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Doughnut Hole Provisions

Doughnut Hole Provisions

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Published by KHNews

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Published by: KHNews on Mar 26, 2010
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09/19/2010

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21(2) R
EPEAL OF PROVISION
.—Section 3315 of 
1
the Patient Protection and Affordable Care Act (in-
2
cluding the amendments made by such section) is re-
3
pealed, and any provision of law amended or re-
4
pealed by such sections is hereby restored or revived
5
as if such section had not been enacted into law.
6
(b) C
LOSING THE
D
ONUT
H
OLE
.—Part D of title
7
 XVIII of the Social Security Act (42 U.S.C. 1395w–101
8
et seq.), as amended by section 3301 of the Patient Pro-
9
tection and Affordable Care Act, is further amended—
10
(1) in section 1860D–43—
11
(A) in subsection (b), by striking ‘‘July 1,
12
2010’’ and inserting ‘‘January 1, 2011’’; and
13
(B) in subsection (c)(2), by striking ‘‘July 
14
1, 2010, and ending on December 31, 2010,’’
15
and inserting ‘‘January 1, 2011, and December
16
31, 2011,’’;
17
(2) in section 1860D–14A—
18
(A) in subsection (a)—
19
(i) by striking ‘‘July 1, 2010’’ and in-
20
serting ‘‘January 1, 2011’’; and
21
(ii) by striking ‘‘April 1, 2010’’ and
22
inserting ‘‘180 days after the date of the
23
enactment of this section’’;
24
(B) in subsection (b)(1)(C)—
25
VerDate Nov 24 2008 12:44 Mar 18, 2010Jkt 000000PO 00000Frm 00021Fmt 6652Sfmt 6201C:\TEMP\HCEARA_001.XMLHOLCPC
March 18, 2010 (12:44 p.m.)
F:\P11\NHI\RECON3\HCEARA_001.XML
f:\VHLC\031810\031810.115.xml (463129|15)
 
22(i) in the heading, by striking ‘‘
2010
 
1
 AND
’’;
2
(ii) by striking ‘‘July 1, 2010’’ and in-
3
serting ‘‘January 1, 2011’’; and
4
(iii) by striking ‘‘May 1, 2010’’ and
5
inserting ‘‘not later than 30 days after the
6
date of the establishment of a model agree-
7
ment under subsection (a)’’;
8
(C) in subsection (c)—
9
(i) in paragraph (1)(A)(iii), by strik-
10
ing ‘‘July 1, 2010, and ending on Decem-
11
 ber 31, 2011’’ and inserting ‘‘January 1,
12
2011, and ending on December 31, 2011’’;
13
and
14
(ii) in paragraph (2), by striking
15
‘‘2010’’ and inserting ‘‘2011’’;
16
(D) in subsection (d)(2)(B), by striking
17
‘‘July 1, 2010, and ending on December 31,
18
2010’’ and inserting ‘‘January 1, 2011, and
19
ending on December 31, 2011’’; and
20
(E) in subsection (g)(1)—
21
(i) in the matter before subparagraph
22
(A), by striking ‘‘an applicable drug’’ and
23
inserting ‘‘a covered part D drug’’;
24
VerDate Nov 24 2008 12:44 Mar 18, 2010Jkt 000000PO 00000Frm 00022Fmt 6652Sfmt 6201C:\TEMP\HCEARA_001.XMLHOLCPC
March 18, 2010 (12:44 p.m.)
F:\P11\NHI\RECON3\HCEARA_001.XML
f:\VHLC\031810\031810.115.xml (463129|15)
 
23(ii) by adding ‘‘and’’ at the end of 
1
subparagraph (C);
2
(iii) by striking subparagraph (D);
3
and
4
(iv) by redesignating subparagraph
5
(E) as subparagraph (D); and
6
(3) in section 1860D–2(b) —
7
(A) in paragraph (2)(A), by striking ‘‘The
8
coverage’’ and inserting ‘‘Subject to subpara-
9
graphs (C) and (D), the coverage’’;
10
(B) in paragraph (2)(B), by striking ‘‘sub-
11
paragraph (A)(ii)’’ and inserting ‘‘subpara-
12
graphs (A)(ii), (C), and (D)’’;
13
(C) by adding at the end of paragraph (2)
14
the following new subparagraphs:
15
‘‘(C) C
OVERAGE FOR GENERIC DRUGS IN
 
16
COVERAGE GAP
.—
17
‘‘(i) I
N GENERAL
.—Except as pro-
18
 vided in paragraph (4), the coverage for an
19
applicable beneficiary (as defined in section
20
1860D–14A(g)(1)) has coinsurance (for
21
costs above the initial coverage limit under
22
paragraph (3) and below the out-of-pocket
23
threshold) for covered part D drugs that
24
VerDate Nov 24 2008 12:44 Mar 18, 2010Jkt 000000PO 00000Frm 00023Fmt 6652Sfmt 6201C:\TEMP\HCEARA_001.XMLHOLCPC
March 18, 2010 (12:44 p.m.)
F:\P11\NHI\RECON3\HCEARA_001.XML
f:\VHLC\031810\031810.115.xml (463129|15)

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