| 1 | 1 | | I |
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| 2 | 2 | | 118THCONGRESS |
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| 3 | 3 | | 2 |
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| 4 | 4 | | DSESSION H. R. 7718 |
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| 5 | 5 | | To amend title XVIII of the Social Security Act to assure pharmacy access |
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| 6 | 6 | | and choice for medicare beneficiaries. |
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| 7 | 7 | | IN THE HOUSE OF REPRESENTATIVES |
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| 8 | 8 | | MARCH19, 2024 |
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| 9 | 9 | | Mr. G |
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| 10 | 10 | | ALLEGOintroduced the following bill; which was referred to the Com- |
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| 11 | 11 | | mittee on Energy and Commerce, and in addition to the Committee on |
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| 12 | 12 | | Ways and Means, for a period to be subsequently determined by the |
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| 13 | 13 | | Speaker, in each case for consideration of such provisions as fall within |
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| 14 | 14 | | the jurisdiction of the committee concerned |
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| 15 | 15 | | A BILL |
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| 16 | 16 | | To amend title XVIII of the Social Security Act to assure |
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| 17 | 17 | | pharmacy access and choice for medicare beneficiaries. |
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| 18 | 18 | | Be it enacted by the Senate and House of Representa-1 |
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| 19 | 19 | | tives of the United States of America in Congress assembled, 2 |
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| 20 | 20 | | SECTION 1. ASSURING PHARMACY ACCESS AND CHOICE 3 |
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| 21 | 21 | | FOR MEDICARE BENEFICIARIES. 4 |
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| 22 | 22 | | Section 1860D–4(b)(1) of the Social Security Act (42 5 |
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| 23 | 23 | | U.S.C. 1395w–104(b)(1)) is amended by striking subpara-6 |
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| 24 | 24 | | graph (A) and inserting the following: 7 |
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| 25 | 25 | | ‘‘(A) I |
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| 26 | 26 | | N GENERAL.— 8 |
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| 27 | 27 | | VerDate Sep 11 2014 01:03 Apr 03, 2024 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7718.IH H7718 |
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| 28 | 28 | | ssavage on LAPJG3WLY3PROD with BILLS 2 |
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| 29 | 29 | | •HR 7718 IH |
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| 30 | 30 | | ‘‘(i) PARTICIPATION OF ANY WILLING 1 |
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| 31 | 31 | | PHARMACY.—A PDP sponsor offering a 2 |
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| 32 | 32 | | prescription drug plan shall permit any 3 |
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| 33 | 33 | | pharmacy that meets the standard contract 4 |
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| 34 | 34 | | terms and conditions under such plan to 5 |
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| 35 | 35 | | participate as a network pharmacy of such 6 |
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| 36 | 36 | | plan. 7 |
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| 37 | 37 | | ‘‘(ii) C |
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| 38 | 38 | | ONTRACT TERMS AND CONDI -8 |
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| 39 | 39 | | TIONS.— 9 |
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| 40 | 40 | | ‘‘(I) I |
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| 41 | 41 | | N GENERAL.—For plan 10 |
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| 42 | 42 | | years beginning on or after January 11 |
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| 43 | 43 | | 1, 2028, in accordance with clause (i), 12 |
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| 44 | 44 | | contract terms and conditions offered 13 |
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| 45 | 45 | | by such PDP sponsor shall be reason-14 |
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| 46 | 46 | | able and relevant according to stand-15 |
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| 47 | 47 | | ards established by the Secretary 16 |
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| 48 | 48 | | under subclause (II). 17 |
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| 49 | 49 | | ‘‘(II) S |
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| 50 | 50 | | TANDARDS.—Not later 18 |
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| 51 | 51 | | than the first Monday in April of 19 |
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| 52 | 52 | | 2027, the Secretary shall establish 20 |
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| 53 | 53 | | standards for reasonable and relevant 21 |
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| 54 | 54 | | contract terms and conditions for pur-22 |
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| 55 | 55 | | poses of this clause. 23 |
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| 56 | 56 | | ‘‘(III) R |
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| 57 | 57 | | EQUEST FOR INFORMA -24 |
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| 58 | 58 | | TION.—Not later than January 1, 25 |
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| 59 | 59 | | VerDate Sep 11 2014 01:03 Apr 03, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7718.IH H7718 |
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| 60 | 60 | | ssavage on LAPJG3WLY3PROD with BILLS 3 |
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| 61 | 61 | | •HR 7718 IH |
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| 62 | 62 | | 2025, for purposes of establishing the 1 |
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| 63 | 63 | | standards under subclause (II), the 2 |
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| 64 | 64 | | Secretary shall issue a request for in-3 |
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| 65 | 65 | | formation to seek input on trends in 4 |
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| 66 | 66 | | prescription drug plan and network 5 |
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| 67 | 67 | | pharmacy contract terms and condi-6 |
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| 68 | 68 | | tions, current prescription drug plan 7 |
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| 69 | 69 | | and network pharmacy contracting 8 |
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| 70 | 70 | | practices, whether pharmacy reim-9 |
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| 71 | 71 | | bursement and dispensing fees under 10 |
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| 72 | 72 | | this part cover pharmacy ingredient 11 |
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| 73 | 73 | | and operational costs, areas in current 12 |
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| 74 | 74 | | regulations or program guidance re-13 |
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| 75 | 75 | | lated to contracting between prescrip-14 |
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| 76 | 76 | | tion drug plans and network phar-15 |
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| 77 | 77 | | macies requiring clarification or addi-16 |
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| 78 | 78 | | tional specificity, factors for consider-17 |
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| 79 | 79 | | ation in determining the reasonable-18 |
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| 80 | 80 | | ness and relevance of contract terms 19 |
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| 81 | 81 | | and conditions between prescription 20 |
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| 82 | 82 | | drug plans and network pharmacies, 21 |
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| 83 | 83 | | and other issues determined appro-22 |
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| 84 | 84 | | priate by the Secretary.’’. 23 |
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| 85 | 85 | | Æ |
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| 86 | 86 | | VerDate Sep 11 2014 01:03 Apr 03, 2024 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6301 E:\BILLS\H7718.IH H7718 |
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| 87 | 87 | | ssavage on LAPJG3WLY3PROD with BILLS |
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