I
106TH CONGRESS
2D SESSION
H. R. 4375
To amend title XVIII of the Social Security Act to provide for coverage
under the Medicare Program of self-administered drugs that, when used
as a replacement for covered drugs, result in overall cost savings to
the program.
IN THE HOUSE OF REPRESENTATIVES
MAY 3, 2000
Ms. BALDWIN (for herself, Mr. WAXMAN, Mr. STARK, Mr. PALLONE, Mr.
KLECZKA, Mrs. THURMAN, Mr. ALLEN, and Mr. MINGE) introduced the
following bill; which was referred to the Committee on Commerce, and
in addition to the Committee on Ways amd Means, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee con-
cerned
A BILL
To amend title XVIII of the Social Security Act to provide
for coverage under the Medicare Program of self-admin-
istered drugs that, when used as a replacement for cov-
ered drugs, result in overall cost savings to the program.
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 ‘‘Medicare Drug Cost
Savings Act of 2000’’.
SEC. 2. MEDICARE COVERAGE OF COST SAVING SELF-AD-
MINISTERED DRUGS USED AS A REPLACE-
MENT FOR COVERED DRUGS.
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (S);
(2) by striking the period at the end of sub-
paragraph (T) and inserting ‘‘; and’’; and
(3) by inserting after subparagraph (T) the fol-
lowing new subparagraph:
‘‘(U) a self-administered drug (which is ap-
proved by the Food and Drug Administration)
that—
‘‘(i) is a full replacement for a drug or
drug therapy which is otherwise covered under
this title; and
‘‘(ii) as a full replacement for such drug or
drug therapy, results in overall cost savings
under this title for the treatment of the condi-
tion for which such drug or drug therapy is pre-
scribed (as determined by the Secretary);’’.
(b) GAO STUDY.—
(1) IN GENERAL.—The Comptroller General of
the United States shall conduct a study on the im-
plementation by the Secretary of Health and Human
Services of section 1861(s)(2)(U) of the Social Secu-
rity Act, as added by subsection (a). Such study
shall include the identification or evaluation of the
following:
(A) The self-administered drugs that the
Secretary has determined are appropriate for
use as replacement drugs under that section.
(B) The replacement self-administered
drugs for which the Secretary has made pay-
ment under the medicare program under title
XVIII of the Social Security Act (42 U.S.C.
1395 et seq.).
(C) The amount of savings attributable to
the use of such replacement self-administered
drugs.
(D) Additional self-administered drugs
that the Comptroller General determines would
be appropriate for use under that section.
(E) Any impact on utilization and bene-
ficiary access to self-administered drugs under
the medicare program.
(2) REPORT
TO CONGRESS.—Not later than
one year after the date of the enactment of this Act,
the Comptroller General shall submit to Congress a
report on the study conducted under paragraph (1),