[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7213 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 7213
To amend title XVIII of the Social Security Act to provide pharmacy
reimbursement for COVID-19-related and future emergency services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 24, 2022
Mr. Kind (for himself, Mr. McKinley, Ms. Barragan, and Mr. Carter of
Georgia) introduced the following bill; which was referred to the
Committee 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 provide pharmacy
reimbursement for COVID-19-related and future emergency services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Equitable Community Access to
Pharmacist Services Act''.
SEC. 2. COVERAGE OF PHARMACIST SERVICES UNDER MEDICARE PART B.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (GG), by striking ``and'' at the end;
(2) in subparagraph (HH), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(II) pharmacist services and such services and supplies
furnished as an incident to the pharmacist's service as would
otherwise be covered under part B if furnished by a physician
or as an incident to a physician's service that--
``(i) are furnished by a pharmacist, as licensed or
otherwise authorized--
``(I) under State law; or
``(II) under section 319F-3 or section 361
of the Public Health Service Act, or other
similar Federal law;
``(ii) would otherwise be covered under part B if
furnished by a physician, or as incident to a
physician's service; and
``(iii) are services--
``(I) for testing and testing-related
services for COVID-19, influenza, respiratory
syncytial virus, or streptococcal pharyngitis;
``(II) for the initiation of a drug regimen
for COVID-19, influenza, or streptococcal
pharyngitis;
``(III) for the administration of a vaccine
and related services for COVID-19 or influenza;
``(IV) that address a public health need
related to a public health emergency under
section 319F-3 or section 361 of the Public
Health Service Act, or other similar Federal
law; or
``(V) as determined by the Secretary by
program instruction or otherwise, including the
closing of gaps in health equity.''.
(b) Payment.--Section 1833(a)(1) of the Social Security Act (42
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (DD)'' and inserting ``(DD)''; and
(2) by inserting before the semicolon at the end the
following: ``(EE) with respect to pharmacist services described
in section 1861(s)(2)(II) for which payment may be made under
section 1848, the amounts paid shall be equal to 85 percent (or
100 percent, in the case of such services furnished pursuant to
a Federal emergency authority described in clause (i)(II) of
such section) of an amount determined by the Secretary or the
lesser of the actual charge for the services or the physician
fee schedule amount provided under section 1848 if such
services had been furnished by a physician''.
(c) Reassignment of Payment.--Section 1833 of the Social Security
Act (42 U.S.C. 1395l) is amended by adding at the end the new
subsection:
``(ee) With respect to pharmacist services described in section
1861(s)(2)(II) payment may be made on the basis of a claim or request
for payment presented by the pharmacist furnishing such services, or by
a pharmacy, hospital, critical access hospital, skilled nursing
facility or nursing facility (as defined in section 1919(a)),
physician, group practice, or ambulatory surgical center with which the
pharmacist has an employment or contractual relationship that provides
for payment to be made under this part for such services to such
pharmacy, hospital, critical access hospital, skilled nursing facility
or nursing facility, physician, group practice, or ambulatory surgical
center.''.
(d) Prohibition on Balance Billing for Pharmacist Services.--
Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following:
``(vii) A pharmacist.''.
(e) Rule of Construction.--Nothing in this section shall be
construed--
(1) to limit flexibilities provided under section 410.32 of
title 42, Code of Federal Regulations (or any successor
regulation) in response to COVID-19; or
(2) to restrict the ability of pharmacies and pharmacists
to enroll and obtain reimbursement under existing pathways
under title XVIII of the Social Security Act (42 U.S.C. 1395 et
seq.) as of the date of the enactment of this Act, including
reimbursement as mass immunizers.
(f) Implementation Authority.--Notwithstanding any other provision
of law, the Secretary of Health and Human Services shall implement the
provisions of, and the amendments made by, this section by interim
final rule, program instruction, or otherwise not later than the date
that is 60 days after the date of the enactment of this Act.
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