To amend part D of title XVIII of the Social Security Act to provide for continuity of coverage of prescription drugs under Medicare prescription drug plans for full-benefit dual eligible individuals.

Amends part D (Voluntary Prescription Drug Benefit Program ) of title XVIII (Medicare) of the Social Security Act to provide for continuity of coverage of prescription drugs under Medicare prescription drug plans for full-benefit dual eligible individuals transitioning from Medicaid coverage.

[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4937 Introduced in House (IH)]







109th CONGRESS
  2d Session
                                H. R. 4937

 To amend part D of title XVIII of the Social Security Act to provide 
    for continuity of coverage of prescription drugs under Medicare 
  prescription drug plans for full-benefit dual eligible individuals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 9, 2006

  Mrs. Wilson of New Mexico 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 part D of title XVIII of the Social Security Act to provide 
    for continuity of coverage of prescription drugs under Medicare 
  prescription drug plans for full-benefit dual eligible individuals.

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

SECTION 1. MEDICARE CONTINUITY OF COVERAGE OF PRESCRIPTION DRUGS FOR 
              FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS.

    (a) In General.--Section 1860D-2(a) of the Social Security Act (42 
U.S.C. 1395w-102(a)) is amended--
            (1) in paragraph (1), by inserting ``subject to paragraph 
        (6),'' after ``part C''; and
            (2) by adding at the end the following new paragraph:
            ``(6) Continuation of coverage for full-benefit dual 
        eligible individuals transitioning from medicaid coverage.--In 
        the case of an individual who, as of date the individual is 
        first enrolled under a prescription drug plan under this part 
        (or an MA-PD plan under part D), is a full-benefit dual 
        eligible individual and is being provided medical assistance 
        for a prescription drug or biological under title XIX that may 
        be covered as a covered part D drug under this part, qualified 
        prescription drug coverage must include coverage for such drug 
        without the application of coverage limitations, such as prior 
        authorization or quantity limits, unless a prescribing 
        physician certifies that the coverage of such drug is not 
        medically necessary, regardless of whether the individual 
        subsequently remains a full-benefit dual eligible 
        individual.''.
    (b) Effective Date.--The amendments made by subsection (a) shall be 
effective as if included in the enactment of Medicare Prescription 
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173).
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