Page:United States Statutes at Large Volume 124.djvu/487

 124 STAT. 461 PUBLIC LAW 111–148—MAR. 23, 2010 the use of appropriate physicians’ services under part B. Such revisions shall be based on evidence published in peer-reviewed journals or current examples used by integrated delivery sys- tems and made consistent with the rules applicable under subsection (p)(1)(E) with the reference to the ‘1991 NAIC Model Regulation’ deemed a reference to the NAIC Model Regulation as published in the Federal Register on December 4, 1998, and as subsequently updated by the National Association of Insurance Commissioners to reflect previous changes in law and the reference to ‘date of enactment of this subsection’ deemed a reference to the date of enactment of the Patient Protection and Affordable Care Act. To the extent practicable, such revision shall provide for the implementation of revised standards for benefit packages as of January 1, 2015. ‘‘(2) BENEFIT PACKAGES DESCRIBED.—The benefit packages described in this paragraph are benefit packages classified as ‘C’ and ‘F’.’’. (b) CONFORMING AMENDMENT.—Section 1882(o)(1) of the Social Security Act (42 U.S.C. 1395ss(o)(1)) is amended by striking ‘‘, and (w)’’ and inserting ‘‘(w), and (y)’’. Subtitle D—Medicare Part D Improve- ments for Prescription Drug Plans and MA–PD Plans SEC. 3301. MEDICARE COVERAGE GAP DISCOUNT PROGRAM. (a) CONDITION FOR COVERAGE OF DRUGS UNDER PART D.— Part D of Title XVIII of the Social Security Act (42 U.S.C. 1395w– 101 et seq.), is amended by adding at the end the following new section: ‘‘CONDITION FOR COVERAGE OF DRUGS UNDER THIS PART ‘‘SEC. 1860D–43. (a) IN GENERAL.—In order for coverage to be available under this part for covered part D drugs (as defined in section 1860D–2(e)) of a manufacturer, the manufacturer must— ‘‘(1) participate in the Medicare coverage gap discount pro- gram under section 1860D–14A; ‘‘(2) have entered into and have in effect an agreement described in subsection (b) of such section with the Secretary; and ‘‘(3) have entered into and have in effect, under terms and conditions specified by the Secretary, a contract with a third party that the Secretary has entered into a contract with under subsection (d)(3) of such section. ‘‘(b) EFFECTIVE DATE.—Subsection (a) shall apply to covered part D drugs dispensed under this part on or after July 1, 2010. ‘‘(c) AUTHORIZING COVERAGE FOR DRUGS NOT COVERED UNDER AGREEMENTS.—Subsection (a) shall not apply to the dispensing of a covered part D drug if— ‘‘(1) the Secretary has made a determination that the avail- ability of the drug is essential to the health of beneficiaries under this part; or Determination. Contracts. 42 USC 1395w–153. Effective date.