Application to Medicare Advantage program and related managed care programs

42 U.S. Code § 1395w-131. Application to Medicare Advantage program and related managed care programs

(a) Special rules relating to offering of qualified prescription drug coverage
(1) In generalAn MA organization on and after January 1, 2006
(A)
may not offer an MA plan described in section 1395w–21(a)(2)(A) of this title in an area unless either that plan (or another MA plan offered by the organization in that same service area) includes required prescription drug coverage (as defined in paragraph (2)); and
(B) may not offer prescription drug coverage (other than that required under parts A and B) to an enrollee—
(i)
under an MSA plan; or
(ii)
under another MA plan unless such drug coverage under such other plan provides qualified prescription drug coverage and unless the requirements of this section with respect to such coverage are met.
(2) Qualifying coverageFor purposes of paragraph (1)(A), the term “required coverage” means with respect to an MA–PD plan—
(A)
basic prescription drug coverage; or
(B)
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).
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