Medicare Prescription Drug Lifeline Act of 2006

Medicare Prescription Drug Lifeline Act of 2006 - Directs the Secretary of Health and Human Services to establish a process under which an individual may terminate enrollment in the prescription drug plan or the Medicare Advantage Prescription Drug (MA-PD) Plan in which he or she is enrolled and enroll in any prescription drug plan or MA-PD Plan serving the area where the individual resides that provides some coverage of covered part D (Voluntary Prescription Drug Benefit Program) drugs after the individual has reached the initial coverage limit but not yet the annual out-of-pocket threshold.

Sets forth a special rule permitting applicable individuals to enroll in a prescription drug plan outside the region in which they reside.

Directs the Comptroller General to study and report to Congress on: (1) the costs to the Medicare program of eliminating the initial coverage limit and providing specified standard prescription drug coverage until the individual reaches the annual out-of-pocket threshold; and (2) the adjustment to the applicable coinsurance that would be necessary to eliminate the initial coverage limit under such conditions without increasing the costs to the Medicare program.

[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3703 Introduced in Senate (IS)]








109th CONGRESS
  2d Session
                                S. 3703

    To provide for a temporary process for individuals entering the 
Medicare coverage gap to switch to a plan that provides coverage in the 
                                  gap.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 20, 2006

 Ms. Snowe (for herself and Mr. Wyden) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
    To provide for a temporary process for individuals entering the 
Medicare coverage gap to switch to a plan that provides coverage in the 
                                  gap.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Prescription Drug Lifeline 
Act of 2006''.

SEC. 2. TEMPORARY PROCESS FOR INDIVIDUALS ENTERING THE MEDICARE 
              COVERAGE GAP TO SWITCH TO A PLAN THAT PROVIDES COVERAGE 
              IN THE GAP.

    (a) Process.--Notwithstanding any other provision of law, by not 
later than 30 days after the date of enactment of this Act, the 
Secretary of Health and Human Services (in this section referred to as 
the ``Secretary'') shall establish a process under which an applicable 
individual may terminate enrollment in the prescription drug plan or 
the MA-PD plan in which they are enrolled and enroll in any 
prescription drug plan or MA-PD plan--
            (1) that provides some coverage of covered part D drugs (as 
        defined in subsection (e) of section 1860D-2 of the Social 
        Security Act (42 U.S.C. 1395w-102)) after the individual has 
        reached the initial coverage limit under the plan but has not 
        reached the annual out-of-pocket threshold under subsection 
        (b)(4)(B) of such section; and
            (2) subject to subsection (b), that serves the area in 
        which the individual resides.
    (b) Special Rule Permitting Applicable Individuals to Enroll in a 
Prescription Drug Plan Outside of the Region in Which the Individual 
Resides.--In the case of an applicable individual that resides in a PDP 
region under section 1860D-11(a)(2) of the Social Security Act (42 
U.S.C. 1395w-111(a)(2)) in which there is no prescription drug plan 
available that provides some coverage of brand name covered part D 
drugs (as so defined) after the individual has reached the initial 
coverage limit under the plan but before the individual has reached 
such annual out-of-pocket threshold, the Secretary shall ensure that 
the process established under subsection (a) permits the individual to 
enroll in a prescription drug plan that provides such coverage but is 
in another PDP region. The Secretary shall determine the PDP region in 
which the individual may enroll in such a prescription drug plan.
    (c) Notification of Applicable Individuals.--Under the process 
established under subsection (a), the Secretary shall notify, or 
require sponsors of prescription drug plans and organizations offering 
MA-PD plans to notify, applicable individuals of the option to change 
plans under such process. Such notice shall be provided to an 
applicable individual within 30 days of meeting the definition of such 
an individual.
    (d) Process in Effect for Remaining Portion of 2006.--The process 
established under subsection (a) shall remain in effect through 
December 31, 2006.
    (e) Definitions.--In this section:
            (1) Applicable individual.--The term ``applicable 
        individual'' means a part D eligible individual (as defined in 
        section 1860D-1(a)(3)(A) of the Social Security Act (42 U.S.C. 
        1395w-101(a)(3)(A)) who, with respect to a year--
                    (A) is enrolled in a prescription drug plan or an 
                MA-PD plan that does not provide any coverage of 
                covered part D drugs (as so defined) after the 
                individual has reached the initial coverage limit under 
                the plan but has not reached such annual out-of-pocket 
                threshold; and
                    (B) has reached such initial coverage limit or is 
                within $750 of reaching such limit.
            (2) Prescription drug plan; ma-pd plan.--The terms 
        ``prescription drug plan'' and ``MA-PD plan'' have the meanings 
        given those terms in section 1860D-41(a)(14) of the Social 
        Security Act (42 U.S.C. 1395w-151(a)(14)) and section 1860D-
        1(a)(3)(C) of such Act (42 U.S.C. 1395w-101(a)(3)(C)), 
        respectively.

SEC. 3. GAO STUDY AND REPORT ON THE ELIMINATION OF THE MEDICARE PART D 
              COVERAGE GAP.

    (a) Study.--The Comptroller General of the United States shall 
conduct a study on--
            (1) the costs to the Medicare program of eliminating the 
        initial coverage limit under paragraph (3) of section 1860D-
        2(b) of the Social Security Act (42 U.S.C. 1395w-102(b)) (and 
        providing that standard prescription drug coverage included the 
        coverage described in paragraph (2) of such section until the 
        individual reached the annual out-of-pocket threshold under 
        subsection (b)(4)(B) of such section); and
            (2) the adjustment to the coinsurance under paragraph (2) 
        of such section that would be necessary to eliminate the 
        initial coverage limit (and provide that standard prescription 
        drug coverage included such adjusted coinsurance amount until 
        the individual reached such annual out-of-pocket threshold) 
        without increasing the costs to the Medicare program.
    (b) Report.--Not later than May 1, 2007, the Comptroller General of 
the United States shall submit a report to Congress on the study 
conducted under subsection (a) together with such recommendations as 
the Comptroller General determines to be appropriate.
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