,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #dfdi  ,,in ,,the ,,house ,,of  
,,representatives  ,october #aa1        
#bjai,mr4 ,horsford 7for himself and    
,ms4 ,kendra ,s4 ,horn of ,oklahoma7    
introduced the following bill2 which was
 referred to the ,committee on ,energy  
and ,commerce1 and in addition to the   
,committee on ,ways and ,means1 for a   
period to be subsequently determined by 
the ,speaker1 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 for a cap on  
beneficiary liability under part ,d of  
the ,medicare program1 and for other    
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,capping ,drug      
,costs for ,seniors ,act of #bjai4  #b4 
,medicare part ,d benefit redesign  7a7 
,benefit structure redesign ,section    
#ahfj;,d-#b7;b7 of the ,social ,security
 ,act 7#db ,u4,s4,c4 #aciew-#ajb7;b77 is

 amended--  7#a7 in paragraph 7#b7--    
7,a7 in subparagraph 7,a71 in the matter
 preceding clause 7i71 by inserting for 
a year preceding #bjbb and for costs    
above the annual deductible specified in
 paragraph 7#a7 and up to the annual    
out-of-pocket threshold specified in    
paragraph 7#d77;,b7 for #bjbb and each  
subsequent year after paragraph 7#c72   
7,b7 in subparagraph 7,c7-- 7i7 in      
clause 7i71 in the matter preceding     
subclause 7,i71 by inserting for a year 
preceding #bjbb1 after paragraph 7#d712 
and  7ii7 in clause 7ii77,,iii71 by     
striking and each subsequent year and   
inserting and #bjba2 and  7,c7 in       
subparagraph 7,d7--  7i7 in clause 7i7--
 7,i7 in the matter preceding subclause 
7,i71 by inserting for a year preceding 
#bjbb1 after paragraph 7#d712 and       
7,,ii7 in subclause 7,i77bb71 by        
striking a year after #bjah and         
inserting each of years #bjah through   
#bjba2 and  7ii7 in clause 7ii77,v71 by 
striking #bjai and each subsequent year 

and inserting each of years #bjai       
through #bjba2  7#b7 in paragraph       
7#c77;,a7-- 7,a7 in the matter preceding
 clause 7i71 by inserting for a year    
preceding #bjbb1 after and 7#d712 and   
7,b7 in clause 7ii71 by striking for a  
subsequent year and inserting for each  
of years #bjjg through #bjba2 and  7#c7 
in paragraph 7#d7--  7,a7 in            
subparagraph 7,a7-- 7i7 in clause 7i7-- 
7,i7 by redesignating subclauses 7,i7   
and 7,,ii7 as items 7aa7 and 7bb71      
respectively1 and moving the margin of  
each such redesignated item #b ems to   
the right2  7,,ii7 in the matter        
preceding item 7aa71 as redesignated by 
subclause 7,i71 by striking is equal to 
the greater of-- and inserting 8is equal
 to--  7,i7 for a year preceding #bjbb1 
the greater of--  2  7,,iii7 by striking
 the period at the end of item 7bb71 as 
redesignated by subclause 7,i71 and     
inserting 2 and2 and  7,,iv7 by adding  
at the end the following3  7,,ii7 for   
#bjbb and each succeeding year1 #j4  2  

and  7ii7 in clause 7ii7--  7,i7 by     
striking clause 7i77,i7 and inserting   
clause 7i77,i77aa72 and  7,,ii7 by      
adding at the end the following new     
sentence3 ,the ,secretary shall continue
 to calculate the dollar amounts        
specified in clause 7i77,i77aa71        
including with the adjustment under this
 clause1 after #bjba for purposes of    
section #ahfj;,d-#ad7;a77#a77;,d77iii742
  7,b7 in subparagraph 7,b7-- 7i7 in    
clause 7i7--  7,i7 in subclause 7,v71 by
 striking or at the end2  7,,ii7 in     
subclause 7,,vi7--  7aa7 by striking for
 a subsequent year and inserting for    
#bjba2 and  7bb7 by striking the period 
at the end and inserting a semicolon2   
and  7,,iii7 by adding at the end the   
following new subclauses3  7,,vii7 for  
#bjbb1 is equal to #b1jjj2 or  7,,viii7 
for a subsequent year1 is equal to the  
amount specified in this subparagraph   
for the previous year1 increased by the 
annual percentage increase described in 
paragraph 7#f7 for the year involved4  2

