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US Laws | Affordable Health Care Act (HR3950F)
TITLE III--IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH CARE
Subtitle D--Medicare Part D Improvements for Prescription Drug Plans and MA-PD Plans

(3) EFFECTIVE DATE- The amendments made by this subsection shall apply to drugs dispensed on or after July 1, 2010. (5334)

SEC. 3302. IMPROVEMENT IN DETERMINATION OF MEDICARE PART D LOW-INCOME BENCHMARK PREMIUM. (5335)(Text)

(a) In General- Section 1860D-14(b)(2)(B)(iii) of the Social Security Act (42 U.S.C. 1395w-114(b)(2)(B)(iii)) is amended by inserting ", determined without regard to any reduction in such premium as a result of any beneficiary rebate under section 1854(b)(1)(C) or bonus payment under section 1853(n)" before the period at the end. (5336)

(b) Effective Date- The amendment made by subsection (a) shall apply to premiums for months beginning on or after January 1, 2011. (5337)

SEC. 3303. VOLUNTARY DE MINIMIS POLICY FOR SUBSIDY ELIGIBLE INDIVIDUALS UNDER PRESCRIPTION DRUG PLANS AND MA-PD PLANS. (5338)(Text)

(a) In General- Section 1860D-14(a) of the Social Security Act (42 U.S.C. 1395w-114(a)) is amended by adding at the end the following new paragraph: (5339)

"(5) WAIVER OF DE MINIMIS PREMIUMS- The Secretary shall, under procedures established by the Secretary, permit a prescription drug plan or an MA-PD plan to waive the monthly beneficiary premium for a subsidy eligible individual if the amount of such premium is de minimis. If such premium is waived under the plan, the Secretary shall not reassign subsidy eligible individuals enrolled in the plan to other plans based on the fact that the monthly beneficiary premium under the plan was greater than the low-income benchmark premium amount.". (5340)

(b) Authorizing the Secretary To Auto-enroll Subsidy Eligible Individuals in Plans That Waive De Minimis Premiums- Section 1860D-1(b)(1) of the Social Security Act (42 U.S.C. 1395w-101(b)(1)) is amended-- (5341)

(1) in subparagraph (C), by inserting "except as provided in subparagraph (D)," after "shall include," (5342)

(2) by adding at the end the following new subparagraph: (5343)

"(D) SPECIAL RULE FOR PLANS THAT WAIVE DE MINIMIS PREMIUMS- The process established under subparagraph (A) may include, in the case of a part D eligible individual who is a subsidy eligible individual (as defined in section 1860D-14(a)(3)) who has failed to enroll in a prescription drug plan or an MA-PD plan, for the enrollment in a prescription drug plan or MA-PD plan that has waived the monthly beneficiary premium for such subsidy eligible individual under section 1860D-14(a)(5). If there is more than one such plan available, the Secretary shall enroll such an individual under the preceding sentence on a random basis among all such plans in the PDP region. Nothing in the previous sentence shall prevent such an individual from declining or changing such enrollment.". (5344)

(c) Effective Date- The amendments made by this subsection shall apply to premiums for months, and enrollments for plan years, beginning on or after January 1, 2011. (5345)

SEC. 3304. SPECIAL RULE FOR WIDOWS AND WIDOWERS REGARDING ELIGIBILITY FOR LOW-INCOME ASSISTANCE. (5346)(Text)

(a) In General- Section 1860D-14(a)(3)(B) of the Social Security Act (42 U.S.C. 1395w-114(a)(3)(B)) is amended by adding at the end the following new clause: (5347)

"(vi) SPECIAL RULE FOR WIDOWS AND WIDOWERS- Notwithstanding the preceding provisions of this subparagraph, in the case of an individual whose spouse dies during the effective period for a determination or redetermination that has been made under this subparagraph, such effective period shall be extended through the date that is 1 year after the date on which the determination or redetermination would (but for the application of this clause) otherwise cease to be effective.". (5348)

(b) Effective Date- The amendment made by subsection (a) shall take effect on January 1, 2011. (5349)

SEC. 3305. IMPROVED INFORMATION FOR SUBSIDY ELIGIBLE INDIVIDUALS REASSIGNED TO PRESCRIPTION DRUG PLANS AND MA-PD PLANS. (5350)(Text)

Section 1860D-14 of the Social Security Act (42 U.S.C. 1395w-114) is amended-- (5351)

(1) by redesignating subsection (d) as subsection (e); and (5352)

(2) by inserting after subsection (c) the following new subsection: (5353)

"(d) Facilitation of Reassignments- Beginning not later than January 1, 2011, the Secretary shall, in the case of a subsidy eligible individual who is enrolled in one prescription drug plan and is subsequently reassigned by the Secretary to a new prescription drug plan, provide the individual, within 30 days of such reassignment, with-- (5354)

"(1) information on formulary differences between the individual"s former plan and the plan to which the individual is reassigned with respect to the individual"s drug regimens; and (5355)

"(2) a description of the individual"s right to request a coverage determination, exception, or reconsideration under section 1860D-4(g), bring an appeal under section 1860D-4(h), or resolve a grievance under section 1860D-4(f).". (5356)

SEC. 3306. FUNDING OUTREACH AND ASSISTANCE FOR LOW-INCOME PROGRAMS. (5357)(Text)

(a) Additional Funding for State Health Insurance Programs- Subsection (a)(1)(B) of section 119 of the Medicare Improvements for Patients and Providers Act of 2008 (42 U.S.C. 1395b-3 note) is amended by striking "(42 U.S.C. 1395w-23(f))" and all that follows through the period at the end and inserting "(42 U.S.C. 1395w-23(f)), to the Centers for Medicare & Medicaid Services Program Management Account-- (5358)

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