Directs the Secretary of Health and Human Services to provide for an outpatient prescription drug benefit program for eligible Medicare beneficiaries.
Outlines premiums and cost-sharing provisions, including those for a $250 deductible waivable for generic drugs, as well as coinsurance provisions.
Sets out patient protections.
Authorizes the Secretary to develop and implement an Employer Incentive Program that encourages sponsors of employment-based health care coverage to provide adequate prescription drug benefits to retired individuals.
Establishes a Medicare Pharmacy and Therapeutics Advisory Committee.
Amends SSA title XVIII part C (Medicare+Choice) to require each Medicare+Choice plan, with specified exceptions, to provide enrolled members items and services for which benefits are available under new part D.
Amends SSA title XVIII part D to exclude Medicare part D costs from determination of the part B monthly premium.
Amends SSA title XIX (Medicaid) to: (1) include in Medicare cost-sharing for qualified Medicare beneficiaries premiums under OPDBP; and (2) provide for expanding medical assistance with regard to OPDBP coinsurance and deductible. Sets at 100 percent the Federal Medicaid percentage with respect to such medical assistance.
Amends SSA title XI to increase Medicaid payments to territories.
Amends SSA title XVIII to revise requirements for benefit packages for Medicare supplemental policies, and with regard to comprehensive immunosuppressive drug coverage for transplant patients.
Directs the Secretary to study whether to: (1) establish a uniform format for pharmacy benefit cards provided to beneficiaries by eligible entities under OPDBP; and (2) develop systems to transfer prescriptions electronically under OPDBP from the prescriber to the pharmacist.
Outlines provisions for General Accounting Office and Medicare Payment Advisory Commission (MedPAC) studies involving OPDBP.