Medication Therapy Management Empowerment Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to provide access to services under medication therapy management programs for Medicare part D (Voluntary Prescription Drug Program) eligible individuals with a single chronic disease.
Allows the application of this Act only if the Chief Actuary for the Centers for Medicare & Medicaid Services determines that such application with regard to a particular single chronic disease is not projected to increase overall costs to the Medicare program over the following five year period.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1024 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 1024
To amend title XVIII of the Social Security Act to provide part D
eligible individuals with single chronic diseases access to services
under medication therapy management programs under the Medicare part D
prescription drug program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 7, 2013
Mrs. McMorris Rodgers 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 XVIII of the Social Security Act to provide part D
eligible individuals with single chronic diseases access to services
under medication therapy management programs under the Medicare part D
prescription drug program.
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 ``Medication Therapy Management
Empowerment Act of 2013''.
SEC. 2. ACCESS TO SERVICES UNDER MEDICATION THERAPY MANAGEMENT PROGRAMS
FOR MEDICARE PART D ELIGIBLE INDIVIDUALS WITH SINGLE
CHRONIC DISEASES.
Section 1860D-4(c)(2)(A) of the Social Security Act (42 U.S.C.
1395w-104(c)(2)(A)) is amended--
(1) in clause (ii), by striking subclause (I) and inserting
the following:
``(I) have--
``(aa) multiple chronic
diseases (such as diabetes,
asthma, hypertension,
hyperlipidemia, and congestive
heart failure); or
``(bb) subject to clause
(iii), any single chronic
disease, including diabetes,
hypertension, heart failure,
dyslipidemia, respiratory
disease (such as asthma,
chronic obstructive pulmonary
disease or chronic lung
disorder), bone disease-
arthritis (such as osteoporosis
or osteoarthritis), rheumatoid
arthritis, or mental health
disorder (such as depression,
schizophrenia, or bipolar
disorder).''; and
(2) by adding at the end the following:
``(iii) Determinations relating to program
costs for including individuals with single
chronic diseases.--
``(I) Initial determinations.--With
regard to any single chronic disease,
clause (ii)(I)(bb) shall only be
applied if the Chief Actuary for the
Centers for Medicare & Medicaid
Services determines that the
application of such clause with regard
to such disease is not projected to
increase overall costs to the Medicare
program under this title over the five
year period beginning on the date of
determination.
``(II) Review of determinations.--
In the case that clause (ii)(I)(bb) is
applied with respect to a single
chronic disease pursuant to a
determination under subclause (I), not
later than five years after such date
of determination, the Chief Actuary for
the Centers for Medicare & Medicaid
Services shall review the effect of the
application of such clause with respect
to such disease on the actual cost of
the Medicare program under this title
during such five years. Based on such
review, if the Chief Actuary is unable
to determine that, with regard to such
single chronic disease, the application
of such clause did not increase costs
to the Federal government under the
Medicare program under this title over
such period, then the Secretary shall
review the findings of the Chief
Actuary and determine whether such
clause shall continue to be applied
with regard to such single chronic
disease. In conducting such review and
making such determination, the
Secretary shall consider the extent to
which the application of such clause
with regard to such single chronic
disease effects the health outcomes of
part D eligible individuals and any
savings and costs to the Federal
government under the Medicare program
under this title.''.
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Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
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