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HR 2761 100th Congress House Social Welfare Ambulatory care Catastrophic health insurance Costs Drugs Drugs and narcotics Drugstores Electronic data processing Health Health maintenance organizations Insulin Local and Municipal Government Local officials and employees Medical economics Medicare Pharmacists Social security eligibility State officials and employees States

Medicare Prescription Drug Catastrophic Protection Act of 1987

Introduced: June 24, 1987 See on congress.gov
 Everywhere this bill has been 6 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Jul 1, 1988
Provisions of Measure Incorporated Into H.R.2470.
Jul 13, 1987
Referred to Subcommittee on Health and the Environment.
Jul 1, 1987
Referred to Subcommittee on Health.
Jun 24, 1987
Referred to House Committee on Ways and Means.
Jun 24, 1987
Referred to House Committee on Energy and Commerce.
Jun 24, 1987
Introduced in House
 Plain-English summary Congressional Research Service

Medicare Prescription Drug Catastrophic Protection Act of 1987 - Amends title XVIII (Medicare) of the Social Security Act to cover catastrophic expenses for outpatient prescription drugs and insulin (outpatient drugs) under part B (Supplementary Medical Insurance) of the Medicare program. Sets the annual deductible for such coverage at $250 for 1989, with subsequent annual adjustments of such deductible reflecting changes in the cost of medical care. Covers all costs in excess of such deductible provided the cost for each drug does not exceed payment limits based on the average cost for each drug. Authorizes the Secretary to deny payment for outpatient drugs which are prescribed or dispensed with excessive frequency or in excessive quantities.

Authorizes a pharmacy to enter into an agreement with the Secretary of Health and Human Services to accept payment under part B of the Medicare program on an assigned basis for outpatient drugs furnished to part B enrollees. Sets forth the obligations of participating pharmacies, including the requirements that they: (1) charge Medicare beneficiaries no more for drugs than they charge the general public; (2) keep patient records for all outpatient drugs dispensed to such beneficiaries; (3) assist beneficiaries in determining whether or not their expenses have exceeded the annual deductible; and (4) offer to counsel each of their beneficiaries on the appropriate use of such drugs and the availability of therapeutically equivalent outpatient drugs. Requires the Secretary to provide each participating pharmacy with: (1) a distinctive emblem indicating its status as such; and (2) information on the payment limits established for outpatient drugs.

Requires Medicare carriers which make determinations or payments with respect to outpatient drugs to offer to receive requests from participating pharmacies for payments for such drugs through electronic communications and respond to requests by such pharmacies as to whether or not an individual has paid the deductible for such drugs.

Directs the Secretary to: (1) take this Act's amendments into account in estimating the adjusted average per capita cost used in computing payments to be made to health maintenance organizations; and (2) require such organizations to adjust their agreements with Medicare beneficiaries in consideration of such amendments.

Provides Medicare coverage of all State and local government employees.

What's happening now July 1, 1988

Provisions of Measure Incorporated Into H.R.2470.

 Committees of jurisdiction 4