,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #eecd  ,,in ,,the ,,house ,,of  
,,representatives  ,december #bc1       
#bjai,mr4 ,kind 7for himself1 ,mr4      
,burgess1 ,ms4 ,eshoo1 ,mr4 ,smith of   
,missouri1 ,mr4 ,mc,eachin1 and ,ms4    
,herrera ,beutler7 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 extended months of ,medicare        
coverage of immunosuppressive drugs for 
kidney transplant patients1 and for     
other purposes4  #a4 ,short title ,this 
,act may be cited as the ,comprehensive 
,immunosuppressive ,drug ,coverage for  
,kidney ,transplant ,patients ,act of   
#bjai4  #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  
,in general ,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 ,in    
general ,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 adding at the end the following 
new subsection3  7b7 ,individuals       
eligible for immunosuppressive drug     
coverage  7#a7 ,in general ,except as   
provided under paragraph 7#b71 every    

individual whose insurance benefits     
under part ,a have ended 7whether       
before1 on1 or after ,january #a1 #bjbb7
 by reason of section #bbf;,a7b77#b7 is 
eligible to enroll in the insurance     
program established by this part solely 
for purposes of coverage of             
immunosuppressive drugs in accordance   
with section #ahcg7m74  7#b7 ,exception 
if other health insurance coverage is   
available  7,a7 ,in general ,an         
individual described in paragraph 7#a7  
shall not be eligible for enrollment in 
the insurance program described in such 
paragraph with respect to any period in 
which the individual--  7i7 is enrolled 
in a group health plan1 as defined in   
section #bgia7;a77#a7 of the ,public    
,health ,service ,act1 or individual    
health insurance coverage1 as defined in
 section #bgia7;b77#e7 of such ,act1 as 
determined in accordance with           
subparagraph 7,b72  7ii7 is eligible for
 benefits under-- 7,i7 a ,state plan    
under title ,,xix2  7,,ii7 a ,state     

child health plan under title ,,xxi2 or 
7,,iii7 the ,,tricare program under     
chapter #ee of title #aj1 ,united       
,states ,code2  7iii7 is enrolled in a  
health benefits plan under chapter #hi  
of title #e1 ,united ,states ,code2     
7iv7 is eligible for health care        
benefits under the laws administered by 
the ,secretary of ,veterans ,affairs2 or
  7v7 is eligible to receive services   
from the ,indian ,health ,service4  7,b7
 ,eligibility determinations  7i7 ,in   
general ,the ,secretary1 in consultation
 with the ,administrator of ,social     
,security1 shall establish procedures   
for determining whether an individual   
described in paragraph 7#a7 who is to be
 enrolled in the insurance program      
described in such paragraph meets the   
requirements for such enrollment under  
this subsection1 including the          
requirement that the individual not have
 other health insurance coverage as     
described in subparagraph 7,a74  7ii7   
,attestation regarding other coverage   

,the procedures established under clause
 7i7 shall include a requirement that-- 
7,i7 the individual provide to the      
,secretary an attestation that the      
individual does not have such other     
health insurance coverage2 and  7,,ii7  
update such attestation-- 7aa7 on an    
annual basis2 or  7bb7 if the health    
insurance coverage situation of the     
individual has changed4  7,c7           
,identification and reduction of        
improper payments ,the ,secretary1 in   
consultation with the ,administrator of 
,social ,security1 shall--  7i7         
establish procedures to ensure that any 
information provided with respect to    
other health insurance coverage         
described in subparagraph 7,a7 of this  
paragraph for an individual described in
 paragraph 7#a7 is provided to the      
appropriate medicare administrative     
contractor for purposes of identifying  
any improper payments made with respect 
to immunosuppressive drug coverage under
 this part2 and  7ii7 provide education 

to prevent or reduce such improper      
payments1 including education through   
the improper payment outreach and       
education program under section         
#ahdg;,a#i7;h74  4  7,b7 ,conforming    
amendment ,sections #ahcg1 #ahch1 and   
#ahci of the ,social ,security ,act 7#db
 ,u4,s4,c4 #aciep1 #db ,u4,s4,c4 #acieq1
 #db ,u4,s4,c4 #acier7 are each amended 
by striking #ahcf and inserting         
#ahcf7;a7 each place it appears4  7b7   
,enrollment for individuals only        
eligible for coverage of                
immunosuppressive drugs ,section #ahcg  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #aciep7 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  
whose entitlement for hospital insurance
 benefits under part ,a ends by reason  
of section #bbf;,a7b77#b7 prior to      
,january #a1 #bjbb1 may enroll beginning
 on the first day of the third month    
before the month in which the individual
 first satisfies section #ahcf7;b71 or a
 date specified by the ,secretary prior 
to the first date on which coverage is  
effective under section #ahch7;g77#b71  
whichever is later4 ,in implementing the
 preceding sentence1 the ,secretary     
shall consider procedures to expedite   
the enrollment of such an individual if 
practicable for purposes of providing   
continued coverage of immunosuppressive 
drugs for such individual pursuant to   
section #ahch7;g77#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 #bjbb1 shall be deemed to  

have enrolled in the medical insurance  
program established by this part for    
purposes of coverage of                 
immunosuppressive drugs4  7#d7 ,the     
,secretary shall establish a process    
under which an individual described in  
paragraph 7#a7 whose other health       
insurance coverage described in section 
#ahcf7;b77#b77;,a71 or coverage under   
this part 7including the medical        
insurance program established under this
 part for purposes of coverage of       
immunosuppressive drugs7 is terminated  
voluntarily or involuntary may enroll or
 reenroll1 if applicable1 in the medical
 insurance program established under    
this part for purposes of coverage of   
immunosuppressive drugs4  4  7c7        
,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;b77#a71 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 7or reenrolls7 in part ,b for   
coverage of immunosuppressive drugs     
under paragraph 7#b7 or 7#d7 of section 
#ahcg7m71 such individual's coverage    
period shall begin on ,january #a1 #bjbb
 7or such earlier date as the ,secretary
 may specify if practicable for purposes
 of providing continued coverage of     
immunosuppressive drugs for such an     
individual71 or the month following the 
month in which the individual so enrolls
 7or reenrolls71 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;a7 or #bbf;,a 
or is no longer eligible for such       
coverage as a result of the application 
of section #ahcf7;b77#b74  7#e7 ,the    
,secretary may conduct public education 
activities to raise awareness of the    
availability of more comprehensive1     
qualified health plans for beneficiaries
 eligible under this subsection4  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
 inserting or section #ahcg7m77#c7 after
 section #ahcg7;f7 each place it        
appears4  7d7 ,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 year 7beginning with #bjba71   
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 7c71 7f71   
and 7i71 but shall not be adjusted under
 subsection 7b74  4  7e7 ,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 inserting after paragraph 7#c7 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 the following sentence at
 the end of the flush matter following  
paragraph 7#d71 as added by paragraph   
7#b7 of this subsection3  ,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  7f7 ,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  7g7 ,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