‘‘(5) PAYMENT FOR SOCIAL SECURITY BENEFIT 
PROTECTION PREMIUM REDUCTIONS.— 
‘‘(A) IN
GENERAL.—In addition to pay-
ments provided under section 1860D–15 to a 
PDP sponsor or an MA organization, in the 
case of each part D eligible individual who is 
enrolled in a prescription drug plan offered by 
such sponsor or an MA–PD plan offered by 
such organization and who has a premium re-
duced under section 1860D–13(a)(1)(F), the 
Secretary shall provide for payment to such 
sponsor or organization of an amount equiva-
lent to the amount of such premium reduction. 
‘‘(B) APPLICATION OF PROVISIONS.—The 
provisions of subsections (d) and (f) of section 
1860D–15 (relating to payment methods and 
disclosure of information) shall apply to pay-
ment under subparagraph (A) in the same man-
ner as they apply to payments under such sec-
tion.’’. 
(b) DISREGARD OF PREMIUM REDUCTIONS IN DE-
TERMINING DEDICATED REVENUES UNDER MMA COST 
CONTAINMENT.—Section 801(c)(3)(D) of the Medicare 
Prescription Drug, Improvement, and Modernization Act 
of 2003 (Public Law 108–173) is amended by adding at 
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the end the following: ‘‘Such premiums shall also be deter-
mined without regard to any reductions effected under 
section 1839(f) or 1860D–13(a)(1)(F) of such title.’’. 
(c) EFFECTIVE DATES.— 
(1) PART D PREMIUM.—The amendments made 
by subsection (a) apply to premiums for months be-
ginning with January 2007. 
(2) MMA PROVISION.—The amendment made 
by subsection (b) shall take effect on the date of the 
enactment of this Act. 
TITLE V—BENEFICIARY 
PROTECTION PROVISIONS 
SEC. 501. EXTENSION OF OPEN ENROLLMENT PERIOD; SUS-
PENSION OF LATE ENROLLMENT PENALTIES; 
ALLOWING ONE-TIME CHANGE IN PLAN DUR-
ING FIRST YEAR OF ENROLLMENT. 
(a) EXTENSION OF OPEN ENROLLMENT PERIOD FOR 
2006.—Section 1851(e)(3)(B) of the Social Security Act 
(42 U.S.C. 1395w–21(e)(3)(B)) is amended in clause (iii) 
by striking ‘‘May 15, 2006’’ and inserting ‘‘November 14, 
2006’’. 
(b) NO
LATE
ENROLLMENT
PENALTIES
FOR 
MONTHS
BEFORE
JANUARY
2008.—Section 1860D– 
13(b)(3)(B) of such Act (42 U.S.C. 1395w–113(b)(3)(B)) 
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is amended by inserting ‘‘(after December 2007)’’ after 
‘‘any month’’. 
(c) CHANGE IN PLAN DURING FIRST YEAR OF EN-
ROLLMENT.—Section 1860D–1(b)(1) of such Act (42 
U.S.C. 1395w–101(b)(1)) is amended by adding at the 
end the following new subparagraph: 
‘‘(D) CHANGE
IN
PRESCRIPTION
DRUG 
PLAN ALLOWED DURING FIRST YEAR OF EN-
ROLLMENT.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), at any time during the 12-month pe-
riod beginning with the first month in 
which a part D eligible individual is en-
rolled in a prescription drug plan under 
this part, the individual may change the 
prescription drug plan in which the indi-
vidual is enrolled. 
‘‘(ii) LIMITATION
OF
ONE
CHANGE 
DURING PERIOD.—An individual may exer-
cise the right under clause (i) only once 
during such 12-month period and the exer-
cise of such right shall be in addition to 
the exercise of any other rights to change 
such an enrollment during such period.’’. 
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SEC. 502. COUNTING EXPENDITURES UNDER STATE DRUG 
ASSISTANCE PROGRAMS AGAINST TRUE OUT- 
OF-POCKET COSTS. 
Section 1860D–2(b)(4)(C)(ii) of the Social Security 
Act (42 U.S.C. 1395w–102(b)(4)(C)(ii)) is amended by in-
serting ‘‘, AIDS Drug Assistance Program, or other State 
drug assistance program’’ after ‘‘State Pharmaceutical 
Assistance Program’’. 
SEC. 503. PRICE DISCLOSURE. 
