,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #ghgg  ,,in ,,the ,,house ,,of  
,,representatives  ,july #cj1 #bjbj,mr4 
,katko 7for himself and ,mrs4 ,murphy of
 ,florida7 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   
,medicare part ,d beneficiaries with    
certain offset payments and reduce the  
growth rate of the ,medicare part ,d    
out-of-pocket cost threshold1 and for   
other purposes4  #a4 ,short title ,this 
,act may be cited as the ,lowering ,drug
 ,costs for ,seniors ,act of #bjbj4  #b4
 ,growth rate of ,medicare part ,d      
out-of-pocket cost threshold  7a7       
,providing ,medicare part ,d            

beneficiaries with certain #bjbj offset 
payments ,section #ahfj;,d-#b7;b77#d7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #aciew-#ajb7;b77#d77 is       
amended by adding at the end the        
following new subparagraph3  7,f7 #bjbj 
offset payments  7i7 ,in general        
,subject to clause 7iv71 the ,secretary 
shall provide for payment from the      
,medicare ,prescription ,drug ,account  
as follows3 7,i7 ,in the case of a      
specified individual 7as defined in     
clause 7ii77,i77 who as of the last day 
of a calendar quarter in #bjbj has      
incurred costs for covered part ,d drugs
 so that the individual has exceeded the
 annual out-of-pocket threshold applied 
under subparagraph 7,b77i77,v7 for      
#bjbj1 payment to the individual by not 
later than #aeth day of the third month 
following the end of such quarter of the
 amount by which such threshold so      
applied exceeded the target threshold   
for #bjbj4  7,,ii7 ,in the case of a    
specified individual who is not         

described in subclause 7,i7 and who as  
of the last day of #bjbj has incurred   
costs for covered part ,d drugs so that 
the individual has exceeded the target  
threshold for #bjbj1 payment to the     
individual by not later than ,december  
#ca1 #bjba1 of the amount by which such 
incurred costs exceeded the target      
threshold for #bjbj4  7ii7 ,definitions 
,for purposes of this subparagraph3 7,i7
 ,specified individual ,the term        
specified individual means an individual
 who-- 7aa7 is enrolled in a            
prescription drug plan or an ,,ma- ,,pd 
plan2  7bb7 is not enrolled in a        
qualified retiree prescription drug     
plan2 and  7cc7 is not entitled to an   
income-related subsidy under section    
#ahfj;,d-#ad7;a74  7,,ii7 ,target       
threshold for #bjbj ,the term target    
threshold for #bjbj means the annual    
out-of-pocket threshold that would have 
been applied under subparagraph 7,b77i7 
for #bjbj if such threshold had been    
determined in accordance with subclause 

7,,iv7 of such subparagraph instead of  
subclause 7,v7 of such subparagraph4    
7iii7 ,notification ,in the case of any 
specified individual who during #bjbj   
has incurred costs for covered part ,d  
drugs so that the individual has        
exceeded the target threshold for #bjbj1
 the ,secretary shall1 not later than   
,september #cj1 #bjba1 provide to such  
individual a notification informing such
 individual of such individual's right  
to a payment described in clause 7i7 and
 the estimated timing of such payment4  
7iv7 ,clarification ,the ,secretary     
shall provide only #a payment under this
 subparagraph with respect to any       
individual4  7v7 ,implementation ,the   
,secretary may implement this           
subparagraph by program instruction or  
otherwise4  4  7b7 ,reduced growth rate 
for #bjba of ,medicare part ,d          
out-of-,pocket cost threshold ,section  
#ahfj;,d-#b7;b77#d77;,b77i7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#ajb7;b77#d77;,b77i77 is         

amended-- 7#a7 in subclause 7,v71 by    
striking at the end or2  7#b7 by        
redesignating subclause 7,,vi7 as       
subclause 7,,viii72 and  7#c7 by        
inserting after subclause 7,v7 the      
following new subclauses3  7,,vi7 for   
#bjba1 is equal to the amount that would
 have been applied under this           
subparagraph for #bjbj if such amount   
had been determined in accordance with  
subclause 7,,iv7 instead of subclause   
7,v71 increased by the lesser of-- 7aa7 
the annual percentage increase described
 in paragraph 7#g7 for #bjba1 plus #b   
percentage points2 or  7bb7 the annual  
percentage increase described in        
paragraph 7#f7 for #bjba2  7,,vii7 for  
#bjbb1 is equal to the amount that would
 have been applied under this           
subparagraph for #bjbb if the amendments
 made by section #aaja7;d77#a7 of the   
,health ,care and ,education            
,reconciliation ,act of #bjaj and by    
section #b of the ,lowering ,drug ,costs
 for ,seniors ,act of #bjbj had not been

 enacted2 or  4