,,ii  #aacth ,,congress  #ast ,session  
,s4 #adic  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #aj1
 #bjac,mr4 ,cardin 7for himself and ,ms4
 ,mikulski7 introduced the following    
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xviii of the ,social
 ,security ,act to encourage the use of 
dispensing techniques that foster       
efficiency and reduce wasteful          
dispensing of outpatient prescription   
drugs in long-term care facilities4  #a4
 ,short title ,this ,act may be cited as
 the ,medicare ,efficient ,drug         
,dispensing ,act of #bjac4  #b4         
,incentives for use of dispensing       
techniques that foster efficiency and   
reduce wasteful dispensing of outpatient
 drugs in long-term care facilities  7a7
 ,in general ,section                   
#ahfj;,d-#d7;c77#a7 of the ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;c77#a77 is amended by      
adding at the end the following3  7,e7  

,a payment structure that encourages the
 use of dispensing techniques that      
foster efficiency and reduce wasteful   
dispensing of outpatient prescription   
drugs in long-term care facilities4  4  
7b7 ,pharmacy fees ,section             
#ahfj;,d-#d7;c77#c7 of the ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;c77#c77 is amended-- 7#a7  
by striking ,the ,secretary shall and   
inserting the following3  7,a7 ,in      
general ,the ,secretary shall  2 and    
7#b7 by adding at the end the following3
  7,b7 ,consideration in pharmacy fees  
,the ,,pdp sponsor of a prescription    
drug plan shall take into account in    
establishing dispensing fees for        
services provided in connection with    
dispensing covered part ,d drugs to     
enrollees who reside in a long-term care
 facility1 the utilization of dispensing
 techniques to minimize the dispensing  
of unused drugs1 and the incremental    
costs associated with the type of       
dispensing methodology and the          

requirements applicable to long-term    
care pharmacies under the program under 
this part4 ,each such sponsor shall not 
use payment structures1 including       
prorated daily dispensing fees1 that    
discourage the adoption of techniques to
 minimize the dispensing of unused drugs
 with respect to covered part ,d drugs  
dispensed in long-term care facilities4 
,each such sponsor shall disclose to the
 ,secretary upon request and in         
accordance with the requirements of     
section #ahfj;,d-#ae7;f7 the amount of  
any such dispensing fee4  4