article: SECTION 1. SHORT TITLE; TABLE OF CONTENTS. (a) Short Title.--This Act may be cited as the ``Meeting Our Responsibility to Medicare Beneficiaries Act of 2005''. (b) Table of Contents.--The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. TITLE I--ELIMINATING SPECIAL INTEREST PREFERENCES Sec. 101. Negotiating fair prices for medicare prescription drugs. Sec. 102. Elimination of MA Regional Plan Stabilization Fund (Slush Fund). Sec. 103. Application of risk adjustment reflecting characteristics for the entire medicare population in payments to Medicare Advantage organizations. TITLE II--IMPROVING THE MEDICARE PROGRAM FOR BENEFICIARIES Sec. 201. Eliminating coverage gap. Sec. 202. Requiring two prescription drug plans to avoid Federal fallback. Sec. 203. Waiver of part D late enrollment penalty for transition period. Sec. 204. Improving the transition of full-benefit dual eligible individuals to coverage under the medicare drug benefit. Sec. 205. Part B premium reduction. Sec. 206. Study and report on providing incentives to preserve retiree coverage. Sec. 207. Promoting transparency in employer subsidy payments. TITLE I--ELIMINATING SPECIAL INTEREST PREFERENCES SEC. 101. NEGOTIATING FAIR PRICES FOR MEDICARE PRESCRIPTION DRUGS. (a) In General.--Section 1860D-11 of the Social Security Act (42 U.S.C. 1395w-111) is amended by striking subsection (i) (relating to noninterference) and by inserting the following new subsection: ``(i) Authority To Negotiate Prices With Manufacturers.-- ``(1) In general.--The Secretary shall have authority similar to that of other Federal entities that purchase prescription drugs in bulk to negotiate contracts with manufacturers of covered part D drugs, consistent with the requirements and in furtherance of the goals of providing quality care and containing costs under this part. ``(2) Required use of authority.-- ``(A) Fallback plans.--The Secretary shall exercise the authority described in paragraph (1) with respect to covered part D drugs offered under each fallback prescription drug plan under subsection (g). ``(B) PDPs and ma-pd plans.--In order to ensure that beneficiaries enrolled under prescription drug plans and MA-PD plans and taxpayers are getting fair and affordable prices for covered part D drugs that reflect the bulk purchasing power of such enrollees, the Secretary shall exercise the authority described in paragraph (1) with respect to such drugs offered under all such plans if the Secretary determines that the negotiated prices available under such plans for such drugs are not fair and affordable prices compared to the prices obtained by other Federal government programs for such drugs.''. (b) Effective Date.--The amendment made by this section shall take effect as if included in the enactment of section 101(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 Stat. 2071). SEC. 102. ELIMINATION OF MA REGIONAL PLAN STABILIZATION FUND (SLUSH FUND). (a) In General.--Subsection (e) of section 1858 of the Social Security Act (42 U.S.C. 1395w-27a) is repealed. (b) Conforming Amendment.--Section 1858(f)(1) of the Social Security Act (42 U.S.C. 1395w-27a(f)(1)) is amended by striking ``subject to subsection (e),''. (c) Effective Date.--The amendments made by this section shall take effect as if included in the enactment of section 221(c) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 Stat. 2181). SEC. 103. APPLICATION OF RISK ADJUSTMENT REFLECTING CHARACTERISTICS FOR THE ENTIRE MEDICARE POPULATION IN PAYMENTS TO MEDICARE ADVANTAGE ORGANIZATIONS. Effective January 1, 2006, in applying risk adjustment factors to payments to organizations under section 1853 of the Social Security Act (42 U.S.C. 1395w-23), the Secretary of Health and Human Services shall ensure that payments to such organizations are adjusted based on such factors to ensure that the health status of the enrollee is reflected in such adjusted payments, including adjusting for the difference between the health status of the enrollee and individuals enrolled under the original medicare fee-for-service program under parts A and B of title XVIII of such Act. Payments to such organizations must, in aggregate, reflect such differences. TITLE II--IMPROVING THE MEDICARE PROGRAM FOR BENEFICIARIES SEC. 201. ELIMINATING COVERAGE GAP. (a) In General.--Section 1860D-2(b)(4)(B) of the Social Security Act (42 U.S.C. 1395w-102(b)(4)(B)) is amended to read as follows: ``(B) Annual out-of-pocket threshold.--For purposes of this part, the `annual out-of-pocket threshold' specified in this subparagraph for a year is equal to the greater of-- ``(i) $3,600; or ``(ii) the initial coverage limit for the year specified in paragraph (3).''. (b) Conforming Amendment.--Section 1860D-22(a)(3)(B)(ii) of the Social Security Act (42 U.S.C. 1395w-132(b)(4)(B)(ii)) is amended by striking ``and the annual out-of-pocket threshold, respectively, are annually adjusted under paragraphs (1) and (4)(B) of section 1860D- 2(b)'' and inserting ``is annually adjusted under paragraph (1) of section 1860D-2(b) (using the percentage increase specified in paragraph (6) of such section)''. (c) Effective Date.--The amendments made by this section shall take effect as if included in the enactment of section 101(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 Stat. 2071). SEC. 202. REQUIRING TWO PRESCRIPTION DRUG PLANS TO AVOID FEDERAL FALLBACK. (a) In General.--Section 1860D-3(a) of the Social Security Act (42 U.S.C. 1395w-103(a)) is amended-- (1) in paragraph (1)-- (A) by striking ``qualifying plans (as defined in paragraph (3))'' and inserting ``prescription drug plans''; and (B) by striking ``, at least one of which is a prescription drug plan''; (2) in paragraph (2), by striking ``qualifying plans'' and inserting ``prescription drug plans''; and (3) by striking paragraph (3). (b) Effective Date.--The amendments made by this section shall take effect as if included in the enactment of section 101(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 Stat. 2071). SEC. 203. WAIVER OF PART D LATE ENROLLMENT PENALTY FOR TRANSITION PERIOD. (a) In General.