,,ii  #aafth ,,congress  #ast ,session  
,s4 #cjac  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #aj1 
#bjai,mr4 ,toomey 7for himself and ,mr4 
,crapo7 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 allow for the offering
 of additional prescription drug plans  
under ,medicare part ,d4  #a4 ,short    
title ,this ,act may be cited as the    
,encouraging ,innovative ,benefit       
,design to ,lower ,costs for ,seniors   
,act4  #b4 ,allowing the offering of    
additional prescription drug plans under
 ,medicare part ,d  7a7 ,rescinding and 
issuance of new guidance ,not later than
 one year after the date of the         
enactment of this ,act1 the ,secretary  
of ,health and ,human ,services 7in this
 section referred to as the ,secretary7 
shall--  7#a7 rescind sections of any   
sub-regulatory guidance that limit the  
number of prescription drug plans in    

each ,,pdp region that may be offered by
 a ,,pdp sponsor under part ,d of title 
,,xviii of the ,social ,security ,act   
7#db ,u4,s4,c4 #aciew-#aja et seq472 and
  7#b7 issue new guidance specifying    
that a ,,pdp sponsor may offer up to #d 
7or a greater number if determined      
appropriate by the ,secretary7          
prescription drug plans in each ,,pdp   
region1 except in case where the ,,pdp  
sponsor may offer up to #b additional   
plans in a ,,pdp region pursuant to     
section #ahfj;,d-#aa7;d77#d7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#aaa7;d77#d771 as added by       
subsection 7b74  7b7 ,offering of       
additional plans ,section               
#ahfj;,d-#aa7;d7 of the ,social         
,security ,act 7#db ,u4,s4,c4           
#aciew-#aaa7;d77 is amended by adding at
 the end the following new paragraph3   
7#d7 ,offering of additional plans  7,a7
 ,in general ,for plan year #bjbb and   
each subsequent plan year1 a ,,pdp      
sponsor may offer up to #b additional   

prescription drug plans in a ,,pdp      
region 7in addition to any limit        
established by the ,secretary under this
 part7 provided that the ,,pdp sponsor  
complies with subparagraph 7,b7 with    
respect to at least one such            
prescription drug plan4  7,b7           
,requirements ,in order to be eligible  
to offer up to #b additional plans in a 
,,pdp region pursuant to subparagraph   
7,a71 a ,,pdp sponsor must ensure that1 
with respect to at least one such       
prescription drug plan1 the sponsor or  
any entity that provides pharmacy       
benefits management services under a    
contract with any such sponsor or plan  
does not receive direct or indirect     
remuneration1 as defined in section     
#dbc4cjh of title #db1 ,code of ,federal
 ,regulations 7or any successor         
regulation71 unless at least #aj percent
 of the aggregate reductions in price or
 other remuneration received by the     
,,pdp sponsor or entity from drug       
manufacturers with respect to the plan  

and plan year--  7i7 are reflected at   
the point-of-sale to the enrollee2 or   
7ii7 are used to reduce total           
beneficiary cost-sharing estimated by   
the ,,pdp sponsor for prescription drug 
coverage under the plan in the annual   
bid submitted by the ,,pdp sponsor under
 section #ahfj;,d-#aa7;b74  7,c7        
,definition of reductions in price ,for 
purposes of subparagraph 7,b71 the term 
reductions in price refers only to      
collectible amounts1 as determined by   
the ,secretary1 which excludes amounts  
which after adjudication and            
reconciliation with pharmacies and      
manufacturers are duplicate in nature1  
contrary to other contractual clauses1  
or otherwise ineligible 7such as due to 
beneficiary disenrollment or            
coordination of benefits74  4  7c7 ,rule
 of construction ,nothing in the        
provisions of1 or amendments made by1   
this section shall be construed as      
limiting the ability of the ,secretary  
to increase any limit otherwise         

applicable on the number of prescription
 drug plans that a ,,pdp sponsor may    
offer1 at the discretion of the ,,pdp   
sponsor1 in a ,,pdp region under part ,d
 of title ,,xviii of the ,social        
,security ,act 7#db ,u4,s4,c4           
#aciew-#aja et seq474