In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Q: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care Waiver Fairness Act of 
2011''.

SEC. 2. PPACA WAIVER PROCESS.

    (a) In General.--Title I of the Patient Protection and Affordable 
Care Act (Public Law 111-148) is amended by adding at the end the 
following new subtitle:

                      ``Subtitle G--Waiver Process

``SEC. 1601. ESTABLISHMENT OF WAIVER PROCESS.

    ``(a) In General.--The applicable authorities (as defined in 
subsection (c)) shall collectively establish a process (in this section 
referred to as the `waiver process') under which the administrator of a 
health plan, an employer, an individual, or other entity may seek to 
waive the application of a requirement under this title with respect to 
such plan, employer, individual, or entity. Among the requirements 
under this title, such process shall apply to the following:
            ``(1) Section 5000A of the Internal Revenue Code of 1986 
        (relating to requirement to maintain minimum essential 
        coverage), as inserted by section 1501(b).
            ``(2) Section 6055 of the Internal Revenue Code of 1986 
        (relating to reporting of health insurance coverage), as 
        inserted by section 1502(a).
            ``(3) Section 18A of the Fair Labor Standards Act of 1938 
        (42 U.S.C. 218a, relating to automatic enrollment for employees 
        of large employers), as inserted by section 1511.
            ``(4) Section 18B of the Fair Labor Standards Act of 1938 
        (42 U.S.C. 218b, relating to notice to employees), as inserted 
        by section 1512.
            ``(5) Section 4980H of the Internal Revenue Code of 1986 
        (relating to shared responsibility for employers regarding 
        health coverage), as inserted by section 1513(a).
            ``(6) Section 6056 of the Internal Revenue Code of 1986 
        (relating to certain employers required to report on health 
        insurance coverage), as inserted by section 1514(a).
            ``(7) Section 10108 (relating to free choice vouchers).
            ``(8) Regulations regarding the treatment of group health 
        plans or health insurance coverage as a grandfathered health 
        plan (as defined in section 1251(e)).
            ``(9) Section 2718(b) of the Public Health Service Act 
        (relating to medical loss ratios), as inserted by section 1001.
    ``(b) Waiver Process.--
            ``(1) In general.--The applicable authorities shall 
        establish the waiver process consistent with the following:
                    ``(A) Notice and guidance.--Public notice and 
                guidance shall be provided regarding the process for 
                submission of waiver requests.
                    ``(B) Standard.--A waiver request with respect to 
                the application of a requirement to a plan, employer, 
                individual, or entity shall be accompanied by a 
                statement that--
                            ``(i) identifies the specific requirement 
                        (or requirements) to be waived; and
                            ``(ii) describes how the imposition of each 
                        specific requirement for which a waiver is 
                        requested on the plan, employer, individual, or 
                        entity would result in a significant decrease 
                        in access to coverage or a significant increase 
                        in premiums or other costs for such plan, 
                        employer, individual, or entity.
                    ``(C) Deemed approval.--A waiver request filed that 
                is accompanied by such a statement shall be deemed to 
                be approved.
                    ``(D) Publication of data.--The applicable 
                authorities shall regularly publish data regarding the 
                waiver requests received for the different 
                requirements.
            ``(2) Treatment of approved waivers.--In the case of 
        approval under the waiver process of a waiver request with 
        respect to a requirement of this title and an entity, 
        notwithstanding any other provision of law, such requirement 
        shall not apply to such entity on and after the date of 
        approval of the request.
            ``(3) Relation to other exemptions and exceptions.--Nothing 
        in this section shall be construed as superceding other 
        provisions of this title insofar as they provide for 
        exceptions, exemptions, or other special treatment with respect 
        to requirements under this title.
    ``(c) Applicable Authority.--In this section, the term `applicable 
authority' means--
            ``(1) except as otherwise provided in this subsection, the 
        Secretary of Health and Human Services;
            ``(2) the Secretary of Labor with respect to the provisions 
        of this title, including amendments made by this title, that 
        are administered by such Secretary; and
            ``(3) the Secretary of the Treasury with respect to the 
        provisions of this title, including amendments made by this 
        title, that are administered by such Secretary, including 
        sections of the Internal Revenue Code of 1986 specified in 
        subsection (a).
    ``(d) References to Requirements Under This Title.--In this 
section, a reference to a requirement under this title include such a 
requirement under an amendment made by this title, including as amended 
by title X of this Act or by the provisions of the Health Care and 
Education Reconciliation Act of 2010 (Public Law 111-152).
    ``(e) Public Awareness Campaign.--Of the amounts available in the 
Prevention and Public Health Fund established under section 4002, 
notwithstanding any other provision of law, $50,000,000 shall be 
available to and expended by the Secretary of Health and Human Services 
to conduct, in coordination with other applicable authorities, a public 
awareness campaign of the waiver process. Amounts made available under 
this subsection shall remain available until expended.''.
    (b) Clerical Amendment.--The table of contents of such Act is 
amended by adding at the end of the items relating to title I the 
following:

