article: SECTION 1. EXTENSION OF MEDICARE PRESCRIPTION DRUG INITIAL ENROLLMENT PERIODS FOR 2006 AND 2007; SUSPENSION OF LATE ENROLLMENT PENALTY THROUGH DECEMBER 31, 2007. (a) Extension of Medicare Prescription Drug Initial Enrollment Periods for 2006 and 2007.--Section 1860D-1(b)(1) of the Social Security Act (42 U.S.C. 1395w-101(b)(1)) is amended-- (1) in subparagraph (B)(iii), by inserting ``subparagraph (D) and'' after ``Subject to''; and (2) by adding at the end the following new subparagraph: ``(D) Extension of initial enrollment periods.--For purposes of subparagraph (B)(iii), in applying section 1851(e)(1), with respect to the annual, coordinated election period-- ``(i) for 2006, such period shall begin on November 15, 2005, and end on November 14, 2006; and ``(ii) for 2007, such period shall begin on November 15, 2006, and end on November 14, 2007.''. (b) Suspension of Late Enrollment Penalty Through December 31, 2007.--Section 1860D-13(b)(3)(B) of such Act (42 U.S.C. 1395w- 113(b)(3)(B)) is amended by inserting ``(after December 2007)'' after ``any month''. SEC. 2. OPEN ENROLLMENT AND DISENROLLMENT IN PRESCRIPTION DRUG PLANS ALLOWED DURING FIRST 12 MONTHS OF ENROLLMENT. Section 1860D-1(b)(1) of the Social Security Act (42 U.S.C. 1395w- 101(b)(1)) is amended by adding at the end the following new subparagraph: ``(D) Open enrollment and disenrollment period for first 12 months of enrollment.--In establishing the process under subparagraph (A), in the case of a part D eligible individual who initially enrolls under section 1860D-1(a) in a prescription drug plan on or after the date of enactment of this paragraph, the Secretary shall permit such individual to change such enrollment into another prescription drug plan once at any time during the first 12 months of such initial enrollment (other than during an annual, coordinated election period referred to in section 1860D- 1(b)(1)(B)(iii)).''. SEC. 3. LIMITATIONS ON CHANGING PRESCRIPTION DRUG PLAN FORMULARIES; NOTICE OF CHANGE IN FORMULARY. (a) Limitation on Removal or Change of Covered Part D Drugs From the Prescription Drug Plan Formulary.--Section 1860D-4(b)(3)(E) of the Social Security Act (42 U.S.C. 1395w-104(b)(3)(E)) is amended to read as follows: ``(E) Removing a drug from formulary or imposing a restriction or limitation on coverage.-- ``(i) Limitation on removal, limitation, or restriction.-- ``(I) In general.--Subject to subclause (II) and clause (ii), beginning with 2006, the PDP sponsor of a prescription drug plan may not remove a covered part D drug from the plan formulary or impose a restriction or limitation on the coverage of such a drug (such as through the application of a preferred status, usage restriction, step therapy, prior authorization, or quantity limitation) other than at the beginning of each plan year except as the Secretary may permit to take into account new therapeutic uses and newly covered part D drugs. ``(II) Special rule for newly enrolled individuals.--Subject to clause (ii), in the case of an individual who enrolls in a prescription drug plan on or after the date of enactment of this subparagraph, the PDP sponsor of such plan may not remove a covered part D drug from the plan formulary or impose a restriction or limitation on the coverage of such a drug (such as through the application of a preferred status, usage restriction, step therapy, prior authorization, or quantity limitation) during the period beginning on the date of such enrollment and ending on December 31 of the immediately succeeding plan year except as the Secretary may permit to take into account new therapeutic uses and newly covered part D drugs. ``(ii) Exceptions to limitation on removal.--Clause (i) shall not apply with respect to a covered part D drug that-- ``(I) is a brand name drug for which there is a generic drug approved under section 505(j) of the Food and Drug Cosmetic Act (21 U.S.C. 355(j)) that is placed on the market during the period in which there are limitations on removal or change in the formulary under subclause (I) or (II) of clause (i); ``(II) is a brand name drug that goes off-patent during such period; ``(III) is a drug for which the Commissioner of Food and Drugs issues a clinical warning that imposes a restriction or limitation on the drug during such period; or ``(IV) has been determined to be ineffective during such period. ``(iii) Notice of removal under application of exception to limitation.--The PDP sponsor of a prescription drug plan shall provide appropriate notice (such as under subsection (a)(3)) of any removal or change under clause (ii) to the Secretary, affected enrollees, physicians, pharmacies, and pharmacists.''. (b) Notice of Change in Formulary and Other Restrictions or Limitations on Coverage.-- (1) In general.--Section 1860D-4(a) of such Act (42 U.S.C. 1395w-104(a)) is amended by adding at the end the following new paragraph: ``(5) Annual notice of changes in formulary and other restrictions or limitations on coverage.--Each PDP sponsor offering a prescription drug plan shall furnish to each enrollee at the time of each annual coordinated election period (referred to in section 1860D-1(b)(1)(B)(iii)) for a plan year a notice of any changes in the formulary or other restrictions or limitations on coverage of a covered part D drug under the plan that will take effect for the plan year.''. (2) Effective date.--The amendment made by paragraph (1) shall apply to annual coordinated election periods beginning after the date of the enactment of this Act.
summary: Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to: (1) extend the 2006 and 2007 initial enrollment periods for the Medicare prescription drug benefit; (2) suspend the late enrollment penalty through December 31, 2007; and (3) permit Medicare beneficiaries to change enrollment in a prescription drug plan during the first 12 months of enrollment. Prohibits a PDP sponsor, beginning with 2006, from removing a covered part D drug from the plan formulary, or imposing a restriction or limitation on the coverage of such a drug, other than at the beginning of each plan year, except as the Secretary may permit to take into account new therapeutic uses and newly covered part D drugs. Requires each PDP sponsor to furnish to each plan enrollee, at the time of each annual coordinated election period, a notice of any changes in the formulary or other part D drug coverage restrictions or limitations that will take effect for the upcoming plan year.