 and  7ii7 in clause 7ii71 by striking  
clause 7i77,,ii7 and inserting clause   
7i72  7,c7 in subparagraph 7,c77i71 by  
striking and for amounts and inserting  
and1 for a year preceding #bjbb1 for    
amounts2 and  7,d7 in subparagraph 7,e71
 by striking ,in applying and inserting 
,for each of years #bjaa through #bjba1 
in applying4  7b7 ,decreasing           
reinsurance payment amount ,section     
#ahfj;,d-#ae7;b77#a7 of the ,social     
,security ,act 7#db ,u4,s4,c4           
#aciew-#aae7;b77#a77 is amended by      
inserting after #hj percent the         
following3 7or1 with respect to a       
coverage year after #bjba1 #bj percent74
  7c7 ,manufacturer discount program    
7#a7 ,in general ,part ,d of title      
,,xviii of the ,social ,security ,act   
7#db ,u4,s4,c4 #aciew-#aja et seq47 is  
amended by inserting after section      
#ahfj;,d-#ad;,a the following new       
section3  #ahfj;,d-#ad;,b4 ,manufacturer
 discount program  7a7 ,establishment   
,the ,secretary shall establish a       

manufacturer discount program 7in this  
section referred to as the program74    
,under the program1 the ,secretary shall
 enter into agreements described in     
subsection 7b7 with manufacturers and   
provide for the performance of the      
duties described in subsection 7c74 ,the
 ,secretary shall establish a model     
agreement for use under the program by  
not later than ,january #a1 #bjba1 in   
consultation with manufacturers1 and    
allow for comment on such model         
agreement4  7b7 ,terms of agreement     
7#a7 ,in general  7,a7 ,agreement ,an   
agreement under this section shall      
require the manufacturer to provide     
applicable beneficiaries access to      
discounted prices for applicable drugs  
of the manufacturer that are dispensed  
on or after ,january #a1 #bjbb4  7,b7   
,provision of discounted prices at the  
point-of-sale ,the discounted prices    
described in subparagraph 7,a7 shall be 
provided to the applicable beneficiary  
at the pharmacy or by the mail order    

service at the point-of-sale of an      
applicable drug4  7,c7 ,timing of       
agreement  7i7 ,special rule for #bjbb  
,in order for an agreement with a       
manufacturer to be in effect under this 
section with respect to the period      
beginning on ,january #a1 #bjbb1 and    
ending on ,december #ca1 #bjbb1 the     
manufacturer shall enter into such      
agreement not later than #cj days after 
the date of the establishment of a model
 agreement under subsection 7a74  7ii7  
#bjbc and subsequent years ,in order for
 an agreement with a manufacturer to be 
in effect under this section with       
respect to plan year #bjbc or a         
subsequent plan year1 the manufacturer  
shall enter into such agreement 7or such
 agreement shall be renewed under       
paragraph 7#d77;,a77 not later than     
,january #cj of the preceding year4     
7#b7 ,provision of appropriate data     
,each manufacturer with an agreement in 
effect under this section shall collect 
and have available appropriate data1 as 

determined by the ,secretary1 to ensure 
that it can demonstrate to the          
,secretary compliance with the          
requirements under the program4  7#c7   
,compliance with requirements for       
administration of program ,each         
manufacturer with an agreement in effect
 under this section shall comply with   
requirements imposed by the ,secretary  
or a third party with a contract under  
subsection 7d77#c71 as applicable1 for  
purposes of administering the program1  
including any determination under       
subparagraph 7,a7 of subsection 7c77#a7 
or procedures established under such    
subsection 7c77#a74  7#d7 ,length of    
agreement  7,a7 ,in general ,an         
agreement under this section shall be   
effective for an initial period of not  
less than #ab months and shall be       
automatically renewed for a period of   
not less than #a year unless terminated 
under subparagraph 7,b74  7,b7          
,termination  7i7 ,by the ,secretary    
,the ,secretary may provide for         

