Source: https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title42-chapter7-subchapter18-partD-subpart5&saved=%7CZ3JhbnVsZWlkOlVTQy1wcmVsaW0tdGl0bGU0Mi1zZWN0aW9uMTM5NXctMTUy%7C%7C%7C0%7Cfalse%7Cprelim&edition=prelim
Timestamp: 2020-07-06 23:49:20
Document Index: 343608901

Matched Legal Cases: ['art 5', 'art 5', 'art 5', '§1860', '§101', '§1860', '§101', '§1101', '§704', '§1395', '§1860', '§3301', '§1101', '§1101', '§1101', '§1395', '§3311']

[USC02] 42 USC CHAPTER 7, SUBCHAPTER XVIII, Part D, subpart 5: definitions and miscellaneous provisions
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42 USC CHAPTER 7, SUBCHAPTER XVIII, Part D, subpart 5: definitions and miscellaneous provisions
The term "prescription drug plan" means prescription drug coverage that is offered—
For purposes of applying provisions of part C under this part with respect to a prescription drug plan and a PDP sponsor, unless otherwise provided in this part such provisions shall be applied as if—
(Aug. 14, 1935, ch. 531, title XVIII, §1860D–41, as added Pub. L. 108–173, title I, §101(a)(2), Dec. 8, 2003, 117 Stat. 2148.)
(Aug. 14, 1935, ch. 531, title XVIII, §1860D–42, as added Pub. L. 108–173, title I, §101(a)(2), Dec. 8, 2003, 117 Stat. 2149; amended Pub. L. 111–152, title I, §1101(a)(1), Mar. 30, 2010, 124 Stat. 1036; Pub. L. 114–198, title VII, §704(d), July 22, 2016, 130 Stat. 750.)
Section 402 of the Social Security Amendments of 1967, referred to in subsec. (b), is section 402 of Pub. L. 90–248, title IV, Jan. 2, 1968, 81 Stat. 930, which enacted section 1395b–1 of this title and amended section 1395ll of this title.
2016—Subsec. (d). Pub. L. 114–198 added subsec. (d).
2010—Subsec. (c). Pub. L. 111–152 added subsec. (c).
§1395w–153. Condition for coverage of drugs under this part
In order for coverage to be available under this part for covered part D drugs (as defined in section 1395w–102(e) of this title) of a manufacturer, the manufacturer must—
(1) participate in the Medicare coverage gap discount program under section 1395w–114a of this title;
(2) have entered into and have in effect an agreement described in subsection (b) of such section with the Secretary; and
(3) have entered into and have in effect, under terms and conditions specified by the Secretary, a contract with a third party that the Secretary has entered into a contract with under subsection (d)(3) of such section.
(c) Authorizing coverage for drugs not covered under agreements
(1) the Secretary has made a determination that the availability of the drug is essential to the health of beneficiaries under this part; or
(2) the Secretary determines that in the period beginning on January 1, 2011, and 1 December 31, 2011, there were extenuating circumstances.
(d) Definition of manufacturer
In this section, the term "manufacturer" has the meaning given such term in section 1395w–114a(g)(5) of this title.
(Aug. 14, 1935, ch. 531, title XVIII, §1860D–43, as added Pub. L. 111–148, title III, §3301(a), Mar. 23, 2010, 124 Stat. 461; amended Pub. L. 111–152, title I, §1101(b)(1), Mar. 30, 2010, 124 Stat. 1037.)
2010—Subsec. (b). Pub. L. 111–152, §1101(b)(1)(A), substituted "January 1, 2011" for "July 1, 2010".
Subsec. (c)(2). Pub. L. 111–152, §1101(b)(1)(B), substituted "January 1, 2011, and December 31, 2011," for "July 1, 2010, and ending on December 31, 2010,".
1 So in original. Probably should be followed by "ending on".
§1395w–154. Improved Medicare prescription drug plan and MA–PD plan complaint system
The Secretary shall develop and maintain a complaint system, that is widely known and easy to use, to collect and maintain information on MA–PD plan and prescription drug plan complaints that are received (including by telephone, letter, e-mail, or any other means) by the Secretary (including by a regional office of the Department of Health and Human Services, the Medicare Beneficiary Ombudsman, a subcontractor, a carrier, a fiscal intermediary, and a Medicare administrative contractor under section 1395kk–1 of this title) through the date on which the complaint is resolved. The system shall be able to report and initiate appropriate interventions and monitoring based on substantial complaints and to guide quality improvement.
(b) Model electronic complaint form
The Secretary shall develop a model electronic complaint form to be used for reporting plan complaints under the system. Such form shall be prominently displayed on the front page of the Medicare.gov Internet website and on the Internet website of the Medicare Beneficiary Ombudsman.
(c) Annual reports by the Secretary
The Secretary shall submit to Congress annual reports on the system. Such reports shall include an analysis of the number and types of complaints reported in the system, geographic variations in such complaints, the timeliness of agency or plan responses to such complaints, and the resolution of such complaints.
(1) MA–PD plan
The term "MA–PD plan" has the meaning given such term in section 1395w–151(a)(9) of this title.
(2) Prescription drug plan
The term "prescription drug plan" has the meaning given such term in section 1395w–151(a)(14) of this title.
The term "system" means the plan complaint system developed and maintained under subsection (a).
(Pub. L. 111–148, title III, §3311, Mar. 23, 2010, 124 Stat. 475.)