I
118THCONGRESS
2
DSESSION H. R. 7718
To amend title XVIII of the Social Security Act to assure pharmacy access
and choice for medicare beneficiaries.
IN THE HOUSE OF REPRESENTATIVES
MARCH19, 2024
Mr. G
ALLEGOintroduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall within
the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to assure
pharmacy access and choice for medicare beneficiaries.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. ASSURING PHARMACY ACCESS AND CHOICE 3
FOR MEDICARE BENEFICIARIES. 4
Section 1860D–4(b)(1) of the Social Security Act (42 5
U.S.C. 1395w–104(b)(1)) is amended by striking subpara-6
graph (A) and inserting the following: 7
‘‘(A) I
N GENERAL.— 8
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‘‘(i) PARTICIPATION OF ANY WILLING 1
PHARMACY.—A PDP sponsor offering a 2
prescription drug plan shall permit any 3
pharmacy that meets the standard contract 4
terms and conditions under such plan to 5
participate as a network pharmacy of such 6
plan. 7
‘‘(ii) C
ONTRACT TERMS AND CONDI -8
TIONS.— 9
‘‘(I) I
N GENERAL.—For plan 10
years beginning on or after January 11
1, 2028, in accordance with clause (i), 12
contract terms and conditions offered 13
by such PDP sponsor shall be reason-14
able and relevant according to stand-15
ards established by the Secretary 16
under subclause (II). 17
‘‘(II) S
TANDARDS.—Not later 18
than the first Monday in April of 19
2027, the Secretary shall establish 20
standards for reasonable and relevant 21
contract terms and conditions for pur-22
poses of this clause. 23
‘‘(III) R
EQUEST FOR INFORMA -24
TION.—Not later than January 1, 25
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2025, for purposes of establishing the 1
standards under subclause (II), the 2
Secretary shall issue a request for in-3
formation to seek input on trends in 4
prescription drug plan and network 5
pharmacy contract terms and condi-6
tions, current prescription drug plan 7
and network pharmacy contracting 8
practices, whether pharmacy reim-9
bursement and dispensing fees under 10
this part cover pharmacy ingredient 11
and operational costs, areas in current 12
regulations or program guidance re-13
lated to contracting between prescrip-14
tion drug plans and network phar-15
macies requiring clarification or addi-16
tional specificity, factors for consider-17
ation in determining the reasonable-18
ness and relevance of contract terms 19
and conditions between prescription 20
drug plans and network pharmacies, 21
and other issues determined appro-22
priate by the Secretary.’’. 23
Æ
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