article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007''. SEC. 2. PROVISION OF APPROPRIATE COVERAGE OF IMMUNOSUPPRESSIVE DRUGS UNDER THE MEDICARE PROGRAM FOR KIDNEY TRANSPLANT RECIPIENTS. (a) Continued Entitlement to Immunosuppressive Drugs.-- (1) Kidney transplant recipients.--Section 226A(b)(2) of the Social Security Act (42 U.S.C. 426-1(b)(2)) is amended by inserting ``(except for coverage of immunosuppressive drugs under section 1861(s)(2)(J))'' after ``shall end''. (2) Application.--Section 1836 of the Social Security Act (42 U.S.C. 1395o) is amended-- (A) by striking ``Every individual who'' and inserting ``(a) In General.--Every individual who''; and (B) by adding at the end the following new subsection: ``(b) Special Rules Applicable to Individuals Only Eligible for Coverage of Immunosuppressive Drugs.-- ``(1) In general.--In the case of an individual whose eligibility for benefits under this title has ended except for the coverage of immunosuppressive drugs by reason of section 226A(b)(2), the following rules shall apply: ``(A) The individual shall be deemed to be enrolled under this part for purposes of receiving coverage of such drugs. ``(B) The individual shall be responsible for the full amount of the premium under section 1839 in order to receive such coverage. ``(C) The provision of such drugs shall be subject to the application of-- ``(i) the deductible under section 1833(b); and ``(ii) the coinsurance amount applicable for such drugs (as determined under this part). ``(D) If the individual is an inpatient of a hospital or other entity, the individual is entitled to receive coverage of such drugs under this part. ``(2) Establishment of procedures in order to implement coverage.--The Secretary shall establish procedures for-- ``(A) identifying beneficiaries that are entitled to coverage of immunosuppressive drugs by reason of section 226A(b)(2); and ``(B) distinguishing such beneficiaries from beneficiaries that are enrolled under this part for the complete package of benefits under this part.''. (3) Technical amendment.--Subsection (c) of section 226A of the Social Security Act (42 U.S.C. 426-1), as added by section 201(a)(3)(D)(ii) of the Social Security Independence and Program Improvements Act of 1994 (Public Law 103-296; 108 Stat. 1497), is redesignated as subsection (d). (b) Extension of Secondary Payer Requirements for ESRD Beneficiaries.--Section 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 1395y(b)(1)(C)) is amended by adding at the end the following new sentence: ``With regard to immunosuppressive drugs furnished on or after the date of enactment of the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007, this subparagraph shall be applied without regard to any time limitation.''. (c) Effective Date.--The amendments made by this section shall apply to drugs furnished on or after the date of enactment of this Act. SEC. 3. PLANS REQUIRED TO MAINTAIN COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT RECIPIENTS. (a) Application to Certain Health Insurance Coverage.-- (1) In general.--Subpart 2 of part A of title XXVII of the Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is amended by adding at the end the following: ``SEC. 2707. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT RECIPIENTS. ``A group health plan (and a health insurance issuer offering health insurance coverage in connection with a group health plan) shall provide coverage of immunosuppressive drugs in connection with a kidney transplant that is at least as comprehensive as the coverage provided by such plan or issuer on the day before the date of enactment of the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007, and such requirement shall be deemed to be incorporated into this section.''. (2) Conforming amendment.--Section 2721(b)(2)(A) of the Public Health Service Act (42 U.S.C. 300gg-21(b)(2)(A)) is amended by inserting ``(other than section 2707)'' after ``requirements of such subparts''. (b) Application to Group Health Plans and Group Health Insurance Coverage Under the Employee Retirement Income Security Act of 1974.-- (1) In general.--Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following new section: ``SEC. 714. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT RECIPIENTS. ``A group health plan (and a health insurance issuer offering health insurance coverage in connection with a group health plan) shall provide coverage of immunosuppressive drugs in connection with a kidney transplant that is at least as comprehensive as the coverage provided by such plan or issuer on the day before the date of enactment of the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007, and such requirement shall be deemed to be incorporated into this section.''. (2) Conforming amendments.-- (A) Section 732(a) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1191(a)) is amended by striking ``section 711'' and inserting ``sections 711 and 714''. (B) The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 is amended by inserting after the item relating to section 713 the following new item: ``Sec. 714. Coverage of immunosuppressive drugs.''. (c) Application to Group Health Plans Under the Internal Revenue Code of 1986.--Subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended-- (1) in the table of sections, by inserting after the item relating to section 9812 the following new item: ``Sec. 9813. Coverage of immunosuppressive drugs for kidney transplant recipients.''; and (2) by inserting after section 9812 the following: ``SEC. 9813. COVERAGE OF IMMUNOSUPPRESSIVE DRUGS FOR KIDNEY TRANSPLANT RECIPIENTS. ``A group health plan shall provide coverage of immunosuppressive drugs in connection with a kidney transplant that is at least as comprehensive as the coverage provided by such plan on the day before the date of enactment of the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007, and such requirement shall be deemed to be incorporated into this section.''. (d) Effective Date.--The amendments made by this section shall apply to plan years beginning on or after January 1, 2008.
summary: Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2007 - Amends SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) to: (1) continue entitlement to prescription drugs used in immunosuppressive therapy furnished to an individual who receives a kidney transplant for which payment is made under Medicare; and (2) extend Medicare secondary payer requirements for end stage renal disease (ESRD) beneficiaries. Amends title XVIII (Medicare ) of SSA to apply special rules to kidney transplant recipients receiving additional coverage for immunosuppressive drugs. Deems such individual to be enrolled under Medicare part B. Makes him or her responsible for the full amount of the applicable premiums. Applies deductible and coinsurance requirements to the provision of such drugs. Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to set forth requirements for group health plans to provide coverage of immunosuppressive drugs for kidney transplant patients.