2013 US Code
Title 42 - The Public Health and Welfare
Chapter 7 - SOCIAL SECURITY (§§ 301 - 1397mm)
Subchapter XVIII - HEALTH INSURANCE FOR AGED AND DISABLED (§§ 1395 - 1395kkk-1)
Part D - Voluntary Prescription Drug Benefit Program (§§ 1395w-101 - 1395w-154)
Subpart 1 - part d eligible individuals and prescription drug benefits (§§ 1395w-101 - 1395w-104)
Section 1395w-103 - Access to a choice of qualified prescription drug coverage
Publication Title | United States Code, 2012 Edition, Supplement 1, Title 42 - THE PUBLIC HEALTH AND WELFARE |
Category | Bills and Statutes |
Collection | United States Code |
SuDoc Class Number | Y 1.2/5: |
Contained Within | Title 42 - THE PUBLIC HEALTH AND WELFARE CHAPTER 7 - SOCIAL SECURITY SUBCHAPTER XVIII - HEALTH INSURANCE FOR AGED AND DISABLED Part D - Voluntary Prescription Drug Benefit Program subpart 1 - part d eligible individuals and prescription drug benefits Sec. 1395w-103 - Access to a choice of qualified prescription drug coverage |
Contains | section 1395w-103 |
Date | 2013 |
Laws in Effect as of Date | January 16, 2014 |
Positive Law | No |
Disposition | standard |
Source Credit | Aug. 14, 1935, ch. 531, title XVIII, §1860D-3, as added Pub. L. 108-173, title I, §101(a)(2), Dec. 8, 2003, 117 Stat. 2081. |
Statutes at Large Reference | 117 Stat. 2081 |
Public Law Reference | Public Law 108-173 |
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The Secretary shall ensure that each part D eligible individual has available, consistent with paragraph (2), a choice of enrollment in at least 2 qualifying plans (as defined in paragraph (3)) in the area in which the individual resides, at least one of which is a prescription drug plan. In any such case in which such plans are not available, the part D eligible individual shall be given the opportunity to enroll in a fallback prescription drug plan.
(2) Requirement for different plan sponsorsThe requirement in paragraph (1) is not satisfied with respect to an area if only one entity offers all the qualifying plans in the area.
(3) Qualifying plan definedFor purposes of this section, the term "qualifying plan" means—
(A) a prescription drug plan; or
(B) an MA–PD plan described in section 1395w–21(a)(2)(A)(i) of this title that provides—
(i) basic prescription drug coverage; or
(ii) qualified prescription drug coverage that provides supplemental prescription drug coverage so long as there is no MA monthly supplemental beneficiary premium applied under the plan, due to the application of a credit against such premium of a rebate under section 1395w–24(b)(1)(C) of this title.
(b) Flexibility in risk assumed and application of fallback planIn order to ensure access pursuant to subsection (a) of this section in an area—
(1) the Secretary may approve limited risk plans under section 1395w–111(f) of this title for the area; and
(2) only if such access is still not provided in the area after applying paragraph (1), the Secretary shall provide for the offering of a fallback prescription drug plan for that area under section 1395w–111(g) of this title.
(Aug. 14, 1935, ch. 531, title XVIII, §1860D–3, as added Pub. L. 108–173, title I, §101(a)(2), Dec. 8, 2003, 117 Stat. 2081.)
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