HR 1387 IH
107th CONGRESS
1st Session
H. R. 1387
To amend the Social Security Act to improve access to prescription
drugs for low-income Medicare beneficiaries, the Internal Revenue Code and other
Acts to improve access to health care coverage for seniors, the self-employed,
and children, and to amend the Federal Food, Drug, and Cosmetic Act to improve
meaningful access to reasonably priced prescription drugs.
IN THE HOUSE OF REPRESENTATIVES
April 4, 2001
Mr. GANSKE (for himself, Mrs. EMERSON, Mr. FRANK, Mr. WYNN, Mr. HORN, Mr.
GILCHREST, Mr. TRAFICANT, Mr. LEACH, Mr. JONES of North Carolina, Mr. JOHNSON of
Illinois, Mr. SANDERS, Mr. GUTKNECHT, and Mr. TERRY) introduced the following
bill; which was 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
A BILL
To amend the Social Security Act to improve access to prescription
drugs for low-income Medicare beneficiaries, the Internal Revenue Code and other
Acts to improve access to health care coverage for seniors, the self-employed,
and children, and to amend the Federal Food, Drug, and Cosmetic Act to improve
meaningful access to reasonably priced prescription drugs.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE- This Act may be cited as the `Drug Availability and
Health Care Access Improvement Act of 2001'.
(b) TABLE OF CONTENTS- The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I--MEDICAID PRESCRIPTION DRUG COVERAGE FOR LOW-INCOME MEDICARE
BENEFICIARIES
Sec. 101. Medicaid prescription drug coverage for low-income medicare
beneficiaries.
TITLE II--IMPROVED ACCESS OF MEDICARE BENEFICIARIES TO MEDICARE+CHOICE
PLANS
Sec. 201. Improved access to Medicare+Choice plans through an increase
in the minimum Medicare+Choice capitation rate.
TITLE III--IMPROVED ACCESS TO REASONABLY PRICED PRESCRIPTION DRUGS
Sec. 301. Amendments to program for importation of certain prescription
drugs by pharmacists and wholesalers.
TITLE I--MEDICAID PRESCRIPTION DRUG COVERAGE FOR LOW-INCOME MEDICARE
BENEFICIARIES
SEC. 101. MEDICAID PRESCRIPTION DRUG COVERAGE FOR LOW-INCOME MEDICARE
BENEFICIARIES.
(a) IN GENERAL- Section 1902(a)(10) of the Social Security Act (42 U.S.C.
1396a(a)(10)) is amended--
(1) by striking `and' at the end of subparagraph (F);
(2) by adding `and' at the end of subparagraph (G); and
(3) by inserting after subparagraph (G) the following new
subparagraph:
`(H) for making medical assistance available for prescribed drugs (in
the same amount, duration, and scope as for individuals described in
subparagraph (A)) for qualified medicare beneficiaries described in
section 1905(p)(1) and for individuals who would be such qualified
medicare beneficiaries but for the fact that their income exceeds the
income level established by the State under section 1905(p)(2) but is less
than 175 percent of the official poverty line (referred to in such
section) for a family of the size involved;'.
(b) 100 PERCENT FEDERAL FINANCING OF ADDITIONAL COSTS- Section 1903(a) of
such Act (42 U.S.C. 1396b(a)) is amended--
(1) by redesignating paragraph (7) as paragraph (8); and
(2) by adding after paragraph (6) the following new paragraph:
`(7) an amount equal to 100 percent of amounts as expended as medical
assistance for prescribed drugs described in section 1902(a)(10)(H) to
individuals who are eligible for such assistance only on the basis of such
section; and'.
(c) PERMITTING CHARGING OF SLIDING SCALE PREMIUMS FOR QUALIFYING
INDIVIDUALS WITH INCOMES ABOVE 135 PERCENT OF POVERTY LINE- Section 1916 of
such Act Social Security Act is amended--
(1) in subsection (b), by striking `or (E)' and inserting `, (E), or
(H)'; and
(A) by inserting `(1)' after `(d)', and
(B) by adding at the end the following new paragraph:
`(2)(A) With respect to an individual described in section 1902(a)(10)(H)
whose income (as determined under section 1905(p)(1)(B)) exceeds 135 percent
of the official poverty line referred to in that section, the State plan of a
State shall provide for the charging of a premium (expressed as a percentage
of the average actuarial cost of the benefits described in section
1902(a)(10)(H) provided with respect to individuals described in such section)
according to a sliding scale under which such percentage increases from 0
percent to 100 percent, in reasonable increments (as determined by the
Secretary), as the individual's income increases from 135 percent of such
poverty line to 175 percent of such poverty line.
`(B) A State shall not require prepayment of a premium imposed pursuant to
subparagraph (A) and shall
not terminate eligibility of an individual for medical assistance under this
title on the basis of failure to pay any such premium until such failure
continues for a period of not less than 60 days. The State may waive payment of
any such premium in any case where the State determines that requiring such
payment would create an undue hardship.
`(C) A State may permit State or local funds available under other
programs to be used for payment of a premium imposed under subparagraph (A).
Payment of a premium with such funds shall not be counted as income to the
individual with respect to whom such payment is made.'.