                      ``Subtitle G--Waiver Process

``Sec. 1601. Establishment of waiver process.''.

A: Health Care Waiver Fairness Act of 2011 - Amends the Patient Protection and Affordable Care Act (PPACA) to require the Secretary of Health and Human Services (HHS), the Secretary of Labor, and the Secretary of Treasury to establish waiver processes under which the administrator of a health plan, an employer, an individual, or other entity may seek to waive the application of a health insurance coverage requirement under PPACA. Sets forth PPACA requirements that may be waived, including those related to minimum essential coverage and employers offering health care coverage to employees.

Establishes requirements for the waiver process, including requiring submission of a statement describing how the imposition of the PPACA requirement would result in a significant decrease in access to coverage or a significant increase in premiums or other costs for such plan, employer, individual, or entity. Deems to be approved any waiver including such a statement.

Requires the Secretary of HHS to conduct a public awareness campaign of the waiver process with funds made available for the Prevention and Public Health Fund.
****
Q: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Glacier Bay National Park Boundary 
Adjustment Act of 1998''.

SEC. 2. LAND EXCHANGE AND WILDERNESS DESIGNATION.

    (a) In General.--(1) Subject to conditions set forth in subsection 
(c), if the State of Alaska, in a manner consistent with this Act, 
offers to transfer to the United States the lands identified in 
paragraph (2) in exchange for the lands identified in paragraph (4), 
selected from the area described in section 3(b)(1), the Secretary of 
the Interior (in this Act referred to as the ``Secretary'') shall 
complete such exchange no later than 6 months after the issuance of a 
license to Gustavus Electric Company by the Federal Energy Regulatory 
Commission (in this Act referred to as ``FERC''), in accordance with 
this Act. This land exchange shall be subject to the laws applicable to 
exchanges involving lands managed by the Secretary as part of the 
National Park System in Alaska and the appropriate process for the 
exchange of State lands required by State law.
    (2) The lands to be conveyed to the United States by the State of 
Alaska shall be determined by mutual agreement of the Secretary and the 
State of Alaska. Lands that will be considered for conveyance to the 
United States pursuant to the process required by State law are lands 
owned by the State of Alaska in the Long Lake area within Wrangell-St. 
Elias National Park and Preserve, or other lands owned by the State of 
Alaska.
    (3) If the Secretary and the State of Alaska have not agreed on 
which lands the State of Alaska will convey by a date not later than 6 
months after a license is issued pursuant to this Act, the United 
States shall accept, within 1 year after a license is issued, title to 
land having a sufficiently equal value to satisfy State and Federal 
law, subject to clear title and valid existing rights, and absence of 
environmental contamination, and as provided by the laws applicable to 
exchanges involving lands managed by the Secretary as part of the 
National Park System in Alaska and the appropriate process for the 
exchange of State lands required by State law. Such land shall be 
accepted by the United States, subject to the other provisions of this 
Act, from among the following State lands in the priority listed:


