Prescription Drug and Medicare Improvement Act of 2003

Bill: 108-hr-2606
Sponsor: Rep. Thompson, Mike [D-CA-1]
Introduced: 2003-06-25 in the House
Policy area: Health
Subjects: Access to health care
Accreditation (Medical care)
Administrative law judges
Administrative procedure
Administrative remedies
Adult day care
Advice and consent of the Senate
Ambulances
Ambulatory care
Armed Forces and National Security
Auditing
Building construction
Canada
Capital investments
Case management
Case mix (Medical care)
Chiropractic and chiropractors
Chronically ill
Civil Rights and Liberties, Minority Issues
Civil actions and liability
Clinical trials
Clinics
Coinsurance
Collection of accounts
Commerce
Competition
Competitive bidding
Congress
Congressional hearings
Congressional investigations
Congressional reporting requirements
Construction costs
Consumer education
Consumer protection
Cost control
Customs administration
Department of Health and Human Services
Disabled
Discrimination in insurance
Discrimination in medical care
Drug approvals
Drug industry
Drug interactions
Drug therapy
Drug utilization
Drugs
Economics and Public Finance
Education
Electronic data interchange
Emergency medicine
Employee health benefits
Executive reorganization
Families
Federal aid to child health services
Federal aid to education
Federal aid to health facilities
Federally-guaranteed loans
Fees
Finance and Financial Sector
Financial statements
Fines (Penalties)
Foreign Trade and International Finance
Generic drugs
Geriatrics
Government Operations and Politics
Government contractors
Government lending
Government paperwork
Government publicity
Government trust funds
Governmental investigations
Grievance procedures
Health care fraud
Health education
Health insurance
Health maintenance organizations
Higher education
Home care services
Hospital care
Hospital rates
Hospitals
Housing and Community Development
Illegal aliens
Immigrant health
Immigration
Imports
Indexing (Economic policy)
Indian medical care
Infrastructure
Insulin
Insurance premiums
Intellectual property
Judicial review
Kidney diseases
Labeling
Labor and Employment
Law
Long-term care
Managed care
Marketing
Medicaid
Medical economics
Medical education
Medical fees
Medical laboratories
Medical records
Medical residents
Medical savings accounts
Medical supplies
Medical tests
Medically uninsured
Medicare
Medicare Payment Advisory Commission
Medigap
Minorities
Nurse practitioners
Nurses
Nursing homes
Ombudsman
Patent infringement
Patents
Patient satisfaction
Performance measurement
Pharmacies
Pharmacists
Physicians
Physicians' assistants
Poor children
Preferred provider organizations (Medical care)
Prescription pricing
Presidential appointments
Product safety
Prosthesis
Psychologists
Public hospitals
Puerto Rico
Quality of care
Rebates
Reinsurance
Retired military personnel
Retiree health benefits
Revolving funds
Right of privacy
Rural health
Scholarships
Science, Technology, Communications
Small business
Social Security Administration
Social Welfare
Standards
State taxation
Surveys
Taxation
Telephone
Terminal care
Terminally ill
Transportation and Public Works
User charges
Valuation
Veterans' medical care
Wages
Welfare recipients
Wholesale trade

Summary:
action_date: 2003-06-25
text: 
Prescription Drug and Medicare Improvement Act of 2003 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to add a new part D (Voluntary Prescription Drug Benefit Delivery Program) (VPDBDP) under which each individual who is entitled to benefits under Medicare part A (Hospital Insurance) or enrolled under Medicare part B (Supplemental Medical Insurance) is entitled to obtain qualified prescription drug coverage. Authorizes the individual to elect to enroll: (1) in a MedicareAdvantage (MA) plan (replacing the current Medicare+Choice plans under Medicare part C (Medicare+Choice)); or (2) if a fee-for-service enrollee not in an MA plan, in a Medicare Prescription Drug (MPD) plan. Makes separate provision for: (1) enrollees in a MedicareAdvantage medical savings account (MSA) plan; and (2) enrollees in MedicareAdvantage private fee-for-service plans.
 
 Makes the Administrator of the Center for Medicare Choices (CMC), established under this Act, responsible for administration of the VPDBDP.
 
Outlines standard coverage benefit packages for FY 2006. Includes for the standard package an annual deductible of $ 275 , and requires insurers to cover 50 percent of enrollees drug costs up to the initial coverage limit of $ 4,500 . Requires enrollees to cover all costs over $ 4,500 until out-of-pocket expenses reach $3,700 (catastrophic threshhold), after which an enrollee would be responsible only for a ten-percent co-pay . Prescribes a formula for adjustment of such deductible and annual limits for inflation. 
Establishes a bidding process for negotiating the terms and conditions of MPD plan sponsors. 
Provides for full premium subsidy and reduction of cost-sharing for individuals with incomes below 135 percent of the Federal poverty level. 
 Establishes a Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund. 
 Sets out a new Medicare prescription drug discount card and assistance program under the Medicare program. 
 Directs the Secretary to develop or adopt standards for electronic prescribing transactions. 
 Directs the Secretary to establish within the Department of Health and Human Services the CMC, which shall be separate from the Center for Medicare and Medicaid Services, including an Office of Beneficiary Assistance (containing a Medicare Ombudsman) and a Medicare Competitive Policy Advisory Board. 
 Revises Medicare requirements with regard to: (1) part A concerning rural health care, inpatient hospital services, skilled nursing facility services, hospices, and the Federal rate for hospitals in Puerto Rico; (2) part B concerning physicians services and other specified services, as well as demonstration projects for coverage of chiropractic services, Medicare health care quality, Medicare complex clinical case management payment, and Medicare fee-for-service care coordination; and (3) part A and B concerning home health services, as well as a demonstration program for substitute adult day care services. 
Revises requirements with respect to regulatory procedures, the Medicare appeals process, contracting with Medicare administrative contractors, provider education, a Medicare Provider Ombudsman, beneficiary outreach demonstration programs, prepayment review, recovery of overpayments, enforcement, and establishment of a Consumer Ombudsman Account in the Federal Hospital Insurance Trust Fund. 
 Greater Access to Affordable Pharmaceuticals Act - Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) with regard to: (1) the 30-month of Food and Drug Administration approval for any new drug in certain circumstances; and (2) forfeiture of the 180-day marketing exclusivity period by the first new drug applicant to a subsequent applicant. 
Amends the FFDCA to direct the Secretary of Health and Human Services to promulgate regulations permitting pharmacists, wholesalers, and individuals to import prescription drugs from Canada into the United States, subject to specified conditions.

Legislative actions:
action_date: 2003-07-11
text: Referred to the Subcommittee on Health.
action_date: 2003-07-07
text: Referred to the Subcommittee on Health.
action_date: 2003-06-25
text: 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.
action_date: 2003-06-25
text: 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.
action_date: 2003-06-25
text: 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.
action_date: 2003-06-25
text: Introduced in House
action_date: 2003-06-25
text: Introduced in House