I 
112TH CONGRESS 
1ST SESSION H. R. 2969 
To amend title XVIII of the Social Security Act to provide for extended 
months of Medicare coverage of immunosuppressive drugs for kidney 
transplant patients and other renal dialysis provisions. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 20, 2011 
Mr. BURGESS (for himself, Mr. KIND, Mr. LEWIS of California, Mrs. BLACK-
BURN, Mr. HIMES, Mr. LATHAM, Mr. SMITH of New Jersey, Mr. ROGERS 
of Michigan, Mr. HURT, Mr. YOUNG of Florida, Mr. LANCE, Mr. BACH-
US, Mr. MCKINLEY, Mr. KILDEE, Ms. SCHAKOWSKY, Mr. BOREN, Mr. 
STARK, Mr. INSLEE, and Mr. LEWIS of Georgia) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Ways and Means, for a period to be sub-
sequently determined by the Speaker, in each case for consideration of 
such provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for extended months of Medicare coverage of immuno-
suppressive drugs for kidney transplant patients and 
other renal dialysis provisions. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Comprehensive Im-
munosuppressive Drug Coverage for Kidney Transplant 
Patients Act of 2011’’. 
SEC. 2. EXTENDED MONTHS OF COVERAGE OF IMMUNO-
SUPPRESSIVE DRUGS FOR KIDNEY TRANS-
PLANT PATIENTS AND OTHER RENAL DIALY-
SIS PROVISIONS. 
(a) 
MEDICARE
ENTITLEMENT
TO
IMMUNO-
SUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT RECIPI-
ENTS.— 
(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 eligibility for enrollment under part B solely 
for purposes of coverage of immunosuppressive 
drugs described in section 1861(s)(2)(J))’’ before ‘‘, 
with the thirty-sixth month’’. 
(2) INDIVIDUALS
ELIGIBLE
ONLY
FOR
COV-
ERAGE OF IMMUNOSUPPRESSIVE DRUGS.— 
(A) Section 1836 of the Social Security 
Act (42 U.S.C. 1395o) is amended— 
(i) by striking ‘‘Every’’ and inserting 
‘‘(a) IN GENERAL.—Every’’; and 
(ii) by inserting at the end the fol-
lowing new subsection: 
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‘‘(b) 
INDIVIDUALS
ELIGIBLE
FOR
IMMUNO-
SUPPRESSIVE DRUG COVERAGE.—Beginning on January 
1, 2012, every individual whose insurance benefits under 
part A have ended (whether before, on, or after such date) 
by reason of section 226A(b)(2) is eligible for enrollment 
in the insurance program established by this part solely 
for purposes of coverage of immunosuppressive drugs.’’. 
(B) CONFORMING AMENDMENT.—Sections 
1837, 1838, and 1839 of the Social Security 
Act (42 U.S.C. 1395(o), 42 U.S.C. 1395(p), 42 
U.S.C. 1395(q)) are each amended by striking 
‘‘1836’’ and inserting ‘‘1836(a)’’ each place it 
appears. 
(3) ENROLLMENT FOR INDIVIDUALS ONLY ELI-
GIBLE
FOR
COVERAGE
OF
IMMUNOSUPPRESSIVE 
DRUGS.—Section 1837 of the Social Security Act 
(42 U.S.C. 1395(p)) is amended by adding at the 
end the following new subsection: 
‘‘(m)(1) Any individual who is eligible under section 
1836(b) to enroll in the medical insurance program estab-
lished under this part for purposes of coverage of immuno-
suppressive drugs may enroll only in such manner and 
form as may be prescribed by regulations, and only during 
an enrollment period described in this subsection. 
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‘‘(2) An individual described in paragraph (1) may 
enroll beginning on the first day of the third month before 
the month in which the individual first satisfies section 
1836(b). 
‘‘(3) An individual described in paragraph (1) whose 
entitlement for hospital insurance benefits under part A 
ends by reason of section 226A(b)(2) on or after January 
1, 2012, shall be deemed to have enrolled in the medical 
insurance program established by this part for purposes 
of coverage of immunosuppressive drugs.’’. 
(4) COVERAGE PERIOD FOR INDIVIDUALS ONLY 
ELIGIBLE FOR COVERAGE OF IMMUNOSUPPRESSIVE 
DRUGS.— 
(A) IN GENERAL.—Section 1838 of the So-
cial Security Act (42 U.S.C. 1395(q)) is amend-
ed by adding at the end the following new sub-
section: 
‘‘(g) In the case of an individual described in section 
1836(b), the following rules shall apply: 
‘‘(1) In the case of such an individual who is 
deemed to have enrolled in part B for coverage of 
immunosuppressive drugs under section 1837(m)(3), 
such individual’s coverage period shall begin on the 
first day of the month in which the individual first 
satisfies section 1836(b). 