                          copper river meridian

        (A) T.6 S., R. 12 E., partially surveyed, Sec. 5, lots 1, 2, 
    and 3, NE\1/4\, S\1/2\NW\1/4\, and S\1/2\. Containing 617.68 acres, 
    as shown on the plat of survey accepted June 9, 1922.
        (B) T.6 S., R. 11 E., partially surveyed, Sec. 11, lots 1 and 
    2, NE\1/4\, S\1/2\NW\1/4\, SW\1/4\, and N\1/2\SE\1/4\; Sec. 12; 
    Sec. 14, lots 1 and 2, NW\1/4\NW\1/4\. Containing 1,191.75 acres, 
    as shown on the plat of survey accepted June 9, 1922.
        (C) T.6 S., R. 11 E., partially surveyed, Sec. 2, NW\1/4\NE\1/
    4\ and NW\1/4\. Containing 200.00 acres, as shown on the plat of 
    survey accepted June 9, 1922.
        (D) T.6 S., R. 12 E., partially surveyed, Sec. 6. lots 1 
    through 10, E\1/2\SW\1/4\ and SE\1/4\. Containing approximately 
    529.94 acres, as shown on the plat of survey accepted June 9, 1922.
    (4) The lands to be conveyed to the State of Alaska by the United 
States under paragraph (1) are lands to be designated by the Secretary 
and the State of Alaska, consistent with sound land management 
principles, based on those lands determined by FERC with the 
concurrence of the Secretary and the State of Alaska, in accordance 
with section 3(b), to be the minimum amount of land necessary for the 
construction and operation of a hydroelectric project.
    (5) The time periods set forth for the completion of the land 
exchanges described in this Act may be extended as necessary by the 
Secretary should the processes of State law or Federal law delay 
completion of an exchange.
    (6) For purposes of this Act, the term ``land'' means lands, 
waters, and interests therein.
    (b) Wilderness.--(1) To ensure that this transaction maintains, 
within the National Wilderness Preservation System, approximately the 
same amount of area of designated wilderness as currently exists, the 
following lands in Alaska shall be designated as wilderness in the 
priority listed, upon consummation of the land exchange authorized by 
this Act and shall be administered according to the laws governing 
national wilderness areas in Alaska:
        (A) An unnamed island in Glacier Bay National Park lying 
    southeasterly of Blue Mouse Cove in sections 5, 6, 7, and 8, T. 36 
    S., R. 54 E., CRM, and shown on United States Geological Survey 
    quadrangle Mt. Fairweather (D-2), Alaska, containing approximately 
    789 acres.
        (B) Cenotaph Island of Glacier Bay National Park lying within 
    Lituya Bay in sections 23, 24, 25, and 26, T. 37 S., R. 47 E., CRM, 
    and shown on United States Geological Survey quadrangle Mt. 
    Fairweather (C-5), Alaska, containing approximately 280 acres.
        (C) An area of Glacier Bay National Park lying in T. 31. S., R. 
    43 E and T. 32 S., R. 43 E., CRM, that is not currently designated 
    wilderness, containing approximately 2,270 acres.
    (2) The specific boundaries and acreage of these wilderness 
designations may be reasonably adjusted by the Secretary, consistent 
with sound land management principles, to approximately equal, in sum, 
the total wilderness acreage deleted from Glacier Bay National Park and 
Preserve pursuant to the land exchange authorized by this Act.
    (c) Conditions.--Any exchange of lands under this Act may occur 
only if--
        (1) following the submission of a complete license application, 
    FERC has conducted economic and environmental analyses under the 
    Federal Power Act (16 U.S.C. 791-828) (notwithstanding provisions 
    of that Act and the Federal regulations that otherwise exempt this 
    project from economic analyses), the National Environmental Policy 
    Act of 1969 (42 U.S.C. 4321-4370), and the Fish and Wildlife 
    Coordination Act (16 U.S.C. 661-666), that conclude, with the 
    concurrence of the Secretary of the Interior with respect to 
    subparagraphs (A) and (B), that the construction and operation of a 
    hydroelectric power project on the lands described in section 
    3(b)--
            (A) will not adversely impact the purposes and values of 
        Glacier Bay National Park and Preserve (as constituted after 
        the consummation of the land exchange authorized by this 
        section);
            (B) will comply with the requirements of the National 
        Historic Preservation Act (16 U.S.C. 470-470w); and
            (C) can be accomplished in an economically feasible manner;
        (2) FERC held at least one public meeting in Gustavus, Alaska, 
    allowing the citizens of Gustavus to express their views on the 
    proposed project;
        (3) FERC has determined, with the concurrence of the Secretary 
    and the State of Alaska, the minimum amount of land necessary to 
    construct and operate this hydroelectric power project; and
        (4) Gustavus Electric Company has been granted a license by 
    FERC that requires Gustavus Electric Company to submit an 
    acceptable financing plan to FERC before project construction may 
    commence, and the FERC has approved such plan.

