To amend title XIX of the Social Security Act to provide for an offset from the Medicaid clawback for State emergency prescription drug expenditures for Medicare dual-eligible individuals.

Amends title XIX (Medicaid) of the Social Security Act with respect to required state reimbursements to the Secretary of Health and Human Services for federal assumption of Medicaid prescription drug costs for dual-eligible individuals (Medicaid clawback).

Requires an offset from the Medicaid clawback for state prescription drug expenditures for covered part D (Voluntary Prescription Drug Benefit Program) drugs for part D eligible individuals who are: (1) entitled to benefits under the state plan (whether as full-benefit dual eligible individuals, qualified Medicare beneficiaries, or otherwise); and (2) enrolled in a part D plan but unable to access on a timely basis benefits to which they were entitled.

Requires the Secretary to provide for recovery of payment reductions owing to such offset from those part D or Medicare Advantage-Prescription Drug (MA-PD) plans that would otherwise be responsible for the expenditures made by the states.

[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4665 Introduced in House (IH)]







109th CONGRESS
  2d Session
                                H. R. 4665

To amend title XIX of the Social Security Act to provide for an offset 
   from the Medicaid clawback for State emergency prescription drug 
          expenditures for Medicare dual-eligible individuals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 31, 2006

Mr. Cardin (for himself, Ms. Pelosi, Mr. Hoyer, Mr. Rangel, Mr. Stark, 
 Mr. Waxman, Mr. George Miller of California, Ms. Hooley, Mrs. Capps, 
Mr. Wexler, Ms. Norton, Mr. Thompson of California, Mr. Ross, Mr. Davis 
 of Florida, Ms. Matsui, Ms. Woolsey, Mr. Sanders, Mr. McDermott, Ms. 
Eshoo, Ms. Harman, Mr. Gutierrez, Mr. Hastings of Florida, Mr. Nadler, 
 Mr. Engel, Mr. Van Hollen, Mrs. Maloney, Ms. Moore of Wisconsin, Mr. 
  Kanjorski, Mr. Higgins, Mr. Jefferson, Mr. Bishop of New York, Mr. 
Delahunt, Ms. Baldwin, Mr. Hinchey, Mr. Grijalva, Ms. Lee, Mr. DeFazio, 
Mr. Lantos, Mr. Doyle, Ms. DeGette, Mr. Farr, Mr. McGovern, Mr. Ortiz, 
 Ms. Zoe Lofgren of California, Mr. Kildee, Mr. Wynn, Mr. Cleaver, Mr. 
   Kennedy of Rhode Island, Mr. Payne, Mr. Filner, Mr. Michaud, Mr. 
  Ruppersberger, Mr. Ford, Mr. Cummings, Mr. Crowley, Mr. Honda, Mr. 
  Berry, Mr. Frank of Massachusetts, Ms. Schakowsky, and Mr. Price of 
 North Carolina) 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 title XIX of the Social Security Act to provide for an offset 
   from the Medicaid clawback for State emergency prescription drug 
          expenditures for Medicare dual-eligible individuals.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. FEDERAL RESPONSIBILITY FOR STATE EMERGENCY PRESCRIPTION DRUG 
              EXPENDITURES FOR MEDICARE DUAL-ELIGIBLE INDIVIDUALS.

    Section 1935(c) of the Social Security Act (42 U.S.C. 1396v-5(c)) 
is amended--
            (1) in paragraph (1)(A), by striking ``Each of the 50 
        States'' and inserting ``Subject to paragraph (7), each of the 
        50 States''; and
            (2) by adding at the end the following new paragraph:
            ``(7) Offset for emergency state prescription drug 
        expenditures.--
                    ``(A) In general.--The amount of payment for a 
                month (beginning with January 2006 and ending with 
                December 2007) under paragraph (1) shall be reduced by 
                the amount (as documented by the State) that the State 
                expended during the month for payment for part D 
                covered drugs for part D eligible individuals who are 
                entitled to benefits under the State plan (whether as 
                full-benefit dual eligible individuals, qualified 
                medicare beneficiaries, or otherwise) and who are 
                enrolled in a prescription drug plan under part D of 
                title XVIII, but were unable to access on a timely 
                basis prescription drug benefits to which they were 
                entitled under such prescription drug plan.
                    ``(B) Recovery of amount of offset from 
                prescription drug plans.--The Secretary shall provide 
                for recovery of payment reductions made under 
                subparagraph (A) from those prescription drug plans 
                under part D of title XVIII or MA-PD plans under part C 
                of such title that would otherwise be responsible for 
                the expenditures described in such subparagraph. Any 
                such amounts recovered shall be deposited into the 
                Medicare Prescription Drug Account in the Federal 
                Supplementary Medical Insurance Trust Fund.''.
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