,,ii  #aac? ,,congress  #a/ ,session    
,s4 #eeg  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,m>* #ac1 #bjac ,mrs4  
,hagan 7= h]self1 ,mr4 ,rob]ts1 ,mr4    
,frank51 ,ms4 ,klobu*>1 ,mr4 ,johnson ( 
,s\? ,dakota1 & ,mr4 ,br[n7 introduc$ ! 
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to improve access to     
m$ication !rapy managem5t "u "p ,d ( !  
,m$ic>e program4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,m$ication ,!rapy  
,managem5t ,emp[]m5t ,act ( #bjac4  #b4 
,improv$ access to m$ication !rapy      
managem5t "u "p ,d ( ! ,m$ic>e program  
,section #ahfj;,d-#d7;c77#b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#ajd7;c77#b77 is am5d$--  7#a7 9 
subp>agraph 7,a77ii77,i71 by /rik+ h &  
ins]t+ subject to subp>agraph 7,h71 h2 &
  7#b7 by add+ at ! end ! foll[+ new    
subp>agraph3  7,h7 ,expansion (         
def9ition ( t>get$ b5efici>y ! expansion
 r$uces sp5d+  7i7 ,,cms actu>y report  

,n lat] ?an ,janu>y #a1 #bjad1 ! ,*ief  
,actu>y ( ! ,c5t]s = ,m$ic>e  ,m$icaid  
,s]vices 79 ?is subp>agraph ref]r$ to z 
! ,*ief ,actu>y7 %all submit to !       
,secret>y & to ,congress a report on    
:e!r or n ! expansion describ$ 9 clause 
7ii7 w\ld1 if implem5t$1 r$uce          
exp5ditures "u ?is title4 ,if ! ,*ief   
,actu>y det]m9es t su* expansion w\ld   
r$uce sp5d+ "u ?is title1 su* report    
%all include a c]tification ( su*       
det]m9ation4  7ii7 ,expansion describ$  
,! expansion describ$ 9 ?is clause is an
 expansion ( ! def9ition ( t>get$       
b5efici>y "u subp>agraph 7,a77ii7 by    
apply+ subclause 7,i7 ( su* subp>agraph 
z if ! foll[+ 7 ins]t$ be=e ! semicolon 
at ! end3 or a s+le *ronic disease t    
acc\nts = high sp5d+ "u ?is title1      
includ+ diabetes1 hyp]t5sion1 he>t      
failure1 dyslipidemia1 respiratory      
disease 7su* z a/hma1 *ronic ob/ructive 
pulmon>y disease1 or *ronic lung        
disord]s71 bone disease-ar?ritis 7su* z 
o/eoporosis or o/eo>?ritis71 rheumatoid 

ar?ritis1 & m5tal heal? 7su* z          
depression1 s*izophr5ia1 or bipol>      
disord]74  7iii7 ,application if ! ,*ief
 ,actu>y det]m9es t ! expansion r$uces  
sp5d+ ,if ! report "u clause 7i7 conta9s
 ! c]tification describ$ 9 su* clause1 !
 foll[+ rules %all apply3  7,i7         
,implem5tation ( expansion ,subject to  
subclause 7,,iii71 effective ) respect  
to plan ye>s beg9n+ on or aft] ,janu>y  
#a1 #bjae1 subp>agraph 7,a77ii77,i7 %all
 be appli$ to include ! expansion       
describ$ 9 clause 7ii74  7,,ii7 ,updat$ 
,,cms actu>y report bas$ on             
implem5tation ,n lat] ?an ,m>* #a1      
#bjbj1 ! ,*ief ,actu>y %all submit to ! 
,secret>y & to ,congress a report on !  
implem5tation ( ! expansion "u subclause
 7,i74 ,su* report %all include an      
analysis ( :e!r or n su* expansion      
r$uces sp5d+ "u ?is title4  7,,iii7     
,au?ority to t]m9ate expansion if !     
expansion does n r$uce sp5d+ ,if ! ,*ief
 ,actu>y det]m9es 9 ! report "u         
subclause 7,,ii7 t ! expansion does n   

r$uce sp5d+ "u ?is title1 ! ,secret>y   
may1 effective ) respect to plan ye>s   
beg9n+ on or aft] ,janu>y #a1 #bjba1    
apply subp>agraph 7,a77ii77,i7 z if ?is 
subp>agraph _h nev] be5 enact$4 ,9 mak+ 
! det]m9ation "u ! prec$+ s5t5ce1 !     
,secret>y %all take into acc\nt :e!r su*
 expansion improves ! quality ( c>e     
furni%$ to1 & ! heal? outcomes (1       
individuals eligible = s]vices "u a     
m$ication !rapy managem5t program by    
reason ( su* expansion4  4