SEC. 3. ROLE OF FERC.

    (a) License Application.--(1) The FERC licensing process shall 
apply to any application submitted by Gustavus Electric Company to the 
FERC for the right to construct and operate a hydropower project on the 
lands described in subsection (b).
    (2) FERC is authorized to accept and consider an application filed 
by Gustavus Electric Company for the construction and operation of a 
hydropower plant to be located on lands within the area described in 
subsection (b), notwithstanding section 3(2) of the Federal Power Act 
(16 U.S.C. 796(2)). Such application must be submitted within 3 years 
after the date of the enactment of this Act.
    (3) FERC will retain jurisdiction over any hydropower project 
constructed on this site.
    (b) Analyses.--(1) The lands referred to in subsection (a) of this 
section are lands in the State of Alaska described as follows:


                          copper river meridian

    Township 39 South, Range 59 East, partially surveyed, Section 36 
(unsurveyed), SE\1/4\SW\1/4\, S\1/2\SW\1/4\SW\1/4\, NE\1/4\SW\1/4\, 
W\1/2\W\1/2\NW\1/4\SE\1/4\, and S\1/2\SE\1/4\NW\1/4\. Containing 
approximately 130 acres.
    Township 40 South, Range 59 East, partially surveyed, Section 1 
(unsurveyed), NW\1/4\, SW\1/4\, W\1/2\SE\1/4\, and SW\1/4\SW\1/4\NE\1/
4\, excluding U.S. Survey 944 and Native allotment A-442; Section 2 
(unsurveyed), fractional, that portion lying above the mean high tide 
line of Icy Passage, excluding U.S. Survey 944 and U.S. Survey 945; 
Section 11 (unsurveyed), fractional, that portion lying above the mean 
high tide line of Icy Passage, excluding U.S. Survey 944; Section 12 
(unsurveyed), fractional, NW\1/4\NE\1/4\, W\1/2\NW\1/4\SW\1/4\NE\1/4\, 
and those portions of NW\1/4\ and SW\1/4\ lying above the mean high 
tide line of Icy Passage, excluding U.S. Survey 944 and Native 
allotment A-442. Containing approximately 1,015 acres.
    (2) Additional lands and acreage will be included as needed in the 
study area described in paragraph (1) to account for accretion to these 
lands from natural forces.
    (3) With the concurrence of the Secretary and the State of Alaska, 
the FERC shall determine the minimum amount of lands necessary for 
construction and operation of such project.
    (4) The National Park Service shall participate as a joint lead 
agency in the development of any environmental document under the 
National Environmental Policy Act of 1969 in the licensing of such 
project. Such environmental document shall consider both the impacts 
resulting from licensing and any land exchange necessary to authorize 
such project.
    (c) Issuance of License.--(1) A condition of the license to 
construct and operate any portion of the hydroelectric power project 
shall be FERC's approval, prior to any commencement of construction, of 
a finance plan submitted by Gustavus Electric Company.
    (2) The National Park Service, as the existing supervisor of 
potential project lands ultimately to be deleted from the Federal 
reservation in accordance with this Act, waives its right to impose 
mandatory conditions on such project lands pursuant to section 4(e) of 
the Federal Power Act (16 U.S.C. 797(e)).
    (3) FERC shall not license or relicense the project, or amend the 
project license unless it determines, with the Secretary's concurrence, 
that the project will not adversely impact the purposes and values of 
Glacier Bay National Park and Preserve (as constituted after the 
consummation of the land exchange authorized by this Act). 
Additionally, a condition of the license, or any succeeding license, to 
construct and operate any portion of the hydroelectric power project 
shall require the licensee to mitigate any adverse effects of the 
project on the purposes and values of Glacier Bay National Park and 
Preserve identified by the Secretary after the initial licensing.
    (4) A condition of the license to construct and operate any portion 
of the hydroelectric power project shall be the completion, prior to 
any commencement of construction, of the land exchange described in 
this Act.

