SEC. 1184. INCLUDING COSTS INCURRED BY AIDS DRUG ASSISTANCE PROGRAMS AND INDIAN HEALTH SERVICE IN PROVIDING PRESCRIPTION DRUGS TOWARD THE ANNUAL OUT-OF-POCKET THRESHOLD UNDER PART D.

[a] In General- Section- 1860D-2[b][4][C] of the Social Security Act [42 U.S.C. 1395w-102[b][4][C]] is amended--

[1] in clause [i], by striking 'and' at the end;

[2] in clause [ii]--

[A] by striking 'such costs shall be treated as incurred only if' and inserting 'subject to clause [iii], such costs shall be treated as incurred only if';

[B] by striking ', under section 1860D-14, or under a State Pharmaceutical Assistance Program'; and

[C] by striking the period at the end and inserting '; and'; and

[3] by inserting after clause [ii] the following new clause:

'[iii] such costs shall be treated as incurred and shall not be considered to be reimbursed under clause [ii] if such costs are borne or paid--

'[I] under section 1860D-14;

'[II] under a State Pharmaceutical Assistance Program;

'[III] by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization [as defined in section 4 of the Indian Health Care Improvement Act]; or

'[IV] under an AIDS Drug Assistance Program under part B of title XXVI of the Public Health Service Act.'.

[b] Effective Date- The amendments made by subsection [a] shall apply to costs incurred on or after January 1, 2011.