2000 
[DOCID: f:h1387ih.txt]






107th CONGRESS
  1st Session
                                H. R. 1387

  To amend the Social Security Act to improve access to prescription 
drugs for low-income Medicare beneficiaries, the Internal Revenue Code 
 and other Acts to improve access to health care coverage for seniors, 
 the self-employed, and children, and to amend the Federal Food, Drug, 
  and Cosmetic Act to improve meaningful access to reasonably priced 
                          prescription drugs.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 4, 2001

 Mr. Ganske (for himself, Mrs. Emerson, Mr. Frank, Mr. Wynn, Mr. Horn, 
 Mr. Gilchrest, Mr. Traficant, Mr. Leach, Mr. Jones of North Carolina, 
  Mr. Johnson of Illinois, Mr. Sanders, Mr. Gutknecht, and Mr. Terry) 
 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 the Social Security Act to improve access to prescription 
drugs for low-income Medicare beneficiaries, the Internal Revenue Code 
 and other Acts to improve access to health care coverage for seniors, 
 the self-employed, and children, and to amend the Federal Food, Drug, 
  and Cosmetic Act to improve meaningful access to reasonably priced 
                          prescription drugs.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Drug Availability 
and Health Care Access Improvement Act of 2001''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
 TITLE I--MEDICAID PRESCRIPTION DRUG COVERAGE FOR LOW-INCOME MEDICARE 
                             BENEFICIARIES

Sec. 101. Medicaid prescription drug coverage for low-income medicare 
                            beneficiaries.
TITLE II--IMPROVED ACCESS OF MEDICARE BENEFICIARIES TO MEDICARE+CHOICE 
                                 PLANS

Sec. 201. Improved access to Medicare+Choice plans through an increase 
                            in the minimum Medicare+Choice capitation 
                            rate.
   TITLE III--IMPROVED ACCESS TO REASONABLY PRICED PRESCRIPTION DRUGS

Sec. 301. Amendments to program for importation of certain prescription 
                            drugs by pharmacists and wholesalers.

 TITLE I--MEDICAID PRESCRIPTION DRUG COVERAGE FOR LOW-INCOME MEDICARE 
                             BENEFICIARIES

SEC. 101. MEDICAID PRESCRIPTION DRUG COVERAGE FOR LOW-INCOME MEDICARE 
              BENEFICIARIES.

    (a) In General.--Section 1902(a)(10) of the Social Security Act (42 
U.S.C. 1396a(a)(10)) is amended--
            (1) by striking ``and'' at the end of subparagraph (F);
            (2) by adding ``and'' at the end of subparagraph (G); and
            (3) by inserting after subparagraph (G) the following new 
        subparagraph:
                    ``(H) for making medical assistance available for 
                prescribed drugs (in the same amount, duration, and 
                scope as for individuals described in subparagraph (A)) 
                for qualified medicare beneficiaries described in 
                section 1905(p)(1) and for individuals who would be 
                such qualified medicare beneficiaries but for the fact 
                that their income exceeds the income level established 
                by the State under section 1905(p)(2) but is less than 
                175 percent of the official poverty line (referred to 
                in such section) for a family of the size involved;''.
    (b) 100 Percent Federal Financing of Additional Costs.--Section 
1903(a) of such Act (42 U.S.C. 1396b(a)) is amended--
            (1) by redesignating paragraph (7) as paragraph (8); and
            (2) by adding after paragraph (6) the following new 
        paragraph:
            ``(7) an amount equal to 100 percent of amounts as expended 
        as medical assistance for prescribed drugs described in section 
        1902(a)(10)(H) to individuals who are eligible for such 
        assistance only on the basis of such section; and''.
    (c) Permitting Charging of Sliding Scale Premiums for Qualifying 
Individuals With Incomes Above 135 Percent of Poverty Line.--Section 
1916 of such Act Social Security Act is amended--
            (1) in subsection (b), by striking ``or (E)'' and inserting 
        ``, (E), or (H)''; and
            (2) in subsection (d)--
                    (A) by inserting ``(1)'' after ``(d)'', and
                    (B) by adding at the end the following new 
                paragraph:
    ``(2)(A) With respect to an individual described in section 
1902(a)(10)(H) whose income (as determined under section 1905(p)(1)(B)) 
exceeds 135 percent of the official poverty line referred to in that 
section, the State plan of a State shall provide for the charging of a 
premium (expressed as a percentage of the average actuarial cost of the 
benefits described in section 1902(a)(10)(H) provided with respect to 
individuals described in such section) according to a sliding scale 
under which such percentage increases from 0 percent to 100 percent, in 
reasonable increments (as determined by the Secretary), as the 
individual's income increases from 135 percent of such poverty line to 
175 percent of such poverty line.
    ``(B) A State shall not require prepayment of a premium imposed 
pursuant to subparagraph (A) and shall not terminate eligibility of an 
individual for medical assistance under this title on the basis of 
failure to pay any such premium until such failure continues for a 
period of not less than 60 days. The State may waive payment of any 
such premium in any case where the State determines that requiring such 
payment would create an undue hardship.
    ``(C) A State may permit State or local funds available under other 
programs to be used for payment of a premium imposed under subparagraph 
(A). Payment of a premium with such funds shall not be counted as 
income to the individual with respect to whom such payment is made.''.
    (d) Effective Date.--The amendments made by this section take 
effect on the first day of the first year that begins more than 6 
months after the date of the enactment of this Act.

