[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1325 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 1325
To amend title XVIII of the Social Security Act to provide Medicare
entitlement to immunosuppressive drugs for kidney transplant
recipients.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 21, 2013
Mr. Burgess (for himself, Mrs. Blackburn, Mr. Marino, Mr. Cassidy, Mr.
Young of Florida, Mr. Crenshaw, Mr. McDermott, Mr. Bachus, Mr. Grimm,
Mr. Wolf, and Mr. Tiberi) 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 Medicare
entitlement to immunosuppressive drugs for kidney transplant
recipients.
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 ``Comprehensive Immunosuppressive Drug
Coverage for Kidney Transplant Patients Act of 2013''.
SEC. 2. MEDICARE ENTITLEMENT TO IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY
TRANSPLANT RECIPIENTS.
(a) Kidney Transplant Recipients.--Section 226A(b)(2) of the Social
Security Act (42 U.S.C. 426-1(b)(2)) is amended by inserting ``(except
for eligibility for enrollment under part B solely for purposes of
coverage of immunosuppressive drugs described in section
1861(s)(2)(J))'' before ``, with the thirty-sixth month''.
(b) Individuals Eligible Only for Coverage of Immunosuppressive
Drugs.--
(1) In general.--Section 1836 of the Social Security Act
(42 U.S.C. 1395o) is amended--
(A) by striking ``Every'' and inserting ``(a) In
General.--Every''; and
(B) by inserting at the end the following new
subsection:
``(b) Individuals Eligible for Immunosuppressive Drug Coverage.--
Beginning on January 1, 2014, every individual whose insurance benefits
under part A have ended (whether before, on, or after such date) by
reason of section 226A(b)(2) is eligible for enrollment in the
insurance program established by this part solely for purposes of
coverage of immunosuppressive drugs.''.
(2) Conforming amendment.--Sections 1837, 1838, and 1839 of
the Social Security Act (42 U.S.C. 1395(o), 42 U.S.C. 1395(p),
42 U.S.C. 1395(q)) are each amended by striking ``1836'' and
inserting ``1836(a)'' each place it appears.
(c) Enrollment for Individuals Only Eligible for Coverage of
Immunosuppressive Drugs.--Section 1837 of the Social Security Act (42
U.S.C. 1395(p)) is amended by adding at the end the following new
subsection:
``(m)(1) Any individual who is eligible under section 1836(b) to
enroll in the medical insurance program established under this part for
purposes of coverage of immunosuppressive drugs may enroll only in such
manner and form as may be prescribed by regulations, and only during an
enrollment period described in this subsection.
``(2) An individual described in paragraph (1) may enroll beginning
on the first day of the third month before the month in which the
individual first satisfies section 1836(b).
``(3) An individual described in paragraph (1) whose entitlement
for hospital insurance benefits under part A ends by reason of section
226A(b)(2) on or after January 1, 2014, shall be deemed to have
enrolled in the medical insurance program established by this part for
purposes of coverage of immunosuppressive drugs.''.
(d) Coverage Period for Individuals Only Eligible for Coverage of
Immunosuppressive Drugs.--
(1) In general.--Section 1838 of the Social Security Act
(42 U.S.C. 1395(q)) is amended by adding at the end the
following new subsection:
``(g) In the case of an individual described in section 1836(b),
the following rules shall apply:
``(1) In the case of such an individual who is deemed to
have enrolled in part B for coverage of immunosuppressive drugs
under section 1837(m)(3), such individual's coverage period
shall begin on the first day of the month in which the
individual first satisfies section 1836(b).
``(2) In the case of such an individual who enrolls in part
B for coverage of immunosuppressive drugs under section
1837(m)(2), such individual's coverage period shall begin on
the first day of the month in which the individual first
satisfies section 1836(b) or the month following the month in
which the individual so enrolls, whichever is later.
``(3) The provisions of subsections (b) and (d) shall apply
with respect to an individual described in paragraph (1) or
(2).
``(4) In addition to the reasons for termination under
subsection (b), the coverage period of an individual described
in paragraph (1) or (2) shall end when the individual becomes
entitled to benefits under this title under section 226(a),
226(b), or 226A.''.
(2) Conforming amendments.--Section 1838(b) is amended in
the matter following paragraph (2) by adding ``or section
1837(m)(3)'' after ``section 1837(f)'' each place it appears.
(e) Premiums for Individuals Only Eligible for Coverage of
Immunosuppressive Drugs.--Section 1839 of the Social Security Act (42
U.S.C. 1395r) is amended--
(1) in subsection (b), by adding at the end the following
new sentence: ``No increase in the premium shall be effected
for individuals who are enrolled pursuant to section 1836(b)
for coverage only of immunosuppressive drugs.''; and
(2) by adding at the end the following new subsection:
``(j) Determination of Premium for Individuals Only Eligible for
Coverage of Immunosuppressive Drugs.--The Secretary shall, during
September of each year, determine and promulgate a monthly premium rate
for the succeeding calendar year for individuals who enroll only for
the purpose of coverage of immunosuppressive drugs under section
1836(b). Such premium shall be equal to 35 percent of the monthly
actuarial rate for enrollees age 65 and over, determined according to
paragraph (1), for that succeeding calendar year. The monthly premium
of each individual enrolled for coverage of immunosuppressive drugs
under section 1836(b) for each month shall be the amount promulgated in
this subsection. Such amount shall be adjusted in accordance with
subsections (c) and (f).''.
(f) Government Contribution.--Section 1844(a) of the Social
Security Act (42 U.S.C. 1395(w)) is amended--
(1) in paragraph (3), by striking the period at the end and
inserting ``; plus'';
(2) by adding at the end the following new paragraph:
``(4) a Government contribution equal to the estimated
aggregate reduction in premiums payable under part B that
results from establishing the premium at 35 percent of the
actuarial rate under section 1839(j) instead of 50 percent of
the actuarial rate for individuals who enroll only for the
purpose of coverage of immunosuppressive drugs under section
1836(b).''; and
(3) by adding at the end the following flush matter:
``The Government contribution under paragraph (4) shall be
treated as premiums payable and deposited for purposes of
subparagraphs (A) and (B) of paragraph (1).''.
(g) Extension of Secondary Payer Requirements for ESRD
Beneficiaries Eligible for Coverage of Immunosuppressive Drugs.--
Section 1862(b)(1)(C) (42 U.S.C. 1395(y)(b)(1)) is amended by adding at
the end the following new sentence: ``With regard to immunosuppressive
drugs furnished to an individual who enrolls for the purpose of
coverage of immunosuppressive drugs under section 1836(b) on or after
January 1, 2014, this subparagraph shall apply without regard to any
time limitation, except that when such individual becomes entitled to
benefits under this title under sections 226(a) or 226(b), or entitled
to or eligible for benefits under this title under section 226A, the
provisions of subparagraphs (A) and (B), and the time limitations under
this subparagraph, respectively, shall apply.''.
(h) Ensuring Coverage Under the Medicare Savings Program.--Section
1905(p)(1)(A) of the Social Security Act (42 U.S.C. 1396d(p)(1)(A)) is
amended by inserting ``or an individual who is enrolled under part B
for the purpose of coverage of immunosuppressive drugs under section
1836(b)'' after ``section 1818''.
(i) Part D.--Section 1860D-1(a)(3)(A) of the Social Security Act
(42 U.S.C. 1395w-101(a)(3)(A)) is amended by inserting ``(but not
including an individual enrolled solely for coverage of
immunosuppressive drugs under section 1836(b))'' before the period at
the end.
<all>