,,ii  #aacth ,,congress  #ast ,session  
,s4 #cbc  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,february #ac1 #bjac
 ,mr4 ,durbin 7for himself and ,mr4     
,cochran7 introduced the following bill2
 which was read twice and referred to   
the ,committee on ,finance  ,a ,,bill   
,to amend title ,,xviii of the ,social  
,security ,act to provide for extended  
months of ,medicare coverage of         
immunosuppressive drugs for kidney      
transplant patients and other renal     
dialysis provisions4  #a4 ,short title  
,this ,act may be cited as the          
,comprehensive ,immunosuppressive ,drug 
,coverage for ,kidney ,transplant       
,patients ,act of #bjac4  #b4 ,extended 
months of coverage of immunosuppressive 
drugs for kidney transplant patients and
 other renal dialysis provisions  7a7   
,medicare entitlement to                
immunosuppressive drugs for kidney      
transplant recipients  7#a7 ,kidney     
transplant recipients ,section          
#bbf;,a7b77#b7 of the ,social ,security 

,act 7#db ,u4,s4,c4 #dbf-a7;b77#b77 is  
amended by inserting 7except for        
eligibility for enrollment under part ,b
 solely for purposes of coverage of     
immunosuppressive drugs described in    
section #ahfa7s77#b77;,j77 before 1 with
 the thirty-sixth month4  7#b7          
,individuals eligible only for coverage 
of immunosuppressive drugs  7,a7        
,section #ahcf of the ,social ,security 
,act 7#db ,u4,s4,c4 #acieo7 is amended--
  7i7 by striking ,every and inserting  
7a7 ,in general4--,every2 and  7ii7 by  
inserting at the end the following new  
subsection3  7b7 ,individuals eligible  
for immunosuppressive drug coverage     
,beginning on ,january #a1 #bjad1 every 
individual whose insurance benefits     
under part ,a have ended 7whether       
before1 on1 or after such date7 by      
reason of section #bbf;,a7b77#b7 is     
eligible for enrollment in the insurance
 program established by this part solely
 for purposes of coverage of            
immunosuppressive drugs4  4  7,b7       

,conforming amendment ,sections #ahcg1  
#ahch1 and #ahci of the ,social         
,security ,act 7#db ,u4,s4,c4 #acie7p71 
#db ,u4,s4,c4 #acie7q71 #db ,u4,s4,c4   
#acie7r77 are each amended by striking  
#ahcf and inserting #ahcf7;a7 each place
 it appears4  7#c7 ,enrollment for      
individuals only eligible for coverage  
of immunosuppressive drugs ,section     
#ahcg of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acie7p77 is amended by      
adding at the end the following new     
subsection3  7m7 7#a7 ,any individual   
who is eligible under section #ahcf7;b7 
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 regulations1 and only     
during an enrollment period described in
 this subsection4  7#b7 ,an individual  
described in paragraph 7#a7 may enroll  
beginning on the first day of the third 
month before the month in which the     

individual first satisfies section      
#ahcf7;b74  7#c7 ,an individual         
described in paragraph 7#a7 whose       
entitlement for hospital insurance      
benefits under part ,a ends by reason of
 section #bbf;,a7b77#b7 on or after     
,january #a1 #bjad1 shall be deemed to  
have enrolled in the medical insurance  
program established by this part for    
purposes of coverage of                 
immunosuppressive drugs4  4  7#d7       
,coverage period for individuals only   
eligible for coverage of                
immunosuppressive drugs  7,a7 ,in       
general ,section #ahch of the ,social   
,security ,act 7#db ,u4,s4,c4 #acieq7 is
 amended by adding at the end the       
following new subsection3  7g7 ,in the  
case of an individual described in      
section #ahcf7;b71 the following rules  
shall apply3  7#a7 ,in the case of such 
an individual who is deemed to have     
enrolled in part ,b for coverage of     
immunosuppressive drugs under section   
#ahcg7m77#c71 such individual's coverage

 period shall begin on the first day of 
the month in which the individual first 
satisfies section #ahcf7;b74  7#b7 ,in  
the case of such an individual who      
enrolls in part ,b for coverage of      
immunosuppressive drugs under section   
#ahcg7m77#b71 such individual's coverage
 period shall begin on the first day of 
the month in which the individual first 
satisfies section #ahcf7;b7 or the month
 following the month in which the       
individual so enrolls1 whichever is     
later4  7#c7 ,the provisions of         
subsections 7b7 and 7d7 shall apply with
 respect to an individual described in  
paragraph 7#a7 or 7#b74  7#d7 ,in       
addition to the reasons for termination 
under subsection 7b71 the coverage      
period of an individual described in    
paragraph 7#a7 or 7#b7 shall end when   
the individual becomes entitled to      
benefits under this title under section 
#bbf7;a71 #bbf7;b71 or #bbf;,a4  4  7,b7
 ,conforming amendments ,section        
#ahch7;b7 of the ,social ,security ,act 

