after the date that is 1 year after the date of the enactment of this Act. (d) Rebate or discount program for certain cancer and hospice patients (1) In general The Secretary of Health and Human Services, in consultation with patient advocacy groups and other relevant stakeholders as determined by such Secretary, shall establish a mechanism by which— (A) any amount paid by an eligible patient in connection with the stewardship fee under section 4192 of the Internal Revenue Code of 1986 (as added by this section) shall be rebated to such patient in as timely a manner as possible, or (B) amounts paid by an eligible patient for active opioids (as defined in section 4192(b) of such Code) are discounted at time of payment or purchase to ensure that such patient does not pay any amount attributable to such fee, with as little burden on the patient as possible. The Secretary shall choose whichever of the options described in subparagraph (A) or (B) is, in the Secretary's determination, most effective and efficient in ensuring eligible patients face no economic burden from such fee. (2) Eligible patient For purposes of this section, the term eligible patient means— (A) a patient for whom any active opioid (as so defined) is prescribed to treat pain relating to cancer or cancer treatment