SEC. 4. ROLE OF SECRETARY OF THE INTERIOR.

    (a) Special Use Permit.--Notwithstanding the provisions of the 
Wilderness Act (16 U.S.C. 1133-1136), the Secretary shall issue a 
special use permit to Gustavus Electric Company to allow the completion 
of the analyses referred to in section 3. The Secretary shall impose 
conditions in the permit as needed to protect the purposes and values 
of Glacier Bay National Park and Preserve.
    (b) Park System.--The lands acquired from the State of Alaska under 
this Act shall be added to and administered as part of the National 
Park System, subject to valid existing rights. Upon completion of the 
exchange of lands under this Act, the Secretary shall adjust, as 
necessary, the boundaries of the affected National Park System units to 
include the lands acquired from the State of Alaska; and adjust the 
boundary of Glacier Bay National Park and Preserve to exclude the lands 
transferred to the State of Alaska under this Act. Any such adjustment 
to the boundaries of National Park System units resulting from this Act 
shall not be charged against any acreage limitations under section 
103(b) of Public Law 96-487.
    (c) Wilderness Area Boundaries.--The Secretary shall make any 
necessary modifications or adjustments of boundaries of wilderness 
areas as a result of the additions and deletions caused by the land 
exchange referenced in section 2. Any such adjustment to the boundaries 
of National Park System units shall not be considered in applying any 
acreage limitations under section 103(b) of Public Law 96-487.
    (d) Concurrence of the Secretary.--Whenever in this Act the 
concurrence of the Secretary is required, it shall not be unlawfully 
withheld or unreasonably delayed.

SEC. 5. APPLICABLE LAW.

    The authorities and jurisdiction provided in this Act shall 
continue in effect until such time as this Act is expressly modified or 
repealed by Congress.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.

