Seniors Prescription Insurance Coverage Equity (SPICE) Act of 1999 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to add a new part D (SPICE Drug Benefit Program) (SPICE program) (redesigning the current Medicare part D (Miscellaneous Provisions) as Medicare part E (Miscellaneous Provisions) to establish a voluntary SPICE program, administered by the SPICE Board which also operates a Seniors Prescription Insurance Coverage Equity Office established within the Department of Health and Human Services, under which all individuals entitled to Medicare part A (Hospital Insurance) benefits and enrolled in Medicare part B (Supplementary Medical Insurance) shall be provided access to coverage of outpatient prescription drugs that meet specified requirements. Grants such access via either enrollment in a Medicare+Choice (Medicare part C) plan, enrollment in a SPICE Medicare supplemental policy, or enrollment in a group health plan, all as defined by this Act. Provides for described financial assistance for covered beneficiaries for them to obtain enrollment coverage, with such assistance varying depending upon beneficiary income.

Vests the Board with outreach and other specified duties, such as establishing procedures for enrollment and enhanced financial assistance with regard to eligible Medicare beneficiaries and the SPICE program, and conducting certain ongoing studies, as well as a study and report to Congress on permitting an alternative outpatient prescription drug benefit package under Medicare supplemental health insurance policies (Medigap) provisions.

Outlines requirements for the offering of SPICE program coverage, which include prohibiting pre-existing condition exclusions with respect to coverage and allowing use of reasonable cost containment methods.

Establishes in the Treasury the SPICE Trust Fund, consisting in part of amounts from the taxes imposed on tobacco and tobacco-related products and from the on-budget surplus, to be available only for expenditures to carry out the SPICE program. Makes appropriations and authorizes appropriations.

Amends the Omnibus Budget Reconciliation Act of 1990 to include with Medigap policy comparison information for Medigap policies, information on the SPICE program for purposes of State grant application plans for State-wide health insurance, counseling, and assistance grants.

Amends the Internal Revenue Code to impose a variety of excise taxes on specified tobacco and tobacco-related products, as well as with regard to the manufacture or the importation of roll-your-own tobacco, and to make modifications to certain tobacco excise tax provisions, such as placing a restriction on importation of previously exported tobacco products.