(d) EFFECTIVE DATE- The amendments made by this section take effect on the
first day of the first year that begins more than 6 months after the date of
the enactment of this Act.
TITLE II--IMPROVED ACCESS OF MEDICARE BENEFICIARIES TO MEDICARE+CHOICE
PLANS
SEC. 201. IMPROVED ACCESS TO MEDICARE+CHOICE PLANS THROUGH AN INCREASE IN
THE MINIMUM MEDICARE+CHOICE CAPITATION RATE.
(a) IN GENERAL- Section 1853(c)(1)(B) of the Social Security Act (42
U.S.C. 1395w-23(c)(1)(B)), as amended by section 601(a) of Medicare, Medicaid,
and SCHIP Benefits Improvement and Protection Act of 2000 (as enacted into law
by section 1(a)(6) of Public Law 106-554), is amended--
(1) by redesignating clause (iv) as clause (v);
(2) by inserting after clause (iii) the following new clause:
`(I) for any area in the 50 States and the District of Columbia,
$600; and
`(II) for any other area, the minimum amount specified in clause
(iii) for that area for 2001 increased by the national per capita
Medicare+Choice growth percentage, described in paragraph (6)(A) for
2002.'; and
(3) in clause (v), as so redesignated--
(A) by striking `2002' and inserting `2003'; and
(B) by striking `or clause (iii)' and inserting `or clause
(iv)'.
(b) EFFECTIVE DATE- The amendments made by subsection (a) apply to years
beginning with 2002.
TITLE III--IMPROVED ACCESS TO REASONABLY PRICED PRESCRIPTION
DRUGS
SEC. 301. AMENDMENTS TO PROGRAM FOR IMPORTATION OF CERTAIN PRESCRIPTION
DRUGS BY PHARMACISTS AND WHOLESALERS.
Section 804 of the Federal Food, Drug, and Cosmetic Act (as added by
section 745(c)(2) of Public Law 106-387) is amended--
(1) by striking subsections (e) and (f) and inserting the following
subsections:
`(e) TESTING; APPROVED LABELING-
`(1) TESTING- Regulations under subsection (a)--
`(A) shall require that testing referred to in paragraphs (6) through
(8) of subsection (d) be conducted by the importer of the covered product
pursuant to subsection (a), or the manufacturer of the product;
`(B) shall require that, if such tests are conducted by the importer,
information needed to authenticate the product being tested be supplied by
the manufacturer of such product to the importer; and
`(C) shall provide for the protection of any information supplied by
the manufacturer under subparagraph (B) that is a trade secret or
commercial or financial information that is privileged or
confidential.
`(2) APPROVED LABELING- For purposes of importing a covered product
pursuant to subsection (a), the importer involved may use the labeling
approved for the product under section 505, notwithstanding any other
provision of law.
`(f) DISCRETION OF SECRETARY REGARDING TESTING- The Secretary may waive or
modify testing requirements described in subsection (d) if, with respect to
specific countries or specific distribution chains, the Secretary has entered
into agreements or otherwise approved arrangements that the Secretary
determines ensure that the
covered products involved are not adulterated or in violation of section
505.';
(2) by striking subsections (h) and (i) and inserting the following
subsections:
`(h) PROHIBITED AGREEMENTS; NONDISCRIMINATION-
`(1) PROHIBITED AGREEMENTS- No manufacturer of a covered product may
enter into a contract or agreement that includes a provision to prevent the
sale or distribution of covered products imported pursuant to subsection
(a).
`(2) NONDISCRIMINATION- No manufacturer of a covered product may take
actions that discriminate against, or cause other persons to discriminate
against, United States pharmacists, wholesalers, or consumers regarding the
sale or distribution of covered products.
`(1) STUDY- The Comptroller General of the United States shall conduct a
study on the imports permitted under this section, taking into consideration
the information received under subsection (a). In conducting such study, the
Comptroller General shall--
`(A) evaluate importers' compliance with regulations, determine the
number of shipments, if any, permitted under this section that have been
determined to be counterfeit, misbranded, or adulterated; and
`(B) consult with the United States Trade Representative and United
States Patent and Trademark Office to evaluate the effect of importations
permitted under this section on trade and patent rights under Federal
law.
`(2) REPORT- Not later than 5 years after the effective date of final
regulations issued pursuant to this section, the Comptroller General of the
United States shall prepare and submit to Congress a report containing the
study described in paragraph (1).';
(3) in subsection (k)(2)--
(A) by redesignating subparagraphs (A) through (E) as subparagraphs
(B) through (F), respectively; and
(B) by inserting before subparagraph (B) (as so redesignated) the
following subparagraph:
`(A) The term `discrimination' includes a contract provision, a
limitation on supply, or other measure which has the effect of providing
United States pharmacists, wholesalers, or consumers access to covered
products on terms or conditions that are less favorable than the terms or
conditions provided to any foreign purchaser of such products.';
(4) by striking subsection (m); and
(5) by inserting after subsection (l) the following subsection:
`(m) FUNDING- For the purpose of carrying out this section, there are
authorized to be appropriated such sums as may be necessary for fiscal year
2002 and each subsequent fiscal year.'.
END