7#db ,u4,s4,c4 #acieq7b77 is amended1 in
 the matter following paragraph 7#b71 by
 adding or section #ahcg7m77#c7 after   
section #ahcg7;f7 each place it appears4
  7#e7 ,premiums for individuals only   
eligible for coverage of                
immunosuppressive drugs ,section #ahci  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acier7 is amended--  7,a7 in 
subsection 7b71 by adding at the end the
 following new sentence3 ,no increase in
 the premium shall be effected for      
individuals who are enrolled pursuant to
 section #ahcf7;b7 for coverage only of 
immunosuppressive drugs42 and  7,b7 by  
adding at the end the following new     
subsection3  7j7 ,determination of      
premium for individuals only eligible   
for coverage of immunosuppressive drugs 
,the ,secretary shall1 during ,september
 of each year1 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 #ahcf7;b74 ,such premium  
shall be equal to #ce percent of the    
monthly actuarial rate for enrollees age
 #fe and over1 determined according to  
paragraph 7#a71 for that succeeding     
calendar year4 ,the monthly premium of  
each individual enrolled for coverage of
 immunosuppressive drugs under section  
#ahcf7;b7 for each month shall be the   
amount promulgated in this subsection4  
,such amount shall be adjusted in       
accordance with subsections 7c7 and 7f74
  4  7#f7 ,government contribution      
,section #ahdd7;a7 of the ,social       
,security ,act 7#db ,u4,s4,c4 #aciew7a77
 is amended--  7,a7 in paragraph 7#c71  
by striking the period at the end and   
inserting 2 plus2  7,b7 by adding at the
 end the following new paragraph3  7#d7 
a ,government contribution equal to the 
estimated aggregate reduction in        
premiums payable under part ,b that     
results from establishing the premium at
 #ce percent of the actuarial rate under
 section #ahci7;j7 instead of #ej       

percent of the actuarial rate for       
individuals who enroll only for the     
purpose of coverage of immunosuppressive
 drugs under section #ahcf7;b74  2 and  
7,c7 by adding at the end the following 
flush matter3  ,the ,government         
contribution under paragraph 7#d7 shall 
be treated as premiums payable and      
deposited for purposes of subparagraphs 
7,a7 and 7,b7 of paragraph 7#a74 4  7#g7
 ,extension of secondary payer          
requirements for ,,esrd beneficiaries   
eligible for coverage of                
immunosuppressive drugs ,section        
#ahfb7;b77#a77;,c7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acie7y77b77#a77 is amended by adding at
 the end the following new sentence3    
,with regard to immunosuppressive drugs 
furnished to an individual who enrolls  
for the purpose of coverage of          
immunosuppressive drugs under section   
#ahcf7;b7 on or after ,january #a1      
#bjad1 this subparagraph shall apply    
without regard to any time limitation1  

except that when such individual becomes
 entitled to benefits under this title  
under sections #bbf7;a7 or #bbf7;b71 or 
entitled to or eligible for benefits    
under this title under section #bbf;,a1 
the provisions of subparagraphs 7,a7 and
 7,b71 and the time limitations under   
this subparagraph1 respectively1 shall  
apply44  7#h7 ,ensuring coverage under  
the ,medicare savings program ,section  
#aije7p77#a77;,a7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#acif;d7p77#a77;,a77 is amended by      
inserting or an individual who is       
enrolled under part ,b for the purpose  
of coverage of immunosuppressive drugs  
under section #ahcf7;b7 after section   
#ahah4  7#i7 ,part ,d ,section          
#ahfj;,d-#a7;a77#c77;,a7 of the ,social 
,security ,act 7#db ,u4,s4,c4           
#aciew-#aja7;a77#c77;,a77 is amended by 
inserting 7but not including an         
individual enrolled solely for coverage 
of immunosuppressive drugs under section
 #ahcf7;b77 before the period at the    

end4