124 STAT. 306 PUBLIC LAW 111–148—MAR. 23, 2010 with disabilities have the right to choose to receive their long- term services and supports in the community, rather than in an institutional setting. (3) Despite the Pepper Commission and Olmstead decision, the long-term care provided to our Nation’s elderly and disabled has not improved. In fact, for many, it has gotten far worse. (4) In 2007, 69 percent of Medicaid long-term care spending for elderly individuals and adults with physical disabilities paid for institutional services. Only 6 states spent 50 percent or more of their Medicaid long-term care dollars on home and community-based services for elderly individuals and adults with physical disabilities while 1⁄2 of the States spent less than 25 percent. This disparity continues even though, on aver- age, it is estimated that Medicaid dollars can support nearly 3 elderly individuals and adults with physical disabilities in home and community-based services for every individual in a nursing home. Although every State has chosen to provide certain services under home and community-based waivers, these services are unevenly available within and across States, and reach a small percentage of eligible individuals. (b) SENSE OF THE SENATE.—It is the sense of the Senate that— (1) during the 111th session of Congress, Congress should address long-term services and supports in a comprehensive way that guarantees elderly and disabled individuals the care they need; and (2) long term services and supports should be made avail- able in the community in addition to in institutions. Subtitle F—Medicaid Prescription Drug Coverage SEC. 2501. PRESCRIPTION DRUG REBATES. (a) INCREASE IN MINIMUM REBATE PERCENTAGE FOR SINGLE SOURCE DRUGS AND INNOVATOR MULTIPLE SOURCE DRUGS.— (1) IN GENERAL.—Section 1927(c)(1)(B) of the Social Secu- rity Act (42 U.S.C. 1396r–8(c)(1)(B)) is amended— (A) in clause (i)— (i) in subclause (IV), by striking ‘‘and’’ at the end; (ii) in subclause (V)— (I) by inserting ‘‘and before January 1, 2010’’ after ‘‘December 31, 1995,’’; and (II) by striking the period at the end and inserting ‘‘; and’’; and (iii) by adding at the end the following new sub- clause: ‘‘(VI) except as provided in clause (iii), after December 31, 2009, 23.1 percent.’’; and (B) by adding at the end the following new clause: ‘‘(iii) MINIMUM REBATE PERCENTAGE FOR CERTAIN DRUGS.— ‘‘(I) IN GENERAL.—In the case of a single source drug or an innovator multiple source drug described in subclause (II), the minimum rebate percentage for rebate periods specified in clause (i)(VI) is 17.1 percent.
