[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7718 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 7718
To amend title XVIII of the Social Security Act to assure pharmacy
access and choice for medicare beneficiaries.
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IN THE HOUSE OF REPRESENTATIVES
March 19, 2024
Mr. Gallego 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
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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 Representatives of the
United States of America in Congress assembled,
SECTION 1. ASSURING PHARMACY ACCESS AND CHOICE FOR MEDICARE
BENEFICIARIES.
Section 1860D-4(b)(1) of the Social Security Act (42 U.S.C. 1395w-
104(b)(1)) is amended by striking subparagraph (A) and inserting the
following:
``(A) In general.--
``(i) Participation of any willing
pharmacy.--A PDP sponsor offering a
prescription drug plan shall permit any
pharmacy that meets the standard contract terms
and conditions under such plan to participate
as a network pharmacy of such plan.
``(ii) Contract terms and conditions.--
``(I) In general.--For plan years
beginning on or after January 1, 2028,
in accordance with clause (i), contract
terms and conditions offered by such
PDP sponsor shall be reasonable and
relevant according to standards
established by the Secretary under
subclause (II).
``(II) Standards.--Not later than
the first Monday in April of 2027, the
Secretary shall establish standards for
reasonable and relevant contract terms
and conditions for purposes of this
clause.
``(III) Request for information.--
Not later than January 1, 2025, for
purposes of establishing the standards
under subclause (II), the Secretary
shall issue a request for information
to seek input on trends in prescription
drug plan and network pharmacy contract
terms and conditions, current
prescription drug plan and network
pharmacy contracting practices, whether
pharmacy reimbursement and dispensing
fees under this part cover pharmacy
ingredient and operational costs, areas
in current regulations or program
guidance related to contracting between
prescription drug plans and network
pharmacies requiring clarification or
additional specificity, factors for
consideration in determining the
reasonableness and relevance of
contract terms and conditions between
prescription drug plans and network
pharmacies, and other issues determined
appropriate by the Secretary.''.
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