,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #ddcg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,april #i1 #bjad ,mr4 
,coll9s ( ,georgia 7= himself & ,mr4    
,loebsack7 introduc$ ! foll[+ bill2 :i* 
0 ref]r$ to ! ,committee on ,en]gy &    
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide = ph>macy b5efits manag] /&>ds  
"u ! ,m$ic>e prescription drug program  
to fur!r transp>5cy ( paym5t            
me?odologies to ph>macies1 & = o!r      
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,g5]ic ,drug ,pric+        
,fairness ,act4  #b4 ,ph>macy b5efits   
manag] /&>ds "u ! ,m$ic>e program  7a7  
,9 g5]al ,section #ahfj;,d-#ab7;b7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#aab7;b77 is am5d$ by add+ at !  
end ! foll[+ new p>agraphs3  7#g7       

,ph>macy b5efits manag] transp>5cy      
requirem5ts ,ea* contract ent]$ into ) a
 ,,pdp sponsor "u ?is "p ) respect to a 
prescription drug plan (f]$ by su*      
sponsor %all provide t ! ,,pdp may n    
ent] into a contract ) any ph>macy      
b5efits manag] 7ref]r$ to 9 ?is p>agraph
 z a ,,pbm7 to manage ! prescription    
drug cov]age provid$ "u su* plan1 or to 
control ! co/s ( ! prescription drug    
cov]age "u su* plan1 unless ! ,,pbm     
adh]es to ! foll[+ crit]ia :5 h&l+      
p]sonally id5tifiable utilization &     
claims data or o!r s5sitive pati5t data3
  7,a7 ,! ,,pbm may n transmit any      
p]sonally id5tifiable utilization or    
claims data1 ) respect to a plan        
enrollee1 to a ph>macy own$ by a ,,pbm  
if ! plan enrollee has n volunt>ily     
elect$ 9 writ+ or via secure electronic 
means to fill t p>ticul> prescription at
 ! ,,pbm-own$ ph>macy4  7,b7 ,! ,,pbm   
may n require t a plan enrollee use a   
retail ph>macy1 mail ord] ph>macy1      
specialty ph>macy1 or o!r ph>macy entity

 provid+ ph>macy s]vices 9 :i* ! ,,pbm  
has an own]%ip int]e/ or t has an       
own]%ip int]e/ 9 ! ,,pbm or provide an  
inc5tive to a plan enrollee to enc\rage 
! enrollee to use a retail ph>macy1 mail
 ord] ph>macy1 specialty ph>macy1 or o!r
 ph>macy entity provid+ ph>macy s]vices 
9 :i* ! ,,pbm has an own]%ip int]e/ or t
 has an own]%ip int]e/ 9 ! ,,pbm1 if !  
inc5tive is applicable only to su*      
ph>macies4  4  7b7 ,regul> update (     
prescription drug pric+ /&>d ,p>agraph  
7#f7 ( section #ahfj;,d-#ab7;b7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#aab7;b77 is am5d$ to read z     
foll[s3  7#f7 ,regul> update (          
prescription drug pric+ /&>d  7,a7 ,9   
g5]al ,if ! ,,pdp sponsor ( a           
prescription drug plan uses a /&>d =    
reimbursem5t 7z describ$ 9 subp>agraph  
7,b77 ( ph>macies bas$ on ! co/ ( a     
drug1 ea* contract ent]$ into ) su*     
sponsor "u ?is "p ) respect to ! plan   
%all provide t ! sponsor %all--  7i7    
update su* /&>d n less frequ5tly ?an    

once e #g days1 beg9n+ ) an initial     
update on ,janu>y #a ( ea* ye>1 to      
accurately reflect ! m>ket price (      
acquir+ ! drug2  7ii7 disclose to       
applicable ph>macies ! s\rces us$ = mak+
 any su* update2  7iii7 if ! s\rce = su*
 a /&>d = reimbursem5t is n publicly    
available1 disclose to ! applicable     
ph>macies all individual drug prices to 
be s updat$ 9 advance ( ! use ( su*     
prices = ! reimbursem5t ( claims2 &     
7iv7 e/abli% a process to appeal1       
inve/igate1 & resolve disputes reg>d+   
individual drug prices t are less ?an ! 
ph>macy acquisition price = su* drug4   
7,b7 ,prescription drug pric+ /&>d def9$
 ,= purposes ( subp>agraph 7,a71 a /&>d 
= reimbursem5t ( a ph>macy is any       
me?odology or =mula = v>y+ ! pric+ ( a  
drug or drugs dur+ ! t]m ( ! ph>macy    
reimbursem5t contract t is bas$ on ! co/
 ( ! drug involv$1 includ+ drug pric+   
ref]5ces & am\nts t are bas$ ^u av]age  
:olesale price1 :olesale av]age co/1    
av]age manufactur] price1 av]age sales  

price1 maximum all[able co/ 7,,mac71 or 
o!r co/s1 :e!r publicly available or n4 
4  7c7 ,effective date ,! am5dm5ts made 
by ?is section %all apply to plan ye>s  
beg9n+ on or aft] ,janu>y #a1 #bjae4