I 
116TH CONGRESS 
1ST SESSION H. R. 3029 
To amend title XVIII of the Social Security Act to provide transitional 
coverage and retroactive Medicare part D coverage for certain low-income 
beneficiaries. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 28, 2019 
Mr. OLSON (for himself, Ms. BARRAGA´N, Mr. MARCHANT, and Mr. LEWIS) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
transitional coverage and retroactive Medicare part D 
coverage for certain low-income beneficiaries. 
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 ‘‘Improving Low-Income 
Access to Prescription Drugs Act of 2019’’. 
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SEC. 2. TRANSITIONAL COVERAGE AND RETROACTIVE 
MEDICARE PART D COVERAGE FOR CERTAIN 
LOW-INCOME BENEFICIARIES. 
Section 1860D–14 of the Social Security Act (42 
U.S.C. 1395w–114) is amended— 
(1) by redesignating subsection (e) as sub-
section (f); and 
(2) by adding after subsection (d) the following 
new subsection: 
‘‘(e) LIMITED INCOME NEWLY ELIGIBLE TRANSI-
TION PROGRAM.— 
‘‘(1) IN GENERAL.—The Secretary shall carry 
out a program to provide transitional coverage for 
covered part D drugs for LI NET eligible individ-
uals in accordance with this subsection. 
‘‘(2) LI NET ELIGIBLE INDIVIDUAL DEFINED.— 
For purposes of this subsection, the term ‘LI NET 
eligible individual’ means a part D eligible individual 
who— 
‘‘(A) is a subsidy eligible individual; and 
‘‘(B) has not yet enrolled in a prescription 
drug plan or an MA–PD plan, or, who has so 
enrolled, but with respect to whom coverage 
under such plan has not yet taken effect. 
‘‘(3) TRANSITIONAL COVERAGE.—For purposes 
of this subsection, the term ‘transitional coverage’ 
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means with respect to an LI NET eligible indi-
vidual— 
‘‘(A) immediate access to covered part D 
drugs at the point of sale during the period 
that begins on the first day of the month such 
individual is determined to be a subsidy eligible 
individual and ends on the date that coverage 
under a prescription drug plan or MA–PD plan 
takes effect with respect to such individual; and 
‘‘(B) in the case of an LI NET eligible in-
dividual who is a full-benefit dual eligible indi-
vidual (as defined in section 1935(c)(6)) or a 
recipient of supplemental security income bene-
fits under title XVI, retroactive coverage (in the 
form of reimbursement of the amounts that 
would have been paid under this part had such 
individual been enrolled in a prescription drug 
plan or MA–PD plan) of covered part D drugs 
purchased by such individual during the period 
that begins on the date that is the later of— 
‘‘(i) the date that such individual was 
first eligible for a low-income subsidy 
under this part; or 
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‘‘(ii) the date that is 36 months prior 
to the date such individual enrolls in a pre-
scription drug plan or MA–PD plan, 
and ends on the date that coverage under such 
plan takes effect. 
‘‘(4) PROGRAM ADMINISTRATION.— 
‘‘(A) SINGLE
POINT
OF
CONTACT.—The 
Secretary shall, to the extent feasible, admin-
ister the program under this subsection through 
a contract with a single program administrator. 
‘‘(B) BENEFIT
DESIGN.—The Secretary 
shall ensure that the transitional coverage pro-
vided to LI NET eligible individuals under this 
subsection— 
‘‘(i) provides access to all covered part 
D drugs under an open formulary; 
‘‘(ii) permits all pharmacies deter-
mined by the Secretary to be in good 
standing to process claims under the pro-
gram; 
‘‘(iii) is consistent with such require-
ments as the Secretary considers necessary 
to improve patient safety and ensure ap-
propriate dispensing of medication; and 
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‘‘(iv) meets such other requirements 
as the Secretary may establish. 
‘‘(5) RELATIONSHIP TO OTHER PROVISIONS OF 
THIS TITLE; WAIVER AUTHORITY.— 
‘‘(A) IN GENERAL.—The following provi-
sions shall not apply with respect to the pro-
gram under this subsection: 
‘‘(i) Paragraphs (1) and (3)(B) of sec-
tion 1860D–4(a) (relating to dissemination 
of general information; availability of infor-
mation on changes in formulary through 
the internet). 
‘‘(ii) Subparagraphs (A) and (B) of 
section 1860D–4(b)(3) (relating to require-
ments on development and application of 
formularies; formulary development). 
‘‘(iii) Paragraphs (1)(C) and (2) of 
section 1860D–4(c) (relating to medication 
therapy management program). 
‘‘(B) WAIVER AUTHORITY.—The Secretary 
may waive such other requirements of titles XI 
and this title as may be necessary to carry out 
the purposes of the program established under 
this subsection.’’. 
Æ 
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