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Changing the Nation, One State at a Time
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Changing the Nation, One State at a Time
1 plan pursuant to the Centers for Medicare
2 & Medicaid Services\' request for proposals
3 issued on February 17, 2009, relating to
4 Medicare part D retroactive coverage for
5 certain low income beneficiaries, or a simi-
6 lar subsequent request for proposals.
7 SEC. 1205. INTELLIGENT ASSIGNMENT IN ENROLLMENT.
8 (a) IN GENERAL.--Section 1860D1(b)(1)(C) of the
9 Social Security Act (42 U.S.C. 1395w101(b)(1)(C)) is
10 amended by adding after PDP region\'\' the following: or
11 through use of an intelligent assignment process that is
12 designed to maximize the access of such individual to nec-
13 essary prescription drugs while minimizing costs to such
14 individual and to the program under this part to the max-
15 imum extent possible. In the case the Secretary enrolls
16 such individuals through use of an intelligent assignment
17 process, such process shall take into account the extent
18 to which prescription drugs necessary for the individual
19 are covered in the case of a PDP sponsor of a prescription
20 drug plan that uses a formulary, the use of prior author-
21 ization or other restrictions on access to coverage of such
22 prescription drugs by such a sponsor, and the overall qual-
23 ity of a prescription drug plan as measured by quality rat-
24 ings established by the Secretary.\'\'