termination of an agreement under this  
section for a knowing and willful       
violation of the requirements of the    
agreement or other good cause shown4    
,such termination shall not be effective
 earlier than #cj days after the date of
 notice to the manufacturer of such     
termination4 ,the ,secretary shall      
provide1 upon request1 a manufacturer   
with a hearing concerning such a        
termination1 and such hearing shall take
 place prior to the effective date of   
the termination with sufficient time for
 such effective date to be repealed if  
the ,secretary determines appropriate4  
7ii7 ,by a manufacturer ,a manufacturer 
may terminate an agreement under this   
section for any reason4 ,any such       
termination shall be effective1 with    
respect to a plan year--  7,i7 if the   
termination occurs before ,january #cj  
of a plan year1 as of the day after the 
end of the plan year2 and  7,,ii7 if the
 termination occurs on or after ,january
 #cj of a plan year1 as of the day after

 the end of the succeeding plan year4   
7iii7 ,effectiveness of termination ,any
 termination under this subparagraph    
shall not affect discounts for          
applicable drugs of the manufacturer    
that are due under the agreement before 
the effective date of its termination4  
7iv7 ,notice to third party ,the        
,secretary shall provide notice of such 
termination to a third party with a     
contract under subsection 7d77#c7 within
 not less than #cj days before the      
effective date of such termination4  7c7
 ,duties described ,the duties described
 in this subsection are the following3  
7#a7 ,administration of program         
,administering the program1 including-- 
7,a7 the determination of the amount of 
the discounted price of an applicable   
drug of a manufacturer2  7,b7 the       
establishment of procedures under which 
discounted prices are provided to       
applicable beneficiaries at pharmacies  
or by mail order service at the         
point-of-sale of an applicable drug2    

7,c7 the establishment of procedures to 
ensure that1 not later than the         
applicable number of calendar days after
 the dispensing of an applicable drug by
 a pharmacy or mail order service1 the  
pharmacy or mail order service is       
reimbursed for an amount equal to the   
difference between--  7i7 the negotiated
 price of the applicable drug2 and  7ii7
 the discounted price of the applicable 
drug2  7,d7 the establishment of        
procedures to ensure that the discounted
 price for an applicable drug under this
 section is applied before any coverage 
or financial assistance under other     
health benefit plans or programs that   
provide coverage or financial assistance
 for the purchase or provision of       
prescription drug coverage on behalf of 
applicable beneficiaries as the         
,secretary may specify2 and  7,e7       
providing a reasonable dispute          
resolution mechanism to resolve         
disagreements between manufacturers1    
applicable beneficiaries1 and the third 

party with a contract under subsection  
7d77#c74  7#b7 ,monitoring compliance   
7,a7 ,in general ,the ,secretary shall  
monitor compliance by a manufacturer    
with the terms of an agreement under    
this section4  7,b7 ,notification ,if a 
third party with a contract under       
subsection 7d77#c7 determines that the  
manufacturer is not in compliance with  
such agreement1 the third party shall   
notify the ,secretary of such           
noncompliance for appropriate           
enforcement under subsection 7e74  7#c7 
,collection of data from prescription   
drug plans and ,,ma-,,pd plans ,the     
,secretary may collect appropriate data 
from prescription drug plans and        
,,ma-,,pd plans in a timeframe that     
allows for discounted prices to be      
provided for applicable drugs under this
 section4  7d7 ,administration  7#a7 ,in
 general ,subject to paragraph 7#b71 the
 ,secretary shall provide for the       
implementation of this section1         
including the performance of the duties 

described in subsection 7c74  7#b7      
,limitation ,in providing for the       
implementation of this section1 the     
,secretary shall not receive or         
distribute any funds of a manufacturer  
under the program4  7#c7 ,contract with 
third parties ,the ,secretary shall     
enter into a contract with one or more  
third parties to administer the         
requirements established by the         
,secretary in order to carry out this   
section4 ,at a minimum1 the contract    
with a third party under the preceding  
sentence shall require that the third   
party--  7,a7 receive and transmit      
information between the ,secretary1     
manufacturers1 and other individuals or 
entities the ,secretary determines      
appropriate2  7,b7 receive1 distribute1 
or facilitate the distribution of funds 
of manufacturers to appropriate         
individuals or entities in order to meet
 the obligations of manufacturers under 
agreements under this section2  7,c7    
provide adequate and timely information 

to manufacturers1 consistent with the   
agreement with the manufacturer under   
this section1 as necessary for the      
manufacturer to fulfill its obligations 
under this section2 and  7,d7 permit    
manufacturers to conduct periodic       
audits1 directly or through contracts1  
of the data and information used by the 
third party to determine discounts for  
applicable drugs of the manufacturer    
under the program4  7#d7 ,performance   
requirements ,the ,secretary shall      
establish performance requirements for a
 third party with a contract under      
paragraph 7#c7 and safeguards to protect
 the independence and integrity of the  
activities carried out by the third     
party under the program under this      
section4  7#e7 ,implementation ,the     
,secretary may implement the program    
under this section by program           
instruction or otherwise4  7#f7         
,administration ,chapter #ce of title   
#dd1 ,united ,states ,code1 shall not   
apply to the program under this section4

