108th Congress

Medicare Prescription Drug, Improvement, and Modernization Act of 2003

P.L. 108-173 (H.R. 1068, S. 518, H.R. 1, H.R. 2473)

Impact of Public Law

P.L. 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, amends the Social Security Act to provide a voluntary prescription drug benefit under the Medicare Program.

This legislation establishes a voluntary prescription drug benefit under the Medicare Program. The law requires Medicare to cover an “initial preventive physical examination” for beneficiaries. Screening for the following will be covered: prostate cancer, colorectal cancer, glaucoma, cardiovascular blood tests, and diabetes. Other services will include vaccinations (pneumococcal, influenza, and hepatitis B), mammography, pap smears, diabetes outpatient self-management training, bone mass measurement, and medical nutrition therapy. Under the Act's new health care quality demonstration program, the National Institutes of Health will expand the efforts of the Institutes to evaluate current medical technologies and improve the foundation for evidence-based practice. The National Institute of Diabetes and Digestive and Kidney Diseases will be required to conduct a clinical investigation of pancreatic islet cell transplantation. Payment for routine costs, as well as transplantation and appropriate related items and services for Medicare beneficiaries participating in the clinical trial, are to be paid by the Centers for Medicare and Medicaid Services. Routine costs will include reasonable and necessary routine patient care costs, including immunosuppressive drugs and other followup care. Authorization for the clinical trial was set at such sums as may be necessary.

Legislative History

H.R. 1068, the Pancreatic Islet Cell Transplantation Act of 2003, was introduced by Representative George R. Nethercutt (R-WA) on March 4, 2003. The bill was referred to the House Energy and Commerce Subcommittee on Health. Companion measure S. 518, the Pancreatic Islet Cell Transplantation Act of 2003, was introduced on March 4, 2003, by Senators Susan M. Collins (R-ME) and Patty Murray (D-WA). S. 518 was referred to the Senate Committee on Health, Education, Labor and Pensions.

On June 26, 2003, Senator Collins offered the Medicare Demonstration Project as Senate Amendment 1023 to S. 1, the Medicare Prescription Drug Modernization Act of 2003. Senate Amendment 1023 was passed by the Senate by a voice vote. S. 1 was subsequently passed by the Senate as H.R. 1.

H.R. 2473, the Medicare Prescription Drug and Modernization Act of 2003, was introduced by Representative William M. Thomas (R-CA) on June 16, 2003. On June 17, the bill was reported out of the House Committee on Ways and Means by a vote of 25 to 15. On June 19, it was passed by the House Committee on Energy and Commerce by a vote of 29 to 20. H.R. 2473 was redesignated as H.R. 1, which was sponsored by Representative J. Dennis Hastert (R-IL). H.R. 1 passed the House by a vote of 216 to 215 on June 27. The Senate passed H.R. 1, as amended, by unanimous consent on July 7. A conference committee was appointed, and it reported out House Conference Report 108-391. The House passed the conference report on November 22 by a vote of 220 to 215, and the Senate passed the report on November 25 by a vote of 54 to 44. The measure was signed by the President as P.L. 108-173 on December 8.