A: Glacier Bay National Park Boundary Adjustment Act of 1998 - Provides for:  (1) an exchange of specified State lands in Alaska for specified Federal lands to be completed within six months after the issuance of a license to Gustavus Electric Company (GEC) by the Federal Energy Regulatory Commission (FERC) for the construction and operation of a hydroelectric project on such Federal lands; or (2) the exchange of other specified Alaska lands having a sufficiently equal value to satisfy State and Federal law within one year after such license is issued if the Secretary of the Interior and Alaska have not agreed on which lands Alaska will convey within such six-month period. 
Designates specified State lands and waters in Alaska as wilderness upon consummation of such exchange to ensure that this transaction maintains approximately the same amount of area of designated wilderness. 
Conditions such land exchange on:  (1) FERC's having conducted economic and environmental analyses pursuant to the Federal Power Act (FPA), the National Environmental Policy Act of 1969, and the Fish and Wildlife Coordination Act that conclude that the construction and operation of a hydroelectric power project on such lands will not adversely impact the purposes and values of the Glacier Bay National Park and Preserve, will comply with the requirements of the National Historic Preservation Act, and can be accomplished in an economically feasible manner; (2) FERC holding at least one public meeting in Gustavus, Alaska, allowing its citizens to express their views on the proposed project; (3) FERC having determined, with the concurrence of the Secretary and Alaska, the minimum amount of land necessary to construct and operate the project; (4) GEC having been granted a FERC license that requires it to submit an acceptable financing plan to FERC before project construction commences; and (5) FERC approving such plan. 
Makes the FERC licensing process applicable to any application submitted by GEC to FERC for the right to construct and operate a hydropower project on specified Alaska lands.  Authorizes FERC to accept and consider an application filed by GEC for construction and operation of such a project, notwithstanding FPA provisions, if submitted within three years after this Act's enactment.  Provides for FERC to retain jurisdiction over any hydropower project constructed on such site.  Sets forth additional provisions regarding issuance of a license for construction or operation of such a project. 
(Sec. 4) Directs the Secretary to issue a special use permit to GEC to allow completion of the required analyses.  Requires the Secretary to impose conditions in the permit as needed to protect the purposes and values of the Preserve.  Requires the lands acquired from Alaska to be added to and administered as part of the National Park System, subject to valid existing rights. 
Continues the authorities and jurisdiction provided in this Act until expressly modified or repealed by the Congress.
****
Q: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Prescription Drug Savings 
and Choice Act of 2004''.

SEC. 2. ESTABLISHMENT OF MEDICARE OPERATED PRESCRIPTION DRUG PLAN 
              OPTION.

    (a) In General.--Subpart 2 of part D of the Social Security Act, as 
added by section 101 of the Medicare Prescription Drug, Improvement, 
and Modernization Act of 2003 (Public Law 108-173), is amended by 
inserting after section 1860D-11 the following new section:

