TITLE I--MEDICARE PRESCRIPTION DRUG BENEFIT

SEC. 102. MEDICARE ADVANTAGE CONFORMING AMENDMENTS.

(a) CONFORMING AMENDMENTS TO ENROLLMENT PROCESS-

(1) EXTENDING OPEN ENROLLMENT PERIODS- Section 1851(e) (42 U.S.C. 1395w-21(e)) is amended--

(A) in paragraph (2), by striking `2004' and `2005' and inserting `2005' and `2006' each place it appears; and

(B) in paragraph (4), by striking `2005' and inserting `2006' each place it appears.

(2) ESTABLISHMENT OF SPECIAL ANNUAL, COORDINATED ELECTION PERIOD FOR 6 MONTHS BEGINNING NOVEMBER 15, 2005- Section 1851(e)(3)(B) (42 U.S.C. 1395w-21(e)(3)(B)) is amended to read as follows:

`(B) ANNUAL, COORDINATED ELECTION PERIOD- For purposes of this section, the term `annual, coordinated election period' means--

`(i) with respect to a year before 2002, the month of November before such year;

`(ii) with respect to 2002, 2003, 2004, and 2005, the period beginning on November 15 and ending on December 31 of the year before such year;

`(iii) with respect to 2006, the period beginning on November 15, 2005, and ending on May 15, 2006; and

`(iv) with respect to 2007 and succeeding years, the period beginning on November 15 and ending on December 31 of the year before such year.'.

(3) SPECIAL INFORMATION CAMPAIGN- Section 1851(e)(3) (42 U.S.C. 1395w-21(e)(3)) is amended--

(A) in subparagraph (C), by inserting `and during the period described in subparagraph (B)(iii)' after `(beginning with 1999)'; and

(B) in subparagraph (D)--

(i) in the heading by striking `CAMPAIGN IN 1998' and inserting `CAMPAIGNS'; and

(ii) by adding at the end the following: `During the period described in subparagraph (B)(iii), the Secretary shall provide for an educational and publicity campaign to inform MA eligible individuals about the availability of MA plans (including MA-PD plans) offered in different areas and the election process provided under this section.'.

(4) COORDINATING INITIAL ENROLLMENT PERIODS- Section 1851(e)(1) (42 U.S.C. 1395w-21(e)(1)) is amended by adding at the end the following new sentence: `If any portion of an individual's initial enrollment period under part B occurs after the end of the annual, coordinated election period described in paragraph (3)(B)(iii), the initial enrollment period under this part shall further extend through the end of the individual's initial enrollment period under part B.'.

(5) COORDINATION OF EFFECTIVENESS OF ELECTIONS DURING ANNUAL COORDINATED ELECTION PERIOD FOR 2006- Section 1851(f)(3) (42 U.S.C. 1395w-21(f)(3)) is amended by inserting `, other than the period described in clause (iii) of such subsection' after `subsection (e)(3)(B)'.

(6) LIMITATION ON ONE-CHANGE RULE TO SAME TYPE OF PLAN- Section 1851(e)(2) (42 U.S.C. 1395w-21(e)(2)) is amended--

(A) in subparagraph (B)(i), by inserting `, subparagraph (C)(iii),' after `clause (ii)';

(B) in subparagraph (C)(i), by striking `clause (ii)' and inserting `clauses (ii) and (iii)'; and

(C) by adding at the end of subparagraph (C) the following new clause:

`(iii) LIMITATION ON EXERCISE OF RIGHT WITH RESPECT TO PRESCRIPTION DRUG COVERAGE- Effective for plan years beginning on or after January 1, 2006, in applying clause (i) (and clause (i) of subparagraph (B)) in the case of an individual who--

`(I) is enrolled in an MA plan that does provide qualified prescription drug coverage, the individual may exercise the right under such clause only with respect to coverage under the original fee-for-service plan or coverage under another MA plan that does not provide such coverage and may not exercise such right to obtain coverage under an MA-PD plan or under a prescription drug plan under part D; or

`(II) is enrolled in an MA-PD plan, the individual may exercise the right under such clause only with respect to coverage under another MA-PD plan (and not an MA plan that does not provide qualified prescription drug coverage) or under the original fee-for-service plan and coverage under a prescription drug plan under part D.'.

(b) PROMOTION OF E-PRESCRIBING BY MA PLANS- Section 1852(j) (42 U.S.C. 1395w-22(j)) is amended by adding at the end the following new paragraph:

`(7) PROMOTION OF E-PRESCRIBING BY MA PLANS-

`(A) IN GENERAL- An MA-PD plan may provide for a separate payment or otherwise provide for a differential payment for a participating physician that prescribes covered part D drugs in accordance with an electronic prescription drug program that meets standards established under section 1860D-4(e).

`(B) CONSIDERATIONS- Such payment may take into consideration the costs of the physician in implementing such a program and may also be increased for those participating physicians who significantly increase--

`(i) formulary compliance;

`(ii) lower cost, therapeutically equivalent alternatives;

`(iii) reductions in adverse drug interactions; and

`(iv) efficiencies in filing prescriptions through reduced administrative costs.

`(C) STRUCTURE- Additional or increased payments under this subsection may be structured in the same manner as medication therapy management fees are structured under section 1860D-4(c)(2)(E).'.

(c) OTHER CONFORMING AMENDMENTS-

(1) Section 1851(a)(1) (42 U.S.C. 1395w-21(a)(1)) is amended--

(A) by inserting `(other than qualified prescription drug benefits)' after `benefits';

(B) by striking the period at the end of subparagraph (B) and inserting a comma; and

(C) by adding after and below subparagraph (B) the following:

`and may elect qualified prescription drug coverage in accordance with section 1860D-1.'.

(2) EFFECTIVE DATE- The amendments made by this subsection shall apply on and after January 1, 2006.

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Medicare Prescription Drug, Improvement, and Modernization Act
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