  7e7 ,enforcement  7#a7 ,audits ,each  
manufacturer with an agreement in effect
 under this section shall be subject to 
periodic audit by the ,secretary4  7#b7 
,civil money penalty  7,a7 ,in general  
,the ,secretary may impose a civil money
 penalty on a manufacturer that fails to
 provide applicable beneficiaries       
discounts for applicable drugs of the   
manufacturer in accordance with such    
agreement for each such failure in an   
amount the ,secretary determines is     
commensurate with the sum of--  7i7 the 
amount that the manufacturer would have 
paid with respect to such discounts     
under the agreement1 which will then be 
used to pay the discounts which the     
manufacturer had failed to provide2 and 
7ii7 #be percent of such amount4  7,b7  
,application ,the provisions of section 
#aabh;,a 7other than subsections 7a7 and
 7b77 shall apply to a civil money      
penalty under this paragraph in the same
 manner as such provisions apply to a   
penalty or proceeding under section     

#aabh;,a7a74  7f7 ,clarification        
regarding availability of other covered 
part ,d drugs ,nothing in this section  
shall prevent an applicable beneficiary 
from purchasing a covered part ,d drug  
that is not an applicable drug          
7including a generic drug or a drug that
 is not on the formulary of the         
prescription drug plan or ,,ma-,,pd plan
 that the applicable beneficiary is     
enrolled in74  7g7 ,definitions ,in this
 section3 7#a7 ,applicable beneficiary  
,the term applicable beneficiary means  
an individual who1 on the date of       
dispensing a covered part ,d drug--     
7,a7 is enrolled in a prescription drug 
plan or an ,,ma-,,pd plan2  7,b7 is not 
enrolled in a qualified retiree         
prescription drug plan2 and  7,c7 has   
incurred costs for covered part ,d drugs
 in the year that are equal to or exceed
 the annual deductible specified in     
section #ahfj;,d-#b7;b77#a7 for such    
year4  7#b7 ,applicable drug ,the term  
applicable drug1 with respect to an     

applicable beneficiary means a covered  
part ,d drug-- 7,a7 approved under a new
 drug application under section #eje7;b7
 of the ,federal ,food1 ,drug1 and      
,cosmetic ,act or1 in the case of a     
biologic product1 licensed under section
 #cea of the ,public ,health ,service   
,act2 and  7,b7  7i7 if the ,,pdp       
sponsor of the prescription drug plan or
 the ,,ma organization offering the     
,,ma-,,pd plan uses a formulary1 which  
is on the formulary of the prescription 
drug plan or ,,ma-,,pd plan that the    
applicable beneficiary is enrolled in2  
7ii7 if the ,,pdp sponsor of the        
prescription drug plan or the ,,ma      
organization offering the ,,ma-,,pd plan
 does not use a formulary1 for which    
benefits are available under the        
prescription drug plan or ,,ma-,,pd plan
 that the applicable beneficiary is     
enrolled in2 or  7iii7 is provided      
through an exception or appeal4  7#c7   
,applicable number of calendar days ,the
 term applicable number of calendar days

 means--  7,a7 with respect to claims   
for reimbursement submitted             
electronically1 #ad days2 and  7,b7 with
 respect to claims for reimbursement    
submitted otherwise1 #cj days4  7#d7    
,discounted price  7,a7 ,in general ,the
 term discounted price means1 with      
respect to an applicable drug of a      
manufacturer furnished during a year to 
an applicable beneficiary--  7i7 who has
 not incurred costs for covered part ,d 
drugs in the year that are equal to or  
exceed the annual out-of-pocket         
threshold specified in section          
#ahfj;,d-#b7;b77#d77;,b77i7 for the     
year1 #ij percent of the negotiated     
price of such drug2 and  7ii7 who has   
incurred such costs in the year that are
 equal to or exceed such threshold for  
the year1 #gj percent of the negotiated 
price of such drug4  7,b7 ,clarification
 ,nothing in this section shall be      
construed as affecting the              
responsibility of an applicable         
beneficiary for payment of a dispensing 

