[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9365 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 9365
To amend title XVIII of the Social Security Act to provide for coverage
under the Medicare program of pharmacist services.
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IN THE HOUSE OF REPRESENTATIVES
August 16, 2024
Mr. Davis of North Carolina (for himself and Mr. Nunn of Iowa)
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 provide for coverage
under the Medicare program of pharmacist 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 ``Pharmacy and Medically Underserved
Areas Enhancement Act''.
SEC. 2. MEDICARE COVERAGE OF PHARMACIST SERVICES.
(a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
(1) in subparagraph (II), by striking ``and'' at the end;
(2) in subparagraph (JJ), by inserting ``and'' at the end;
and
(3) by adding at the end the following new subparagraph:
``(KK) pharmacist services furnished by a pharmacist, as
licensed by State law, individually or on behalf of a pharmacy
provider--
``(i) which the pharmacist is legally authorized to
perform in the State in which the individual performs
such services;
``(ii) as would otherwise be covered under this
part if furnished by a physician, or as an incident to
a physician's service; and
``(iii) in a setting located in a health
professional shortage area (as defined in section
332(a)(1)(A) of the Public Health Service Act),
medically underserved area, or medically underserved
population (as defined in section 330(b)(3) of such
Act);''.
(b) Payment.--Section 1833(a)(1) of the Social Security Act (42
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (HH)'' and inserting ``(HH)''; and
(2) by inserting before the semicolon at the end the
following: ``, and (II) with respect to pharmacist services (as
defined in section 1861(s)(2)(KK)), the amounts paid shall be
equal to 80 percent of the lesser of the actual charge or 85
percent of the fee schedule amount provided under section 1848
if such services had been furnished by a physician''.
(c) Effective Date; Pharmacist Specific Codes.--
(1) Effective date.--The amendments made by subsections (a)
and (b) shall apply with respect to services furnished on or
after January 1, 2024.
(2) Pharmacist specific codes.--The Secretary of Health and
Human Services shall develop pharmacist specific codes, as
necessary, under the physician fee schedule under section 1848
of the Social Security Act (42 U.S.C. 1395w-4).
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