[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.


_______________________________________________________________________


                    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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