fee for an applicable drug4  7,c7       
,special case for certain claims  7i7   
,claims spanning deductible ,in the case
 where the entire amount of the         
negotiated price of an individual claim 
for an applicable drug with respect to  
an applicable beneficiary does not fall 
at or above the annual deductible       
specified in section #ahfj;,d-#b7;b77#a7
 for the year1 the manufacturer of the  
applicable drug shall provide the       
discounted price under this section on  
only the portion of the negotiated price
 of the applicable drug that falls at or
 above such annual deductible4  7ii7    
,claims spanning out-of-pocket threshold
 ,in the case where the entire amount of
 the negotiated price of an individual  
claim for an applicable drug with       
respect to an applicable beneficiary    
does not fall entirely below or entirely
 above the annual out-of-pocket         
threshold specified in section          
#ahfj;,d-#b7;b77#d77;,b77i7 for the     
year1 the manufacturer of the applicable

 drug shall provide the discounted      
price--  7,i7 in accordance with        
subparagraph 7,a77i7 on the portion of  
the negotiated price of the applicable  
drug that falls below such threshold2   
and  7,,ii7 in accordance with          
subparagraph 7,a77ii7 on the portion of 
such price of such drug that falls at or
 above such threshold4  7#e7            
,manufacturer ,the term manufacturer    
means any entity which is engaged in the
 production1 preparation1 propagation1  
compounding1 conversion1 or processing  
of prescription drug products1 either   
directly or indirectly by extraction    
from substances of natural origin1 or   
independently by means of chemical      
synthesis1 or by a combination of       
extraction and chemical synthesis4 ,such
 term does not include a wholesale      
distributor of drugs or a retail        
pharmacy licensed under ,state law4     
7#f7 ,negotiated price ,the term        
negotiated price has the meaning given  
such term in section #dbc4ajj of title  

#db1 ,code of ,federal ,regulations 7as 
in effect on the date of enactment of   
section #ahfj;,d-#ad;,a71 except that   
such negotiated price shall not include 
any dispensing fee for the applicable   
drug4  7#g7 ,qualified retiree          
prescription drug plan ,the term        
qualified retiree prescription drug plan
 has the meaning given such term in     
section #ahfj;,d-#bb7;a77#b74  4  7#b7  
,sunset of ,medicare coverage gap       
discount program ,section               
#ahfj;,d-#ad;,a of the ,social ,security
 ,act 7#db ,u4,s4,c4 #acie-aad;a7 is    
amended--  7,a7 in subsection 7a71 in   
the first sentence1 by striking ,the    
,secretary and inserting ,subject to    
subsection 7h71 the ,secretary2 and     
7,b7 by adding at the end the following 
new subsection3  7h7 ,sunset of program 
7#a7 ,in general ,the program shall not 
apply with respect to applicable drugs  
dispensed on or after ,january #a1      
#bjbb1 and1 subject to paragraph 7#b71  
agreements under this section shall be  

terminated as of such date4  7#b7       
,continued application for applicable   
drugs dispensed prior to sunset ,the    
provisions of this section 7including   
all responsibilities and duties7 shall  
continue to apply after ,january #a1    
#bjbb1 with respect to applicable drugs 
dispensed prior to such date4  4  7#c7  
,inclusion of actuarial value of        
manufacturer discounts in bids ,section 
#ahfj;,d-#aa of the ,social ,security   
,act 7#db ,u4,s4,c4 #aciew-#aaa7 is     
amended-- 7,a7 in subsection            
7b77#b77;,c77iii7--  7i7 by striking    
assumptions regarding the reinsurance an
 inserting 8assumptions regarding--     
7,i7 the reinsurance  2 and  7ii7 by    
adding at the end the following3  7,,ii7
 for #bjbb and each subsequent year1 the
 manufacturer discounts provided under  
section #ahfj;,d-#ad;,b subtracted from 
the actuarial value to produce such bid2
 and  2 and  7,b7 in subsection         
7c77#a77;,c7-- 7i7 by striking an       
actuarial valuation of the reinsurance  

