATION PROGRAM FOR DUAL ELIGIBLE 
BENEFICIARIES WITH MENTAL DISABILITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall establish a 3-year demonstration program 
(in this section referred to as ‘‘the demonstration pro-
gram’’) under which the Secretary awards grants and con-
tracts to appropriate, qualified community programs and 
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clinics for individuals with intellectual or developmental 
disabilities or such programs that are described in sub-
section (b)(1) of section 1913 of the Public Health Serv-
ices Act, regardless of whether such program meets the 
criteria described in subsection (c) of such section, to em-
ploy qualified social workers and case managers to provide 
Medicare prescription drug assistance described in sub-
section (c) to target full-benefit dual eligible individuals. 
As a condition of receipt of a grant or contract under this 
subsection, a program or clinic shall collect and maintain 
data identified by the Centers for Medicare & Medicaid 
Services as critical for the final evaluation and report to 
Congress described in subsection (d). 
(b) TARGET FULL-BENEFIT DUAL ELIGIBLE INDI-
VIDUAL DEFINED.—For purposes of this section, the term 
‘‘target full-benefit dual eligible individual’’ means a part 
D eligible individual, as defined in section 1860D– 
1(a)(3)(A) of the Social Security Act (42 U.S.C. 1395w– 
101(a)(3)(A)), who is a full-benefit dual eligible individual 
(as defined in section 1935(c)(6) of the Social Security 
Act (42 U.S.C. 1396u–5(c)(6))) with one or more mental 
disabilities, including mental retardation, dementia, men-
tal illnesses, Alzheimer’s disease, autism, or any other re-
lated condition that produces serious cognitive impair-
ments. 
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(c) TYPES OF ASSISTANCE.—For purposes of sub-
section (a), the Medicare prescription drug assistance de-
scribed in this subsection is one-on-one counseling with re-
spect to one or more of the following areas of assistance: 
(1) Assistance with initial enrollment in a pre-
scription drug plan under part D of title XVIII of 
the Social Security Act or in an MA–PD plan under 
part C of such title. 
(2) Assistance with switching from one such 
prescription drug plan or MA–PD plan to another 
such prescription drug plan or MA–PD plan. 
(3) Assistance with filing for an exception to a 
formulary used by such a plan. 
(4) Assistance with filing a grievance, reconsid-
eration, or appeal under section 1860D–4 of the So-
cial Security Act (42 U.S.C. 1395w–104), including 
assistance with collecting relevant information to file 
such a grievance, reconsideration, or appeal. 
(5) Assistance with navigating utilization man-
agement programs administered by a PDP sponsor 
offering a prescription drug plan under part D of 
title XVIII of the Social Security Act or a Medicare 
Advantage organization offering an MA–PD plan 
under part C of such title. 
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(6) Assistance with obtaining prescription drugs 
from pharmacies participating with such a plan. 
(7) Assistance with facilitating contact with the 
Medicare Beneficiary Ombudsman appointed under 
section 1808(c) of the Social Security Act (42 
U.S.C. 1395b–9). 
(d) EVALUATION AND REPORT.— 
(1) EVALUATION.—The Secretary shall provide 
for an evaluation of the demonstration program. 
Such evaluation may include an analysis of— 
(A) the utilization of the assistance pro-
vided under the program; 
(B) the satisfaction of target full-benefit 
dual eligible individuals with such assistance; 
and 
(C) the success of the program in— 
(i) facilitating access by such individ-
uals to covered part D drugs (as defined in 
section 1860D–2(e) of the Social Security 
Act (42 U.S.C. 1395w–102(e)); and 
(ii) medication compliance. 
(2) REPORT.—Not later than 6 months after 
the date of the completion of the demonstration pro-
gram, the Secretary shall submit to Congress a re-
port on such evaluation and shall include in such re-
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port recommendations regarding the feasibility of 
permanently funding an education and outreach pro-
gram on the prescription drug benefit under the 
Medicare program for target full-benefit dual eligible 
individuals. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated for each of the fiscal years 
2011 through 2013— 
(1) to carry out this section (other than sub-
section (d)), $10,000,000; and 
(2) such sums as may be necessary to carry out 
subsection (d). 
Æ 
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