42 U.S.C. § 1395w–134 — Coordination requirements for plans providing prescription drug coverage

1. (a)Application of benefit coordination requirements to additional plans
   1. (1)In generalThe Secretary shall apply the coordination requirements established under section 1395w–133(a) of this title to Rx plans described in subsection (b) in the same manner as such requirements apply to a State Pharmaceutical Assistance Program.
   2. (2)Application to treatment of certain out-of-pocket expendituresTo the extent specified by the Secretary, the requirements referred to in paragraph (1) shall apply to procedures established under section 1395w–102(b)(4)(D) of this title.
   3. (3)User fees
      1. (A)In generalThe Secretary may impose user fees for the transmittal of information necessary for benefit coordination under section 1395w–102(b)(4)(D) of this title in a manner similar to the manner in which user fees are imposed under section 1395u(h)(3)(B) of this title, except that the Secretary may retain a portion of such fees to defray the Secretary’s costs in carrying out procedures under section 1395w–102(b)(4)(D) of this title.
      2. (B)ApplicationA user fee may not be imposed under subparagraph (A) with respect to a State Pharmaceutical Assistance Program.
2. (b)Rx PlanAn Rx plan described in this subsection is any of the following:
   1. (1)Medicaid programsA State plan under subchapter XIX, including such a plan operating under a waiver under section 1315 of this title, if it meets the requirements of section 1395w–133(b)(2) of this title.
   2. (2)Group health plansAn employer group health plan.
   3. (3)FEHBPThe Federal employees health benefits plan under chapter 89 of title 5.
   4. (4)Military coverage (including TRICARE)Coverage under chapter 55 of title 10.
   5. (5)Other prescription drug coverageSuch other health benefit plans or programs that provide coverage or financial assistance for the purchase or provision of prescription drug coverage on behalf of part D eligible individuals as the Secretary may specify.
3. (c)Relation to other provisions
   1. (1)Use of cost management toolsThe requirements of this section shall not impair or prevent a PDP sponsor or MA organization from applying cost management tools (including differential payments) under all methods of operation.
   2. (2)No affect 1 So in original. Probably should be “effect”. on treatment of certain out-of-pocket expendituresThe requirements of this section shall not affect the application of the procedures established under section 1395w–102(b)(4)(D) of this title.