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793
1 (5) PHARMACY REIMBURSEMENTS THROUGH

2 DECEMBER 31, 2010.—The specific upper limit under

3 section 447.332 of title 42, Code of Federal Regula-
4 tions (as in effect on December 31, 2006) applicable
5 to payments made by a State for multiple source
6 drugs under a State Medicaid plan shall continue to
7 apply through December 31, 2010, for purposes of
8 the availability of Federal financial participation for
9 such payments.
10 (b) DISCLOSURE OF PRICE INFORMATION TO THE

11 PUBLIC.—Section 1927(b)(3) of such Act (42 U.S.C.

12 1396r–8(b)(3)) is amended—
13 (1) in subparagraph (A)—
14 (A) in clause (i), in the matter preceding
15 subclause (I), by inserting ‘‘month of a’’ after
16 ‘‘each’’; and
17 (B) in the last sentence, by striking ‘‘and
18 shall,’’ and all that follows through the period;
19 and
20 (2) in subparagraph (D)(v), by inserting
21 ‘‘weighted’’ before ‘‘average manufacturer prices’’.
22 SEC. 1742. PRESCRIPTION DRUG REBATES.

23 (a) ADDITIONAL REBATE FOR NEW FORMULATIONS

24 OF EXISTING DRUGS.—

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794
1 (1) IN GENERAL.—Section 1927(c)(2) of the
2 Social Security Act (42 U.S.C. 1396r–8(c)(2)) is
3 amended by adding at the end the following new
4 subparagraph:
5 ‘‘(C) TREATMENT OF NEW FORMULA-

6 TIONS.—In the case of a drug that is a line ex-

7 tension of a single source drug or an innovator
8 multiple source drug that is an oral solid dos-
9 age form, the rebate obligation with respect to
10 such drug under this section shall be the
11 amount computed under this section for such
12 new drug or, if greater, the product of—
13 ‘‘(i) the average manufacturer price of
14 the line extension of a single source drug
15 or an innovator multiple source drug that
16 is an oral solid dosage form;
17 ‘‘(ii) the highest additional rebate
18 (calculated as a percentage of average
19 manufacturer price) under this section for
20 any strength of the original single source
21 drug or innovator multiple source drug;
22 and
23 ‘‘(iii) the total number of units of
24 each dosage form and strength of the line
25 extension product paid for under the State

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1 plan in the rebate period (as reported by
2 the State).
3 In this subparagraph, the term ‘line extension’
4 means, with respect to a drug, an extended re-
5 lease formulation of the drug.’’.
6 (2) EFFECTIVE DATE.—The amendment made
7 by paragraph (1) shall apply to drugs dispensed
8 after December 31, 2009.
9 (b) INCREASE MINIMUM REBATE PERCENTAGE FOR

10 SINGLE SOURCE DRUGS.—Section 1927(c)(1)(B)(i) of the

11 Social Security Act (42 U.S.C. 1396r–8(c)(1)(B)(i)) is
12 amended—
13 (1) in subclause (IV), by striking ‘‘and’’ at the
14 end;
15 (2) in subclause (V)—
16 (A) by inserting ‘‘and before January 1,
17 2010’’ after ‘‘December 31, 1995,’’; and
18 (B) by striking the period at the end and
19 inserting ‘‘; and’’; and
20 (3) by adding at the end the following new sub-
21 clause:
22 ‘‘(VI) after December 31, 2009,
23 is 22.1 percent.’’.

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796
1 SEC. 1743. EXTENSION OF PRESCRIPTION DRUG DIS-

