,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #dbib  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #ah1 #bjae   
,mrs4 ,noem 7= h]self & ,mr4 ,pascrell7 
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 provide = rese>* & ! te/+ (
 innovative heal? c>e deliv]y models to 
improve m$ication adh]5ce1 & = o!r      
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,syn*ronization            
,nonadh]5ce ,correction 7,,sync7 ,act ( 
#bjae4  #b4 ,f9d+s ,congress makes !    
foll[+ f9d+s3  7#a7 ,betwe5 "o-half &   
two-?irds ( pati5ts ) *ronic diseases 9 
! ,unit$ ,/ates d n take m$ications z   
prescrib$4  7#b7 ,l[ rates ( m$ication  
adh]5ce result 9 high] heal? c>e co/s1  
r$uc$ effectiv5ess ( heal? c>e treatm5ts
 & regim5s1 negative heal? effects =    

pati5ts1 & t5s ( ?\s&s ( dea?s on an    
annual basis4  7#c7 ,m$ication adh]5ce  
may be l[e/ among pati5ts ) *ronic      
diseases4  7#d7 ,improv+ m$ication      
adh]5ce w\ld r$uce unnecess>y hospital  
admissions & em]g5cy room visits4  7#e7 
,nonadh]5ce is e/imat$ to co/ ! ,unit$  
,/ates heal? c>e sy/em ov]              
#ajj1jjj1jjj1jjj ea* ye>4  7#f7 ,improv+
 m$ication adh]5ce c\ld improve pati5t  
heal? outcomes1 r$uce heal? c>e co/s1 & 
lead to productivity ga9s4  #c4         
,def9itions ,9 ?is ,act3 7#a7 ,! t]m    
applicable individual means an          
applicable individual 7z def9$ 9 section
 #aaae;,a7a77#d77;,a7 ( ! ,social       
,security ,act1 #db ,u4,s4,c4           
#acae7;a77#d77;,a77 :o has be5 prescrib$
 #b or m *ronic c>e m$ications4  7#b7 ,!
 t]m m$ication adh]5ce means a pati5t   
tak+ m$ications accord+ to ! prescrib$  
dosage1 "t1 frequ5cy1 & direction4  7#c7
 ,! t]m m$ication wa/age means1 )       
respect to a m$ication1 a swit* ( !     
m$ication or /r5g? ( ! m$ication )9 !   

same !rapeutic class t occurs be=e !    
expect$ refill date4  7#d7 ,! t]m       
p]si/5ce means ! act ( cont9u+ treatm5t 
) a m$ication = ! prescrib$ duration4   
7#e7 ,! t]m prim>y nonadh]5ce means !   
failure to pickup a newly prescrib$     
m$ication f a ph>macy4  7#f7 ,! t]m     
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  7#g7 ,! t]m           
syn*ronization means ! coord9ation (    
m$ication refills = a pati5t tak+ two or
 m *ronic m$ications su* t ! pati5t's   
m$ications are refill$ on ! same s*$ule 
= a giv5 "t p]iod4  #d4 ,national rese>*
 & report+ /rategy = improv$ m$ication  
adh]5ce  7a7 ,9 g5]al ,! ,secret>y (    
,heal? & ,human ,s]vices1 act+ ?r\gh !  
,ag5cy = ,heal?c>e ,rese>* & ,quality1 !
 ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1 ! 
,heal? ,res\rces & ,s]vices             
,adm9i/ration1 ! ,director ( ! ,national
 ,in/itutes ( ,heal?1 & ! ,director ( ! 
,c5t]s = ,disease ,control & ,prev5tion1
 & 9 coord9ation ) ! ,pati5t-,c5t]$     
,outcomes ,rese>* ,in/itute1 %all       

conduct rese>* & develop in=mation to   
bett] in=m decisionmak]s reg>d+         
m$ication adh]5ce & m$ication p]si/5ce1 
& me?ods to improve m$ication adh]5ce & 
p]si/5ce 9 ,f$]al heal? programs4  7b7  
,activities includ$ ,! activities       
describ$ 9 subsection 7a7 %all include  
developm5t ( annual /ati/ics on         
recomm5d$ m$ications1 ! rate ( m$ication
 adh]5ce1 ! rate ( prim>y nonadh]5ce1 & 
! rate ( m$ication p]si/5ce = pati5ts ) 
*ronic diseases su* z c>diovascul>      
disease1 hyp]t5sion1 diabetes1          
autoimmune diseases1 *ronic ob/ructive  
pulmon>y disease 7,,copd71 & m5tal heal?
 conditions treat$ "u ! foll[+ heal? c>e
 programs3  7#a7 ,m$ic>e ,! ,m$ic>e     
program "u title ,,xviii ( ! ,social    
,security ,act4  7#b7 ,m$icaid ,!       
,m$icaid program "u title ,,xix ( su*   
,act4  7#c7 ,,fehbp ,! ,f$]al ,employees
 ,heal? ,b5efit ,program "u *apt] #hi ( 
title #e1 ,unit$ ,/ates ,code4  7c7     
,bi5nial report on m$ication adh]5ce &  
m$ication p]si/5ce ,n lat] ?an #b ye>s  

