I 
109TH CONGRESS 
2D SESSION 
H. R. 4675 
To amend title XIX of the Social Security Act to provide for an offset 
from the Medicaid clawback for State emergency prescription drug ex-
penditures for covered part D drugs for Medicare beneficiaries. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 31, 2006 
Mr. PALLONE (for himself, Ms. MCCOLLUM of Minnesota, Mr. JEFFERSON, 
Ms. BALDWIN, Mr. HOLT, Mr. SANDERS, Mr. MCDERMOTT, Mr. HIG-
GINS, Mr. BOREN, Mr. HONDA, Mr. STARK, Mr. ANDREWS, Mr. 
GRIJALVA, Mr. BROWN of Ohio, Mr. MICHAUD, Ms. JACKSON-LEE of 
Texas, Mr. BERRY, Mr. LYNCH, Mr. KUCINICH, Mr. CONYERS, Mr. 
FRANK of Massachusetts, Mr. NADLER, Mr. COSTA, and Ms. LEE) intro-
duced 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 subsequently 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 XIX of the Social Security Act to provide 
for an offset from the Medicaid clawback for State emer-
gency prescription drug expenditures for covered part 
D drugs for Medicare 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 ‘‘Medicare State Reim-
bursement Act of 2006’’. 
SEC. 2. FEDERAL RESPONSIBILITY FOR STATE PRESCRIP-
TION DRUG EXPENDITURES FOR COVERED 
PART 
D 
DRUGS 
FOR 
MEDICARE 
BENE-
FICIARIES. 
Section 1935(c) of the Social Security Act (42 U.S.C. 
1396v–5(c)) is amended— 
(1) in paragraph (1)(A), by striking ‘‘Each of 
the 50 States’’ and inserting ‘‘Subject to paragraph 
(7), each of the 50 States’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(7) OFFSET FOR STATE PRESCRIPTION DRUG 
EXPENDITURES FOR COVERED PART D DRUGS FOR 
MEDICARE BENEFICIARIES.— 
‘‘(A) IN GENERAL.—The amount of pay-
ment for a month (beginning with January 
2006) under paragraph (1) shall be reduced by 
an amount equal to the sum of— 
‘‘(i) the amount (as documented by 
the State) that the State expended during 
the month for payment for covered part D 
drugs for part D eligible individuals who 
are enrolled in a prescription drug plan
under part D of title XVIII but were un-
able to access on a timely basis prescrip-
tion drug benefits to which they were enti-
tled under such plan; and 
‘‘(ii) interest on such amount (for the 
period beginning on the day after the date 
on which an expenditure described in sub-
paragraph (A) is made and ending on the 
date on which payment under paragraph 
(1)) at a rate equal to the weighted aver-
age of interest on three-month marketable 
Treasury securities determined for such 
period, increased by 0.1 percentage point. 
‘‘(B) RECOVERY
OF
REDUCED
PAYMENT 
FROM PRESCRIPTION DRUG PLANS.—The Sec-
retary shall provide for recovery of payment re-
ductions made under subparagraph (A) from 
those prescription drug plans under part D of 
title XVIII or MA–PD plans under part C of 
such title that would otherwise be responsible 
for the expenditures described in subparagraph 
(A)(i). Any such amounts recovered shall be de-
posited into the Medicare Prescription Drug Ac-
count in the Federal Supplementary Medical 
Insurance Trust Fund.’’. 
Æ