Medicare Prescription Drug Benefit Act of 1991

Medicare Prescription Drug Benefit Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to provide coverage under part B (Supplementary Medical Insurance) of outpatient prescription drugs and insulin (outpatient drugs). Excludes from such coverage any drug that is intraveneously administered in a home setting. Sets the annual deductible for such coverage at $650 in 1993, increased by $50 for each succeeding year. Prohibits application of such deductible to immunosuppressive drugs provided in the first year after an organ transplant. Sets program payments at 80 percent of the lesser of the actual charge for the drug or the applicable payment limit established under this Act. Outlines provisions for determining payment limits. Directs the Secretary to establish a program to identify and to educate physicians and pharmacies concerning: (1) instances and patterns of unnecessary or inappropriate prescribing or dispensing practices; (2) instances or patterns of substandard care; and (3) potential adverse drug reactions. Requires the Secretary to develop and update annually an information guide concerning the comparative average wholesale prices of at least 500 of the most commonly prescribed outpatient drugs and to mail such guide to Medicare hospitals, physicians, social security offices, senior citizen centers, and other appropriate places by January of each year. Sets forth outpatient drug cost reporting and control provisions. Authorizes a pharmacy to enter into an agreement with the Secretary to accept payment under part B of the Medicare program on an assigned basis for outpatient drugs furnished to part B enrollees. Sets forth the obligations of participating pharmacies. Requires the Secretary to establish a point-of-sale electronic system for use by carriers and participating pharmacies in submitting information respecting outpatient drugs dispensed to Medicare beneficiaries. Prohibits part B coverage of an outpatient drug which is dispensed in a quantity exceeding a 30-day supply or such longer supply, not exceeding 90 days, as the Secretary authorizes. Waives the requirement that a Medicare carrier be an insurer of health care services, authorizing the Secretary to contract with other entities for implementation and operation of the electronic point-of-sale claims processing system and for related functions. Requires Medicare carriers which make determinations or payments with respect to outpatient drugs to offer to receive requests from participating pharmacies for payments for such drugs through electronic communications and to respond to requests by such pharmacies as to whether or not an individual has paid the deductible for such drugs. Requires the Director of the Office of Technology Assessment to appoint individuals with expertise in the provision and financing of covered outpatient drugs to a Prescription Drug Payment Review Commission which shall make recommendations to the Congress each year concerning methods of paying for covered outpatient drugs under part B of the Medicare program. Sets forth miscellaneous outpatient drug study and reporting requirements. Increases the part B premium to $42.40 in 1993, $47.70 in 1994, and $53.60 in 1995.