,,ii  #aacth ,,congress  #ast ,session  
,s4 #eeg  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,march #ac1 #bjac   
,mrs4 ,hagan 7for herself1 ,mr4         
,roberts1 ,mr4 ,franken1 ,ms4           
,klobuchar1 ,mr4 ,johnson of ,south     
,dakota1 and ,mr4 ,brown7 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
 improve access to medication therapy   
management under part ,d of the         
,medicare program4  #a4 ,short title    
,this ,act may be cited as the          
,medication ,therapy ,management        
,empowerment ,act of #bjac4  #b4        
,improved access to medication therapy  
management under part ,d of the         
,medicare program ,section              
#ahfj;,d-#d7;c77#b7 of the ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;c77#b77 is amended--  7#a7 
in subparagraph 7,a77ii77,i71 by        
striking have and inserting subject to  

subparagraph 7,h71 have2 and  7#b7 by   
adding at the end the following new     
subparagraph3  7,h7 ,expansion of       
definition of targeted beneficiary the  
expansion reduces spending  7i7 ,,cms   
actuary report ,not later than ,january 
#a1 #bjad1 the ,chief ,actuary of the   
,centers for ,medicare  ,medicaid       
,services 7in this subparagraph referred
 to as the ,chief ,actuary7 shall submit
 to the ,secretary and to ,congress a   
report on whether or not the expansion  
described in clause 7ii7 would1 if      
implemented1 reduce expenditures under  
this title4 ,if the ,chief ,actuary     
determines that such expansion would    
reduce spending under this title1 such  
report shall include a certification of 
such determination4  7ii7 ,expansion    
described ,the expansion described in   
this clause is an expansion of the      
definition of targeted beneficiary under
 subparagraph 7,a77ii7 by applying      
subclause 7,i7 of such subparagraph as  
if the following were inserted before   

the semicolon at the end3 or a single   
chronic disease that accounts for high  
spending under this title1 including    
diabetes1 hypertension1 heart failure1  
dyslipidemia1 respiratory disease 7such 
as asthma1 chronic obstructive pulmonary
 disease1 or chronic lung disorders71   
bone disease-arthritis 7such as         
osteoporosis or osteoarthritis71        
rheumatoid arthritis1 and mental health 
7such as depression1 schizophrenia1 or  
bipolar disorder74  7iii7 ,application  
if the ,chief ,actuary determines that  
the expansion reduces spending ,if the  
report under clause 7i7 contains the    
certification described in such clause1 
the following rules shall apply3  7,i7  
,implementation of expansion ,subject to
 subclause 7,,iii71 effective with      
respect to plan years beginning on or   
after ,january #a1 #bjae1 subparagraph  
7,a77ii77,i7 shall be applied to include
 the expansion described in clause 7ii74
  7,,ii7 ,updated ,,cms actuary report  
based on implementation ,not later than 

,march #a1 #bjbj1 the ,chief ,actuary   
shall submit to the ,secretary and to   
,congress a report on the implementation
 of the expansion under subclause 7,i74 
,such report shall include an analysis  
of whether or not such expansion reduces
 spending under this title4  7,,iii7    
,authority to terminate expansion if the
 expansion does not reduce spending ,if 
the ,chief ,actuary determines in the   
report under subclause 7,,ii7 that the  
expansion does not reduce spending under
 this title1 the ,secretary may1        
effective with respect to plan years    
beginning on or after ,january #a1      
#bjba1 apply subparagraph 7,a77ii77,i7  
as if this subparagraph had never been  
enacted4 ,in making the determination   
under the preceding sentence1 the       
,secretary shall take into account      
whether such expansion improves the     
quality of care furnished to1 and the   
health outcomes of1 individuals eligible
 for services under a medication therapy
 management program by reason of such   

expansion4  4