PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2105
‘‘(A) COVERAGE UNDER PRESCRIPTION DRUG PLAN OR MA–PD PLAN.—Coverage under a prescription drug plan or under an MA–PD plan. ‘‘(B) MEDICAID.—Coverage under a medicaid plan under title XIX or under a waiver under section 1115. ‘‘(C) GROUP HEALTH PLAN.—Coverage under a group health plan, including a health benefits plan under chapter 89 of title 5, United States Code (commonly known as the Federal employees health benefits program), and a qualified retiree prescription drug plan (as defined in section 1860D–22(a)(2)). ‘‘(D) STATE PHARMACEUTICAL ASSISTANCE PROGRAM.— Coverage under a State pharmaceutical assistance program described in section 1860D–23(b)(1). ‘‘(E) VETERANS’ COVERAGE OF PRESCRIPTION DRUGS.— Coverage for veterans, and survivors and dependents of veterans, under chapter 17 of title 38, United States Code. ‘‘(F) PRESCRIPTION DRUG COVERAGE UNDER MEDIGAP POLICIES.—Coverage under a medicare supplemental policy under section 1882 that provides benefits for prescription drugs (whether or not such coverage conforms to the standards for packages of benefits under section 1882(p)(1)). ‘‘(G) MILITARY COVERAGE (INCLUDING TRICARE).—Coverage under chapter 55 of title 10, United States Code. ‘‘(H) OTHER COVERAGE.—Such other coverage as the Secretary determines appropriate. ‘‘(5) ACTUARIAL EQUIVALENCE REQUIREMENT.—Coverage meets the requirement of this paragraph only if the coverage is determined (in a manner specified by the Secretary) to provide coverage of the cost of prescription drugs the actuarial value of which (as defined by the Secretary) to the individual equals or exceeds the actuarial value of standard prescription drug coverage (as determined under section 1860D–11(c)). ‘‘(6) PROCEDURES TO DOCUMENT CREDITABLE PRESCRIPTION DRUG COVERAGE.— ‘‘(A) IN GENERAL.—The Secretary shall establish procedures (including the form, manner, and time) for the documentation of creditable prescription drug coverage, including procedures to assist in determining whether coverage meets the requirement of paragraph (5). ‘‘(B) DISCLOSURE BY ENTITIES OFFERING CREDITABLE PRESCRIPTION DRUG COVERAGE.— ‘‘(i) IN GENERAL.—Each entity that offers prescription drug coverage of the type described in subparagraphs (B) through (H) of paragraph (4) shall provide for disclosure, in a form, manner, and time consistent with standards established by the Secretary, to the Secretary and part D eligible individuals of whether the coverage meets the requirement of paragraph (5) or whether such coverage is changed so it no longer meets such requirement. ‘‘(ii) DISCLOSURE OF NON-CREDITABLE COVERAGE.— In the case of such coverage that does not meet such requirement, the disclosure to part D eligible individuals under this subparagraph shall include information regarding the fact that because such coverage does not meet such requirement there are limitations on
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