--Section 1860D-13(b) of the Social Security Act (42 U.S.C. 1895w-113(b)) is amended by adding at the end the following new paragraph: ``(8) Waiver of penalty for months prior to 2008.--A part D eligible individual who enrolls for the first time in a prescription drug plan or an MA-PD plan under this part prior to January 1, 2008, shall not be subject an increase in the monthly beneficiary premium established under subsection (a) with respect to months occurring prior to such date.''. (b) Effective Date.--The amendment made by this section shall take effect as if included in the enactment of section 101(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (117 Stat. 2071). SEC. 204. IMPROVING THE TRANSITION OF FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS TO COVERAGE UNDER THE MEDICARE DRUG BENEFIT. (a) In General.--Notwithstanding subsection (d)(1) of section 1935 of the Social Security Act (42 U.S.C. 1396u-5), beginning on January 1, 2006, the Secretary of Health and Human Services shall administer a 12- month period during which full-benefit dual eligible individuals (as defined in section 1935(c)(6) of the Social Security Act) shall gradually transition from receiving medical assistance for prescribed drugs under the medicaid program under title XIX of such Act to obtaining coverage of covered part D drugs (as defined in section 1860D-2(e) (42 U.S.C. 1395w-102(e)) under title XVIII of such Act in order to assure that such individuals continue to receive the outpatient prescription drugs they need. (b) Adjustments to Phased-Down State Contribution.--The Secretary of Health and Human Services shall make appropriate adjustments to the amount of payments required to be made by a State or the District of Columbia under section 1935(c) of the Social Security Act (42 U.S.C. 1396u-5(c)) for months occurring during the period described in subsection (a) in order to account for increased costs for the provision of medical assistance incurred by the State or the District of Columbia by reason of the application of the transition period required under this section. SEC. 205. PART B PREMIUM REDUCTION. Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)) is amended-- (1) in paragraph (3), in the first sentence, by striking ``The Secretary'' and inserting ``Subject to paragraph (5), the Secretary''; and (2) by adding at the end the following new paragraph: ``(5) For each year (beginning with 2006), the Secretary shall reduce the monthly premium rate determined under paragraph (3) for each month in the year for each individual enrolled under this part (including such an individual subject to an increased premium under subsection (b) or (i)) so that the aggregate amount of such reductions in the year is equal to the aggregate amount of reduced expenditures from the Federal Supplementary Medicare Insurance Trust Fund in the year that the Secretary estimates will result from the provisions of section 103 of the Meeting Our Responsibility to Medicare Beneficiaries Act of 2005.''. SEC. 206. STUDY AND REPORT ON PROVIDING INCENTIVES TO PRESERVE RETIREE COVERAGE. (a) Study.--The Secretary of Health and Human Services shall conduct a study to determine what additional incentives should be provided to employers in order for such employers to continue to provide retirees with prescription drug coverage. Such study shall include an assessment of permitting costs incurred by an employer for covered part D drugs on behalf of a retiree to be treated as incurred costs for purposes of reaching the annual out-of-pocket threshold under section 1860D-2(b)(4) of the Social Security Act (42 U.S.C. 1395w- 102(b)(4)). (b) Report.--Not later than January 1, 2006, the Secretary of Health and Human Services shall submit to Congress a report on the study under subsection (a) together with such recommendations for legislation as the Secretary deems appropriate. SEC. 207. PROMOTING TRANSPARENCY IN EMPLOYER SUBSIDY PAYMENTS. (a) In General.--Section 1860D-22(a) of the Social Security Act (42 U.S.C. 1895w-132(a)) is amended by adding at the end the following new paragraph: ``(7) Disclosure of certain information.--The Secretary shall make the following information regarding the sponsor of a qualified prescription drug plan receiving a subsidy under this section available to the public through the Internet website of the Centers for Medicare & Medicaid Services and other appropriate means: ``(A) The information used by the Secretary to ensure that the prescription drug coverage offered under the plan meets the requirements for subsidy payments under this section. ``(B) The total amount of the subsidy payments made to the sponsor under this section.''. (b) Effective Date.--The amendment made by this section shall take effect as if included in the enactment of section 101(a) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173; 117 Stat. 2071).
summary: Meeting Our Responsibility to Medicare Beneficiaries Act of 2005 - Amends title XVIII (Medicare) of the Social Security Act (SSA) with respect to: (1) negotiating fair prices for Medicare prescription drugs; (2) elimination of the MA Regional Plan Stabilization Fund; (3) application of risk adjustment reflecting characteristics for the entire Medicare population in payments to Medicare advantage organizations; (4) modification of the annual out-of-pocket threshold with respect to prescription drug benefits; (5) requiring two prescription drug plans to avoid Federal fallback; (6) waiver of the part D (Voluntary Prescription Drug Benefit Program); (7) transition of full-benefit dual eligible individuals to coverage under the Medicare drug benefit; and (8) Medicare part B (Supplementary Medical Insurance) premium reduction. Directs the Secretary to study and report to Congress on providing incentives to preserve retiree coverage. Amends SSA title XVIII to direct the Secretary to make certain information regarding the sponsor of a qualified prescription drug plan receiving a subsidy under the prescription drug program available to the public through the Internet website of the Centers for Medicare & Medicaid Services.