           ``medicare operated prescription drug plan option

    ``Sec. 1860D-11A. (a) In General.--Notwithstanding any other 
provision of this part, for each year (beginning with 2006), in 
addition to any plans offered under section 1860D-11, the Secretary 
shall offer one or more medicare operated prescription drug plans (as 
defined in subsection (c)) with a service area that consists of the 
entire United States and shall enter into negotiations with 
pharmaceutical manufacturers to reduce the purchase cost of covered 
part D drugs for eligible part D individuals in accordance with 
subsection (b).
    ``(b) Negotiations.--Notwithstanding section 1860D-11(i), for 
purposes of offering a medicare operated prescription drug plan under 
this section, the Secretary shall negotiate with pharmaceutical 
manufacturers with respect to the purchase price of covered part D 
drugs and shall encourage the use of more affordable therapeutic 
equivalents to the extent such practices do not override medical 
necessity as determined by the prescribing physician. To the extent 
practicable and consistent with the previous sentence, the Secretary 
shall implement strategies similar to those used by other Federal 
purchasers of prescription drugs, and other strategies, to reduce the 
purchase cost of covered part D drugs.
    ``(c) Medicare Operated Prescription Drug Plan Defined.--For 
purposes of this part, the term `medicare operated prescription drug 
plan' means a prescription drug plan that offers qualified prescription 
drug coverage and access to negotiated prices described in section 
1860D-2(a)(1)(A). Such a plan may offer supplemental prescription drug 
coverage in the same manner as other qualified prescription drug 
coverage offered by other prescription drug plans.
    ``(d) Monthly Beneficiary Premium.--
            ``(1) Qualified prescription drug coverage.--The monthly 
        beneficiary premium for qualified prescription drug coverage 
        and access to negotiated prices described in section 1860D-
        2(a)(1)(A) to be charged under a medicare operated prescription 
        drug plan shall be uniform nationally. Such premium for months 
        in 2006 shall be $35 and for months in succeeding years shall 
        be based on the average monthly per capita actuarial cost of 
        offering the medicare operated prescription drug plan for the 
        year involved, including administrative expenses.
            ``(2) Supplemental prescription drug coverage.--Insofar as 
        a medicare operated prescription drug plan offers supplemental 
        prescription drug coverage, the Secretary may adjust the amount 
        of the premium charged under paragraph (1).
            ``(3) Requirement for at least one plan with a $35 premium 
        in 2006.--The Secretary shall ensure that at least one medicare 
        operated prescription drug plan offered in 2006 has a monthly 
        premium of $35. ''.
    (b) Conforming Amendments.--
            (1) Section 1860D-3(a) of the Social Security Act, as added 
        by section 101 of the Medicare Prescription Drug, Improvement, 
        and Modernization Act of 2003, is amended by adding at the end 
        the following new paragraph:
            ``(4) Availability of the medicare operated prescription 
        drug plan.--
                    ``(A) In general.--A medicare operated prescription 
                drug plan (as defined in section 1860D-11A(c)) shall be 
                offered nationally in accordance with section 1860D-
                11A.
                    ``(B) Relationship to other plans.--
                            ``(i) In general.--Subject to clause (ii), 
                        a medicare operated prescription drug plan 
                        shall be offered in addition to any qualifying 
                        plan or fallback prescription drug plan offered 
                        in a PDP region and shall not be considered to 
                        be such a plan purposes of meeting the 
                        requirements of this subsection.
                            ``(ii) Designation as a fallback plan.--
                        Notwithstanding any other provision of this 
                        part, the Secretary may designate the medicare 
                        operated prescription drug plan as the fallback 
                        prescription drug plan for any fallback service 
                        area (as defined in section 1860D-11(g)(3)) 
                        determined to be appropriate by the 
                        Secretary.''.
            (2) Section 1860D-13(c)(3) of such Act, as added by such 
        section, is amended--
                    (A) in the heading, by inserting ``and medicare 
                operated prescription drug plans'' after ``Fallback 
                plans''; and
                    (B) by inserting ``or a medicare operated 
                prescription drug plan'' after ``a fallback 
                prescription drug plan''.
            (3) Section 1860D-16(b)(1) of such Act, as added by such 
        section, is amended--
                    (A) in subparagraph (C), by striking ``and'' after 
                the semicolon at the end;
                    (B) in subparagraph (D), by striking the period at 
                the end and inserting ``; and''; and
                    ``(E) payments for expenses incurred with respect 
                to the operation of medicare operated prescription drug 
                plans under section 1860D-11A.''.
            (4) Section 1860D-41(a) of such Act, as added by such 
        section, is amended by adding at the end the following new 
        paragraph:
            ``(19) Medicare operated prescription drug plan.--The term 
        `medicare operated prescription drug plan' has the meaning 
        given such term in section 1860D-11A(c).''.
    (c) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of section 101 of the Medicare 
Prescription Drug, Improvement, and Modernization Act of 2003.

A:
Medicare Prescription Drug Savings and Choice Act of 2004 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, as added by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, to direct the Secretary of Health and Human Services, for each year beginning with 2006, to: (1) offer one or more Medicare operated prescription drug plans nationally that offers qualified prescription drug coverage and access to negotiated prices, while allowing the plan to offer supplemental prescription drug coverage in the same manner as other qualified prescription drug coverage offered by other prescription drug plans; and (2) enter into negotiations with pharmaceutical manufacturers to reduce the purchase cost of covered Medicare part D drugs for eligible part D individuals, and encourage the use of more affordable therapeutic equivalents. Requires the monthly beneficiary premium charged under such a plan to be uniform nationally and for months in 2006 shall be $35 and for months in succeeding years shall be based on the average monthly per capita actuarial cost of offering the Medicare operated prescription drug plan for the year involved, including administrative expenses. Allows for adjustment of such premium amount in case of supplemental prescription drug coverage.
****