§ 1395w–103. Access to a choice of qualified prescription drug coverage

• (a)
  • (1) 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) 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) 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) 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 .