and inserting 8an actuarial valuation   
of--  7i7 the reinsurance  2  7ii7 in   
clause 7i71 as inserted by clause 7i7 of
 this subparagraph1 by adding and at the
 end2 and  7iii7 by adding at the end   
the following3  7ii7 for #bjbb and each 
subsequent year1 the manufacturer       
discounts provided under section        
#ahfj;,d-#ad;,b2  4  7d7 ,conforming    
amendments  7#a7 ,section #ahfj;,d-#b of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #aciew-#ajb7 is amended-- 7,a7
 in subsection 7a77#b77;,a77i77,i71 by  
striking 1 or an increase in the initial
 and inserting or1 for a year preceding 
#bjbb1 an increase in the initial2  7,b7
 in subsection 7c77#a77;,c7-- 7i7 in the
 subparagraph heading1 by striking at   
initial coverage limit2 and  7ii7 by    
inserting for a year preceding #bjbb or 
the annual out-of-pocket threshold      
specified in subsection 7b77#d77;,b7 for
 the year for #bjbb and each subsequent 
year after subsection 7b77#c7 for the   
year each place it appears2 and  7,c7 in

 subsection 7d77#a77;,a71 by striking or
 an initial and inserting or1 for a year
 preceding #bjbb1 an initial4  7#b7     
,section #ahfj;,d-#d7;a77#d77;,b77i7 of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciew-#ajd7;a77#d77;,b77 is  
amended by striking the initial and     
inserting for a year preceding #bjbb1   
the initial4  7#c7 ,section             
#ahfj;,d-#ad7;a7 of the ,social         
,security ,act 7#db ,u4,s4,c4           
#aciew-#aad7;a77 is amended-- 7,a7 in   
paragraph 7#a7--  7i7 in subparagraph   
7,c71 by striking ,the continuation and 
inserting ,for a year preceding #bjbb1  
the continuation2  7ii7 in subparagraph 
7,d77iii71 by striking                  
#ahfj;,d-#b7;b77#d77;,a77i77,i7 and     
inserting                               
#ahfj;,d-#b7;b77#d77;,a77i77,i77aa72 and
  7iii7 in subparagraph 7,e71 by        
striking ,the elimination and inserting 
,for a year preceding #bjbb1 the        
elimination2 and  7,b7 in paragraph     
7#b7--  7i7 in subparagraph 7,c71 by    

striking ,the continuation and inserting
 ,for a year preceding #bjbb1 the       
continuation2 and  7ii7 in subparagraph 
7,e7--  7,i7 by inserting for a year    
preceding #bjbb1 after subsection 7c72  
and  7,,ii7 by striking                 
#ahfj;,d-#b7;b77#d77;,a77i77,i7 and     
inserting                               
#ahfj;,d-#b7;b77#d77;,a77i77,i77aa74    
7#d7 ,section #ahfj;,d-#ba7;d77#g7 of   
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciew-#aca7;d77#g77 is       
amended by striking section             
#ahfj;,d-#b7;b77#d77;,b77i7 and         
inserting section                       
#ahfj;,d-#b7;b77#d77;,c77i74  7#e7      
,section #ahfj;,d-#bb7;a77#b77;,a7 of   
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciew-#acb7;a77#b77;,a77 is  
amended-- 7,a7 by striking the value of 
any discount and inserting the          
following3  the value of-- 7i7 for years
 prior to #bjbb1 any discount  2  7,b7  
in clause 7i71 as inserted by           
subparagraph 7,a7 of this paragraph1 by 

striking the period at the end and      
inserting 2 and2 and  7,c7 by adding at 
the end the following new clause3  7ii7 
for #bjbb and each subsequent year1 any 
discount provided pursuant to section   
#ahfj;,d-#ad;,b4  4  7#f7 ,section      
#ahfj;,d-#da7;a77#f7 of the ,social     
,security ,act 7#db ,u4,s4,c4           
#aciew-#aea7;a77#f77 is amended-- 7,a7  
by inserting for a year before #bjbb    
after #ahfj;,d-#b7;b77#c72 and  7,b7 by 
inserting for such year before the      
period4  7#g7 ,paragraph 7#a7 of section
 #ahfj;,d-#dc7;a7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#aciew-#aec7;a77 is amended to read as  
follows3  7#a7 participate in-- 7,a7 for
 #bjaa through #bjba1 the ,medicare     
coverage gap discount program under     
section #ahfj;,d-#ad;,a2 and  7,b7 for  
#bjbb and each subsequent year1 the     
manufacturer discount program under     
section #ahfj;,d-#ad;,b2  4  7e7        
,effective date ,the amendments made by 
this section shall apply with respect to

 plan year #bjbb and subsequent plan    
years4