aft] ! date ( enactm5t ( ?is ,act 7&    
annually !reaft]71 ! ,secret>y %all     
submit to ,congress a report on !       
/ati/ics collect$ "u subsection 7a71    
toge!r ) recomm5dations = su*           
legislation & adm9i/rative action to    
address problems & improve m$ication    
adh]5ce & m$ication p]si/5ce z !        
,secret>y det]m9es appropriate4  #e4    
,te/+ models = improv+ m$ication adh]5ce
  7a7 ,9 g5]al ,! ,secret>y %all te/    
innovative heal? c>e deliv]y models1 z  
describ$ 9 subsections 7b7 & 7c71 to    
improve m$ication adh]5ce & m$ication   
p]si/5ce1 ) ! goal ( improv+ heal?      
outcomes & decreas+ heal? co/s = *ronic 
c>e conditions4  7b7 ,models ,to te/    
efficacy ( syn*ronization  7#a7 ,9 g5]al
 ,! model describ$ 9 ?is subsection %all
 te/ ! efficacy ( syn*ronization (      
prescription drug m$ications =          
applicable enrollees 9 improv+ m$ication
 adh]5ce1 det]m9+ co/ avoidance1 &      
improv+ outcomes = ^? enrollees4  7#b7  
,p>ticipation ,an applicable enrollee :o

 is eligible to p>ticipate 9 ! model    
te/+ "u ?is subsection %all p>ticipate 9
 ! model te/+1 unless ! enrollee elects 
n to p>ticipate 9 ! model4  7#c7 ,models
 te/$ ,! foll[+ models ( syn*ronization 
%all be te/$ "u ?is subsection3 7,a7    
,model #a ,syn*ronization               
7syn*ronization ( prescription drug     
m$ications & m$ication reconciliation   
phone calls or electronic communication 
) enrollees prior to fill+              
prescriptions74  7,b7 ,model #b         
,syn*ronization 7z describ$ 9           
subp>agraph 7,a77 & compliance-bas$     
packag+4  7,c7 ,model #c ,syn*ronization
 7z describ$ 9 subp>agraph 7,a77 & ongo+
 ph>maci/ c\nsel+ t %all occur at !     
pati5t's reque/ & include review ( !    
appropriat5ess ( ! m$ication regim5 &   
any b>ri]s to m$ication adh]5ce4  7#d7  
,evaluation ,! ,secret>y %all evaluate !
 models 9 p>agraph 7#c7 by collect+ &   
analyz+ relevant plan & enrollee data1  
includ+ at lea/ ! foll[+3  7,a7         
,syn*ronization enrollm5t & drop-out    

rates4  7,b7 ,prim>y m$ication          
nonadh]5ce4  7,c7 ,m$ication adh]5ce &  
p]si/5ce rates4  7,d7 ,demographic      
*>act]i/ics ( applicable enrollees4     
7,e7 ,plan *>act]i/ics1 su* z plan      
b5efit design4  7,f7 ,impact ( ! models 
on applicable enrollees :o are--  7i7   
eligible = b5efits "u a ,/ate plan "u   
title ,,xix ( ! ,social ,security2 or   
7ii7 eligible = premium & co/-%>+       
subsidies "u section #ahfj;,d-#ad7;a7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciew-#aad7;a774  7,g7 ,prescription   
drug claims data 9 comp>ison to o!r     
m$ical claims data = applicable         
enrollees 9 ord] to exam9e ! effect (   
syn*ronization & adh]5ce on ov]all heal?
 sp5d+1 includ+ heal? c>e co/s avoid$1 &
 pati5t outcomes4  7c7 ,te/+ #ij-;,day  
fills at retail ph>macies = ! fir/      
prescription  7#a7 ,9 g5]al ,! ,secret>y
 %all conduct a demon/ration t comp>es !
 use ( #ij-;day fir/ fills (            
prescriptions at retail ph>macies or us+
 mail-ord] = ma9t5ance m$ications aga9/ 

#cj-;day fir/ fills = applicable        
enrollees "u "p ,d ( title ,,xviii ( !  
,social ,security ,act1 to det]m9e :e!r 
!re is an impact on m$ication p]si/5ce1 
co/ avoidance1 & improv+ outcomes = ^?  
enrollees 9 subsequ5t refill p]iods4    
7#b7 ,drugs ,te/$ ,! model "u ?is       
subsection %all only p]ta9 to fir/ fills
 = ma9t5ance drugs treat+ *ronic        
diseases su* z c>diovascul> disease1    
hyp]t5sion1 diabetes1 autoimmune        
diseases1 *ronic ob/ructive pulmon>y    
disease 7,,copd71 & m5tal heal?         
conditions4  7#c7 ,evaluation (         
demon/ration by ,,gao  7,a7 ,provision (
 data = evaluation ,! ,secret>y %all    
make available to ! ,comptroll] ,g5]al (
 ! ,unit$ ,/ates relevant plan &        
enrollee data 9 ord] to enable an       
evaluation ( ! demon/ration "u ?is      
subsection "u subp>agraph 7,b74  7,b7   
,evaluation ,us+ data made available "u 
subp>agraph 7,a7 & o!r relevant data1 ! 
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all evaluate ! demon/ration conduct$ "u

 ?is subsection4 ,su* evaluation %all   
exam9e ! effect ( long-t]m fills &      
adh]5ce on ov]all heal? sp5d+1 includ+  
heal? c>e co/s avoid$1 & pati5t outcome1
 & %all exam9e at lea/ ! foll[+ 9       
relation to "p ,d enrollees us+ #ij-;day
 fir/ fills 9 comp>ison ) ^? enrollees  
us+ #cj-;day fir/ fills3  7i7 ,m$ication
 adh]5ce & p]si/5ce rates4  7ii7 ,co/   
diff]5tials 9 ph>macy co/s4  7iii7      
,prescription drug claims data 9        
comp>ison to o!r m$ical claims4  7iv7   
,m$ication wa/age 7z def9$ 9 section    
#c74  7,c7 ,report ,! ,comptroll] ,g5]al
 %all submit a report to ! ,secret>y &  
,congress on ! evaluation conduct$ "u   
?is p>agraph4