§ 1395w–134. Coordination requirements for plans providing prescription drug coverage

• (a)
  • (1) The 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) To 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)
    • (A) The 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 .
    • (B) A user fee may not be imposed under subparagraph (A) with respect to a State Pharmaceutical Assistance Program.
• (b) An Rx plan described in this subsection is any of the following:
  • (1) A 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) An employer group health plan.
  • (3) The Federal employees health benefits plan under chapter 89 of title 5.
  • (4) Coverage under chapter 55 of title 10.
  • (5) Such 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.
• (c)
  • (1) The 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) The requirements of this section shall not affect the application of the procedures established under section 1395w–102(b)(4)(D) of this title .