United States Code
42 U.S.C. § 1395w-103
Access to a choice of qualified prescription drug coverage
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- S 4886 Medicare Cost Cap Act of 2026 Amends its part · introduced · 119th Congress
- HR 9054 Earned Benefits Equality and Family Reunification Act Amends its part · introduced · 119th Congress
- HR 8923 At HOME Services Act Amends its part · introduced · 119th Congress
- HR 8129 To amend title XVIII of the Social Security Act to establish a full risk ACO program. Amends its part · introduced · 119th Congress
- HR 6145 EXPERTS Act of 2025 Amends its part · introduced · 119th Congress
- S 3210 EXPERTS Act of 2025 Amends its part · introduced · 119th Congress
- HR 1 An act to provide for reconciliation pursuant to title II of H. Con. Res. 14. Amends its part · enacted · 119th Congress
- S 2032 Choose Medicare Act Amends its part · introduced · 119th Congress
- HR 3911 Choose Medicare Act Amends its part · introduced · 119th Congress
- S 1506 Medicare for All Act Amends its part · introduced · 119th Congress
- HR 2590 Mental and Physical Health Care Comorbidities Act of 2025 Amends its part · introduced · 119th Congress
- S 1264 Mental and Physical Health Care Comorbidities Act of 2025 Amends its part · introduced · 119th Congress
- HR 2120 ROCR Value Based Program Act Amends its part · introduced · 119th Congress
- S 1031 ROCR Value Based Program Act Amends its part · introduced · 119th Congress
- HR 746 America First Act Amends its part · introduced · 119th Congress
- S 62 America First Act Amends its part · introduced · 119th Congress
- HR 3623 Educating Future Nurses Act Amends its part · introduced · 118th Congress
- HR 5663 ALS Better Care Act Amends its part 1395w-103(t) · introduced · 118th Congress
- HR 5299 Earned Benefits Equality and Family Reunification Act Amends its part · introduced · 118th Congress
- HR 7742 At HOME Services Act Amends its part · introduced · 118th Congress
- HR 8404 ROCR Value Based Program Act Radiation Oncology Case Rate Value Based Program Act of 2024 Amends its part · introduced · 118th Congress
- HR 8207 Choose Medicare Act Amends its part · introduced · 118th Congress
- S 3450 Mental and Physical Health Care Comorbidities Act of 2023 Amends its part · introduced · 118th Congress
- S 1869 SITE Act Amends its part · introduced · 118th Congress
- S 1655 Medicare for All Act Amends its part · introduced · 118th Congress
- S 1586 Educating Future Nurses Act Amends its part · introduced · 118th Congress
- S 1450 Cutting Medicare Prescription Drug Prices in Half Act Amends its part · introduced · 118th Congress
- HR 1507 Stop Corporate Capture Act Amends its part · introduced · 118th Congress
- HR 2617 Consolidated Appropriations Act, 2023 Amends its part · enacted · 117th Congress
- S 5315 Anti-Corruption and Public Integrity Act Amends its part · introduced · 117th Congress
- HR 9623 Anti-Corruption and Public Integrity Act Amends its part · introduced · 117th Congress
- HR 8454 Medical Marijuana and Cannabidiol Research Expansion Act Amends its part · enacted · 117th Congress
- HR 9390 Stop Corporate Capture Act Amends its part · introduced · 117th Congress
- HR 9328 Mental and Physical Health Care Comorbidities Act of 2022 Amends its part · introduced · 117th Congress
- S 8 Mental and Physical Health Care Comorbidities Act of 2022 Amends its part · introduced · 117th Congress
- HR 6107 Stop Corporate Capture Act Amends its part · introduced · 117th Congress
- HR 7585 Health Equity and Accountability Act of 2022 Amends its part 1395w-103(a)(1) · introduced · 117th Congress
- S 4486 Health Equity and Accountability Act of 2022 Amends its part 1395w-103(a)(1) · introduced · 117th Congress
- S 4204 Medicare for All Act of 2022 Amends its part · introduced · 117th Congress
- S 4011 Capping Drug Costs for Seniors Act of 2022 Amends its part · introduced · 117th Congress
- S 253 Cannabidiol and Marihuana Research Expansion Act Amends its part · introduced · 117th Congress
- S 3615 Cutting Medicare Prescription Drug Prices in Half Act Amends its part · introduced · 117th Congress
- HR 5370 Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2021 Amends its part · introduced · 117th Congress
- HR 5165 Improving Medicare Coverage Act Amends its part · introduced · 117th Congress
- HR 5099 Lowering Medicare Premiums and Prescription Drug Costs Act Amends its part · introduced · 117th Congress
- HR 5011 Choose Medicare Act Amends its part · introduced · 117th Congress
- HR 4417 Capping Drug Costs for Seniors Act of 2021 Amends its part · introduced · 117th Congress
- S 1844 Lowering Medicare Premiums and Prescription Drug Costs Act Amends its part · introduced · 117th Congress
- HR 3 Elijah E. Cummings Lower Drug Costs Now Act Amends its part · introduced · 117th Congress
- S 1180 Choose Medicare Act Amends its part · introduced · 117th Congress
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The law today
From the official United States Code, current through Public Law 119-121.
(a) Assuring access to a choice of coverage (1) Choice of at least two plans in each area
The Secretary shall ensure that each part D eligible individual has available, consistent with paragraph (2), a choice of enrollment in at least 2 qualifying plans (as defined in paragraph (3)) in the area in which the individual resides, at least one of which is a prescription drug plan. In any such case in which such plans are not available, the part D eligible individual shall be given the opportunity to enroll in a fallback prescription drug plan.
(2) Requirement for different plan sponsors
The requirement in paragraph (1) is not satisfied with respect to an area if only one entity offers all the qualifying plans in the area.
(3) Qualifying plan defined For purposes of this section, the term “qualifying plan” means—
(A) a prescription drug plan; or
(B) an MA–PD plan described in section 1395w–21(a)(2)(A)(i) of this title that provides—
(i) basic prescription drug coverage; or
(ii) qualified prescription drug coverage that provides supplemental prescription drug coverage so long as there is no MA monthly supplemental beneficiary premium applied under the plan, due to the application of a credit against such premium of a rebate under section 1395w–24(b)(1)(C) of this title.
(b) Flexibility in risk assumed and application of fallback plan In order to ensure access pursuant to subsection (a) in an area—
(1) the Secretary may approve limited risk plans under section 1395w–111(f) of this title for the area; and
(2) only if such access is still not provided in the area after applying paragraph (1), the Secretary shall provide for the offering of a fallback prescription drug plan for that area under section 1395w–111(g) of this title.
Official text at uscode.house.gov ↗