(a) IN GENERAL.—Section 1860D–2(d)(2) of the So-
cial Security Act (42 U.S.C. 1395w–102(d)(2)) is amend-
ed— 
(1) in the first sentence, by striking ‘‘which are 
passed through’’ and all that follows through ‘‘other 
dispensers’’; 
(2) in the second sentence, by inserting ‘‘do 
not’’ before ‘‘apply’’; and 
(3) in the second sentence, by inserting before 
the period at the end the following: ‘‘and the Sec-
retary shall make the information described in the 
previous sentence available to the public’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1927(b)(3)(D) of such Act (42 U.S.C. 1396r–8(b)(3)(D)) 
is amended by striking the last sentence. 
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SEC. 504. REMOVAL OF COVERED PART D DRUGS FROM 
THE 
PRESCRIPTION 
DRUG 
PLAN 
FOR-
MULARY. 
Section 1860D–4(b)(3)(E) of the Social Security Act 
(42 U.S.C. 1395w–104(b)(3)(E)) is amended to read as 
follows: 
‘‘(E) REMOVING DRUG FROM FORMULARY 
OR CHANGING PREFERRED OR TIER STATUS OF 
DRUG.— 
‘‘(i) LIMITATION
ON
REMOVAL
OR 
CHANGE.—Beginning with 2006, except as 
provided in clause (iii), the PDP sponsor 
of a prescription drug plan may not— 
‘‘(I) remove a covered part D 
drug from the plan formulary; 
‘‘(II) change the preferred or 
tiered cost-sharing status of such a 
drug to a status less favorable to an 
enrollee; or 
‘‘(III) introduce a barrier, such 
as step therapy, prior authorization, 
or quantity limitation, to access to 
covered part D drugs, 
unless advance notice under clause (ii) of 
such removal, change, or introduction has 
been provided and unless such removal, 
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change, or introduction is only effective be-
ginning on January 1 of the year following 
the year in which such notice is provided. 
‘‘(ii) NOTICE.—The notice under this 
clause is an appropriate notice (such as 
under subsection (a)(3)) to the Secretary, 
affected enrollees, physicians, pharmacies, 
and pharmacists during the period begin-
ning on September 1 and ending on Octo-
ber 31 of a year. Such notice shall ensure 
that such information is made available 
prior to the annual, coordinated open elec-
tion 
period 
described 
in 
section 
1851(e)(3)(B)(iii), as applied under section 
1860D–1(b)(1)(B)(iii). 
‘‘(iii) EXCEPTION.—Clause (i) shall 
not apply to a covered part D drug— 
‘‘(I) if it has been determined to 
be unsafe by the Food and Drug Ad-
ministration; and 
‘‘(II) if, during a plan year, the 
drug changes from being a single 
source drug to a multiple source drug 
(as defined in section 1927(k)), and 
the prescription drug plan covers an-
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other bioequivalent multiple source 
drug at the same or lower cost-shar-
ing to enrolled individuals.’’. 
SEC. 505. CODIFICATION OF REQUIREMENT FOR COV-
ERAGE OF ALL OR SUBSTANTIALLY ALL OF 
DRUGS WITHIN SIX CATEGORIES OF DRUGS. 
(a) IN GENERAL.—Section 1860D–4(b)(3) of the So-
cial Security Act (42 U.S.C. 1395w–104(b)(3)) is amend-
ed— 
(1) in subparagraph (C)(i), by striking ‘‘The 
formulary’’ and inserting ‘‘Subject to subparagraph 
(G), the formulary’’; and 
(2) by inserting after subparagraph (F) the fol-
lowing new subparagraph: 
‘‘(G) REQUIRED INCLUSION OF DRUGS IN 
CERTAIN CATEGORIES AND CLASSES.— 
‘‘(i) IN
GENERAL.—The formulary 
must include all or substantially all drugs 
in the following categories that are avail-
able as of April 17 of the prior year and 
shall include at least some drugs from each 
category without restrictions or limitations 
on coverage (such as through the applica-
tion of a less-preferred cost-sharing tier or 
status, usage restriction, step therapy, 
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prior authorization, or a quantity limita-
tion): 
‘‘(I) Immunosuppressant. 
‘‘(II) Antidepressant. 
‘‘(III) Antipsychotic. 
‘‘(IV) Anticonvulsant. 
‘‘(V) Antiretroviral. 
‘‘(VI) Antineoplastic. 
‘‘(ii) 
SUBSTANTIALLY
ALL
DE-
FINED.—For purposes of clause (i), the 
term ‘substantially all’ means all drugs 
and unique dosage forms in the categories 
described in such clause, except for— 
‘‘(I) multi-source brands of the 
identical molecular structure; 
‘‘(II) extended release products 
when the immediate-release product is 
included on the formulary; 
‘‘(III) products that have the 
same active ingredient; and 
‘‘(IV) dosage forms that do not 
provide a unique route of administra-
tion, such as tablets and capsules.’’. 
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