TITLE II--IMPROVED ACCESS OF MEDICARE BENEFICIARIES TO MEDICARE+CHOICE 
                                 PLANS

SEC. 201. IMPROVED ACCESS TO MEDICARE+CHOICE PLANS THROUGH AN INCREASE 
              IN THE MINIMUM MEDICARE+CHOICE CAPITATION RATE.

    (a) In General.--Section 1853(c)(1)(B) of the Social Security Act 
(42 U.S.C. 1395w-23(c)(1)(B)), as amended by section 601(a) of 
Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act 
of 2000 (as enacted into law by section 1(a)(6) of Public Law 106-554), 
is amended--
            (1) by redesignating clause (iv) as clause (v);
            (2) by inserting after clause (iii) the following new 
        clause:
                            ``(iv) For 2002--
                                    ``(I) for any area in the 50 States 
                                and the District of Columbia, $600; and
                                    ``(II) for any other area, the 
                                minimum amount specified in clause 
                                (iii) for that area for 2001 increased 
                                by the national per capita 
                                Medicare+Choice growth percentage, 
                                described in paragraph (6)(A) for 
                                2002.''; and
            (3) in cla
158b
use (v), as so redesignated--
                    (A) by striking ``2002'' and inserting ``2003''; 
                and
                    (B) by striking ``or clause (iii)'' and inserting 
                ``or clause (iv)''.
    (b) Effective Date.--The amendments made by subsection (a) apply to 
years beginning with 2002.

   TITLE III--IMPROVED ACCESS TO REASONABLY PRICED PRESCRIPTION DRUGS

SEC. 301. AMENDMENTS TO PROGRAM FOR IMPORTATION OF CERTAIN PRESCRIPTION 
              DRUGS BY PHARMACISTS AND WHOLESALERS.

    Section 804 of the Federal Food, Drug, and Cosmetic Act (as added 
by section 745(c)(2) of Public Law 106-387) is amended--
            (1) by striking subsections (e) and (f) and inserting the 
        following subsections:
    ``(e) Testing; Approved Labeling.--
            ``(1) Testing.--Regulations under subsection (a)--
                    ``(A) shall require that testing referred to in 
                paragraphs (6) through (8) of subsection (d) be 
                conducted by the importer of the covered product 
                pursuant to subsection (a), or the manufacturer of the 
                product;
                    ``(B) shall require that, if such tests are 
                conducted by the importer, information needed to 
                authenticate the product being tested be supplied by 
                the manufacturer of such product to the importer; and
                    ``(C) shall provide for the protection of any 
                information supplied by the manufacturer under 
                subparagraph (B) that is a trade secret or commercial 
                or financial information that is privileged or 
                confidential.
            ``(2) Approved labeling.--For purposes of importing a 
        covered product pursuant to subsection (a), the importer 
        involved may use the labeling approved for the product under 
        section 505, notwithstanding any other provision of law.
    ``(f) Discretion of Secretary Regarding Testing.--The Secretary may 
waive or modify testing requirements described in subsection (d) if, 
with respect to specific countries or specific distribution chains, the 
Secretary has entered into agreements or otherwise approved 
arrangements that the Secretary determines ensure that the covered 
products involved are not adulterated or in violation of section 
505.'';
            (2) by striking subsections (h) and (i) and inserting the 
        following subsections:
    ``(h) Prohibited Agreements; Nondiscrimination.--
            ``(1) Prohibited agreements.--No manufacturer of a covered 
        product may enter into a contract or agreement that includes a 
        provision to prevent the sale or distribution of covered 
        products imported pursuant to subsection (a).
            ``(2) Nondiscrimination.--No manufacturer of a covered 
        product may take actions that discriminate against, or cause 
        other persons to discriminate against, United States 
        pharmacists, wholesalers, or consumers regarding the sale or 
        distribution of covered products.
    ``(i) Study and Report.--
            ``(1) Study.--The Comptroller General of the United States 
        shall conduct a study on the imports permitted under this 
        section, taking into consideration the information received 
        under subsection (a). In conducting such study, the Comptroller 
        General shall--
                    ``(A) evaluate importers' compliance with 
                regulations, determine the number of shipments, if any, 
                permitted under this section that have been determined 
                to be counterfeit, misbranded, or adulterated; and
                    ``(B) consult with the United States Trade 
                Representative and United States Patent and Trademark 
                Office to evaluate the effect of importations permitted 
                under this section on trade and patent rights under 
                Federal law.
            ``(2) Report.--Not later than 5 years after the effective 
        date of final regulations issued pursuant to this section, the 
        Comptroller General of the United States shall prepare and 
        submit to Congress a report containing the study described in 
        paragraph (1).'';
            (3) in subsection (k)(2)--
                    (A) by redesignating subparagraphs (A) through (E) 
                as subparagraphs (B) through (F), respectively; and
                    (B) by inserting before subparagraph (B) (as so 
                redesignated) the following subparagraph:
                    ``(A) The term `discrimination' includes a contract 
                provision, a limitation on supply, or other measure 
                which has the effect of providing United States 
                pharmacists, wholesalers, or consumers access to 
                covered products on terms or conditions that are less 
                favorable than the terms or conditions provided to any 
                foreign purchaser of such products.'';
            (4) by striking subsection (m); and
            (5) by inserting after subsection (l) the following 
        subsection:
    ``(m) Funding.--For the purpose of carrying out this section, there 
are authorized to be appropriated such sums as may be necessary for 
fiscal year 2002 and each subsequent fiscal year.''.
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