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.

Summary

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.

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3 official files

• Introduced in House (text)

  Introduced in House · EN · 25 April 2006

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• Introduced in House (PDF)

  Introduced in House · EN · 25 April 2006

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• Introduced in House

  summary · EN · 25 April 2006

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