2 COUNTS TO ENROLLEES OF MEDICAID MAN-

3 AGED CARE ORGANIZATIONS.

4 (a) IN GENERAL.—Section 1903(m)(2)(A) of the So-

5 cial Security Act (42 U.S.C. 1396b(m)(2)(A)) is amend-
6 ed—
7 (1) in clause (xi), by striking ‘‘and’’ at the end;
8 (2) in clause (xii), by striking the period at the
9 end and inserting ‘‘; and’’; and
10 (3) by adding at the end the following:
11 ‘‘(xiii) such contract provides that the entity
12 shall report to the State such information, on such
13 timely and periodic basis as specified by the Sec-
14 retary, as the State may require in order to include,
15 in the information submitted by the State to a man-
16 ufacturer under section 1927(b)(2)(A), information
17 on covered outpatient drugs dispensed to individuals
18 eligible for medical assistance who are enrolled with
19 the entity and for which the entity is responsible for
20 coverage of such drugs under this subsection.’’.
21 (b) CONFORMING AMENDMENTS.—Section 1927 of
22 such Act (42 U.S.C. 1396r-8) is amended——
23 (1) in the first sentence of subsection (b)(1)(A),
24 by inserting before the period at the end the fol-
25 lowing: ‘‘, including such drugs dispensed to individ-
26 uals enrolled with a medicaid managed care organi-
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1 zation if the organization is responsible for coverage
2 of such drugs’’;
3 (2) in subsection (b)(2), by adding at the end
4 the following new subparagraph:
5 ‘‘(C) REPORTING ON MMCO DRUGS.—On a
6 quarterly basis, each State shall report to the
7 Secretary the total amount of rebates in dollars
8 received from pharmacy manufacturers for
9 drugs provided to individuals enrolled with
10 Medicaid managed care organizations that con-
11 tract under section 1903(m).’’; and
12 (3) in subsection (j)—
13 (A) in the heading by striking ‘‘EXEMP-
14 TION’’ and inserting ‘‘SPECIAL RULES’’; and
15 (B) in paragraph (1), by striking ‘‘not’’.
16 (c) EFFECTIVE DATE.—The amendments made by
17 this section take effect on July 1, 2010, and shall apply
18 to drugs dispensed on or after such date, without regard
19 to whether or not final regulations to carry out such
20 amendments have been promulgated by such date.
21 SEC. 1744. PAYMENTS FOR GRADUATE MEDICAL EDU-

22 CATION.

23 (a) IN GENERAL.—Section 1905 of the Social Secu-

24 rity Act (42 U.S.C. 1396d), as amended by sections

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798
1 1701(a)(2), 1711(a), and 1713(a), is amended by adding
2 at the end the following new subsection:
3 ‘‘(bb) PAYMENT FOR GRADUATE MEDICAL EDU-
4 CATION.—

5 ‘‘(1) IN GENERAL.—The term ‘medical assist-

6 ance’ includes payment for costs of graduate medical
7 education consistent with this subsection, whether
8 provided in or outside of a hospital.
9 ‘‘(2) SUBMISSION OF INFORMATION.—For pur-
10 poses of paragraph (1) and section
11 1902(a)(13)(A)(v), payment for such costs is not
12 consistent with this subsection unless—
13 ‘‘(A) the State submits to the Secretary, in
14 a timely manner and on an annual basis speci-
15 fied by the Secretary, information on total pay-
16 ments for graduate medical education and how
17 such payments are being used for graduate
18 medical education, including—
19 ‘‘(i) the institutions and programs eli-
20 gible for receiving the funding;
21 ‘‘(ii) the manner in which such pay-
22 ments are calculated;
23 ‘‘(iii) the types and fields of education
24 being supported;

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799
1 ‘‘(iv) the workforce or other goals to
2 which the funding is being applied;
3 ‘‘(v) State progress in meeting such
4 goals; and
5 ‘‘(vi) such other information as the
6 Secretary determines will assist in carrying
7 out paragraphs (3) and (4); and
8 ‘‘(B) such expenditures are made con-
9 sistent with such goals and requirements as are
10 established under paragraph (4).
11 ‘‘(3) REVIEW OF INFORMATION.—The Secretary
12 shall make the information submitted under para-
13 graph (2) available to the Advisory Committee on
14 Health Workforce Evaluation and Assessment (es-
15 tablished under section 2261 of the Public Health
16 Service Act). The Secretary and the Advisory Com-
17 mittee shall independently review the information
18 submitted under paragraph (2), taking into account
19 State and local workforce needs.
20 ‘‘(4) SPECIFICATION OF GOALS AND REQUIRE-

21 MENTS.—The Secretary shall specify by rule, ini-

22 tially published by not later than December 31,
23 2011—
24 ‘‘(A) program goals for the use of funds
25 described in paragraph (1), taking into account

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1 recommendations of the such Advisory Com-
2 mittee and the goals for approved medical resi-
3 dency training programs described in section
4 1886(h)(1)(B); and
5 ‘‘(B) requirements for use of such funds
6 consistent with such goals.
7 Such rule may be effective on an interim basis pend-
8 ing revision after an opportunity for public com-
9 ment.’’.
10 (b) CONFORMING AMENDMENT.—Section
11 1902(a)(13)(A) of such Act (42 U.S.C. 1396a(a)(13)(A))
12 is amended—
13 (1) by striking ‘‘and’’ at the end of clause (iii);
14 (2) by striking ‘‘; and’’ and inserting ‘‘, and’’;
15 and
16 (3) by adding at the end the following new
17 clause:
18 ‘‘(v) in the case of hospitals and at
19 the option of a State, such rates may in-
20 clude, to the extent consistent with section
21 1905(bb), payment for graduate medical
22 education; and’’.
23 (c) EFFECTIVE DATE.—The amendments made by
24 this section shall take effect on the date of the enactment
25 of this Act. Nothing in this section shall be construed as

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