To amend titles XVIII and XIX of the Social Security Act to provide for continuity of Medicare prescription drug coverage for full-benefit dual eligible individuals, for Medicare prescription drug coverage of benzodiazepines and off-label uses of certain prescription drugs and biological products, for optional Medicaid coverage of Medicare prescription drug cost-sharing for full-benefit dual eligible individuals, for authorization to the Secretary of Health and Human Services to waive certain determinations denying Medicare prescription drug coverage, and for holding pharmacies harmless for certain costs incurred during implementation of Medicare part D.

Bill: 109-hr-5193
Sponsor: Rep. Wilson, Heather [R-NM-1]
Introduced: 2006-04-25 in the House
Policy area: Health
Subjects: Access to health care
Administrative remedies
Coinsurance
Compensation (Law)
Computer software
Department of Health and Human Services
Drugs
Finance and Financial Sector
Government Operations and Politics
Health information systems
Health insurance
Health maintenance organizations
Information technology
Law
Managed care
Medicaid
Medical economics
Medical fees
Medicare
Pharmacies
Physicians
Prescription pricing
Science, Technology, Communications
Social Welfare

Summary:
action_date: 2006-04-25
text: 
Amends part D (Voluntary Prescription Drug Benefit Program ) of title XVIII (Medicare) of the Social Security Act (SSA) to provide for continuity of coverage of prescription drugs under Medicare prescription drug plans for full-benefit dual eligible individuals.
 
Provides for Medicare prescription drug coverage of benzodiazepines and of off-label uses of prescription drugs and biologicals.
 
Amends SSA title XIX (Medicaid) to permit state Medicaid programs to cover Medicare prescription drug copayments for full-benefit dual eligible individuals.
 
Amends SSA title XVIII to authorize the Secretary of Health and Human Services to waive denial of Medicare prescription drug coverage.
 
Directs the Secretary to provide for payments from the Medicare Prescription Drug Account necessary to reimburse pharmacies fully for: (1) transaction fees associated with any point-of-sale facilitated identification and enrollment process established to facilitate, at point of sale, the identification of drug plan assignment of full-benefit dual eligible individuals or the enrollment of previously unidentified or new full-benefit dual eligible individuals into Medicare prescription drug coverage; (2) costs associated with technology or software upgrades necessary to make any inquiries as part of a identification and enrollment process; and (3) costs of providing prescription drugs and biological products to part D eligible individuals whose prescription drug plans could not be identified, if the pharmacy involved as not reimbursed for such costs upon completion of plan reconciliation.


Legislative actions:
action_date: 2006-05-15
text: Referred to the Subcommittee on Health.
action_date: 2006-04-25
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: 2006-04-25
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: 2006-04-25
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: 2006-04-25
text: Introduced in House
action_date: 2006-04-25
text: Introduced in House