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‘‘(2) In the case of such an individual who en-
rolls in part B for coverage of immunosuppressive 
drugs under section 1837(m)(2), such individual’s 
coverage period shall begin on the first day of the 
month in which the individual first satisfies section 
1836(b) or the month following the month in which 
the individual so enrolls, whichever is later. 
‘‘(3) The provisions of subsections (b) and (d) 
shall apply with respect to an individual described in 
paragraph (1) or (2). 
‘‘(4) In addition to the reasons for termination 
under subsection (b), the coverage period of an indi-
vidual described in paragraph (1) or (2) shall end 
when the individual becomes entitled to benefits 
under this title under section 226(a), 226(b), or 
226A.’’. 
(B) CONFORMING AMENDMENTS.—Section 
1838(b) is amended in the matter following 
paragraph 
(2) 
by 
adding 
‘‘or 
section 
1837(m)(3)’’ after ‘‘section 1837(f)’’ each place 
it appears. 
(5) PREMIUMS FOR INDIVIDUALS ONLY ELIGI-
BLE
FOR
COVERAGE
OF
IMMUNOSUPPRESSIVE 
DRUGS.—Section 1839 of the Social Security Act 
(42 U.S.C. 1395r) is amended— 
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(A) in subsection (b), by adding at the end 
the following new sentence: ‘‘No increase in the 
premium shall be effected for individuals who 
are enrolled pursuant to section 1836(b) for 
coverage only of immunosuppressive drugs.’’; 
and 
(B) by adding at the end the following new 
subsection: 
‘‘(j) DETERMINATION OF PREMIUM FOR INDIVID-
UALS ONLY ELIGIBLE
FOR COVERAGE
OF IMMUNO-
SUPPRESSIVE DRUGS.—The Secretary shall, during Sep-
tember of each year, determine and promulgate a monthly 
premium rate for the succeeding calendar year for individ-
uals who enroll only for the purpose of coverage of im-
munosuppressive drugs under section 1836(b). Such pre-
mium shall be equal to 35 percent of the monthly actuarial 
rate for enrollees age 65 and over, determined according 
to paragraph (1), for that succeeding calendar year. The 
monthly premium of each individual enrolled for coverage 
of immunosuppressive drugs under section 1836(b) for 
each month shall be the amount promulgated in this sub-
section. Such amount shall be adjusted in accordance with 
subsections (c) and (f).’’. 
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(6) 
GOVERNMENT
CONTRIBUTION.—Section 
1844(a) of the Social Security Act (42 U.S.C. 
1395(w)) is amended— 
(A) in paragraph (3), by striking the pe-
riod at the end and inserting ‘‘; plus’’; 
(B) by adding at the end the following new 
paragraph: 
‘‘(4) a Government contribution equal to the es-
timated aggregate reduction in premiums payable 
under part B that results from establishing the pre-
mium at 35 percent of the actuarial rate under sec-
tion 1839(j) instead of 50 percent of the actuarial 
rate for individuals who enroll only for the purpose 
of coverage of immunosuppressive drugs under sec-
tion 1836(b).’’; and 
(C) by adding at the end the following 
flush matter: 
‘‘The Government contribution under paragraph (4) 
shall be treated as premiums payable and deposited 
for purposes of subparagraphs (A) and (B) of para-
graph (1).’’. 
(7) EXTENSION
OF
SECONDARY
PAYER
RE-
QUIREMENTS
FOR
ESRD
BENEFICIARIES
ELIGIBLE 
FOR COVERAGE OF IMMUNOSUPPRESSIVE DRUGS.— 
Section 1862(b)(1)(C) (42 U.S.C. 1395(y)(b)(1)) is 
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amended by adding at the end the following new 
sentence: ‘‘With regard to immunosuppressive drugs 
furnished to an individual who enrolls for the pur-
pose of coverage of immunosuppressive drugs under 
section 1836(b) on or after January 1, 2012, this 
subparagraph shall apply without regard to any time 
limitation, except that when such individual becomes 
entitled to benefits under this title under sections 
226(a) or 226(b), or entitled to or eligible for bene-
fits under this title under section 226A, the provi-
sions of subparagraphs (A) and (B), and the time 
limitations under this subparagraph, respectively, 
shall apply.’’. 
(8) ENSURING COVERAGE UNDER THE MEDI-
CARE SAVINGS PROGRAM.—Section 1905(p)(1)(A) of 
the Social Security Act (42 U.S.C. 1396d(p)(1)(A)) 
is amended by inserting ‘‘or an individual who is en-
rolled under part B for the purpose of coverage of 
immunosuppressive drugs under section 1836(b)’’ 
after ‘‘section 1818’’. 
(9) PART D.—Section 1860D–1(a)(3)(A) of the 
Social Security Act (42 U.S.C. 1395w–101(a)(3)(A)) 
is amended by inserting ‘‘(but not including an indi-
vidual enrolled solely for coverage of immuno-
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suppressive drugs under section 1836(b))’’ before 
the period at the end. 
Æ 
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