,,ii  #aad? ,,congress  #b;d ,session   
,s4 #cded  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #bh1 #bjaf   
,mr4 ,c>p] 7= himself & ,mr4 ,rob]ts7   
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to improve         
m$ication adh]5ce4  #a4 ,f9d+s ,congress
 makes ! foll[+ f9d+s3 7#a7 ,eighty to  
n9ety p]c5t ( ! means by :i* we prev5t &
 control *ronic disease is ) m$ications4
 ,assur+ ! mo/ appropriate & effective  
m$ications are us$ to optimize pati5t   
outcomes is a national priority4 ,!     
ability ( pati5ts to !n adh]e to !      
m$ication regim5 becomes vital4  7#b7   
,betwe5 #a_/b & #b_/c ( individuals )   
*ronic diseases 9 ! ,unit$ ,/ates d n   
take m$ications z prescrib$4  7#c7      
,suboptimal m$ication use1 includ+      
untreat$ indications 7su* z failure to  
immunize71 ov] or "u dos+ ( m$ications1 
safety issues1 & l[ rates ( m$ication   
adh]5ce result 9 high] heal? c>e co/s1  
r$uc$ effectiv5ess ( heal? c>e treatm5ts

 & regimes1 negative heal? effects =    
pati5ts1 & t5s ( ?\s&s ( dea?s on an    
annual basis4  7#d7 ,appropriate        
m$ication use & adh]5ce may be l[e/     
among individuals ) *ronic diseases4    
7#e7 ,improv+ m$ication adh]5ce w\ld    
r$uce unnecess>y hospital admissions &  
em]g5cy room visits4  7#f7 ,drug !rapy  
problems includ+ und]use & nonadh]5ce is
 e/imat$ to co/ ! heal?c>e sy/em 9 !    
,unit$ ,/ates ov] #bij1jjj1jjj1jjj ea*  
ye>4  7#g7 ,improv+ appropriate         
m$ication adh]5ce c\ld improve pati5t   
heal? outcomes1 r$uce heal? c>e co/s1 & 
lead to productivity ga9s4  #b4         
,national rese>* & report+ /rategy =    
improv$ m$ication adh]5ce ,"p ,a ( title
 ,,iii ( ! ,public ,heal? ,s]vice ,act  
7#db ,u4,s4,c4 #cda et seq47 is am5d$ by
 add+ at ! end ! foll[+3  #caj;,b4      
,national rese>* & report+ /rategy =    
improv$ m$ication adh]5ce  7a7 ,9 g5]al 
,! ,secret>y1 9 coord9ation ) !         
,adm9i/rator ( ! ,ag5cy = ,heal?c>e     
,rese>* & ,quality1 ! ,adm9i/rator ( !  

,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1 & !
 ,director ( ! ,c5t]s = ,disease        
,control & ,prev5tion1 %all report      
annual /ati/ics on m$ication adh]5ce1   
p>ticul>ly ) respect to individuals )   
*ronic diseases su* z c>diovascul>      
disease1 hyp]t5sion1 diabetes1          
autoimmune diseases1 *ronic ob/ructive  
pulmon>y disease1 & m5tal heal?         
conditions1 to bett] in=m decisionmak]s 
reg>d+--  7#a7 prim>y nonadh]5ce1       
includ+ among pati5ts newly prescrib$ "o
 or m m$ications at ! "t ( dis*>ge f an 
acute c>e sett+2  7#b7 m$ication        
p]si/5ce2  7#c7 relat$ quality measures 
) respect to m$ication & me?ods to      
improve m$ication adh]5ce & m$ication   
p]si/5ce2 &  7#d7 ! /rategies us$ by    
private /akehold]s to improve m$ication 
adh]5ce among individuals ) "o or m     
*ronic illnesses4  7b7 ,f$]al heal? c>e 
programs ,! rese>* conduct$1 & in=mation
 & /ati/ics develop$1 "u subsection 7a7 
7o!r ?an p>agraph 7#f7 ( su* subsection7
 %all be ) respect to individuals treat$

 "u ! foll[+ heal? c>e programs3  7#a7  
,! ,m$ic>e program "u title ,,xviii ( ! 
,social ,security ,act4  7#b7 ,!        
,m$icaid program "u title ,,xix ( !     
,social ,security ,act4  7#c7 ,! ,f$]al 
,employees ,heal? ,b5efits ,plan "u     
*apt] #hi ( title #e1 ,unit$ ,/ates     
,code4  7#d7 ,! ,,tric>e program "u     
*apt] #ee ( title #aj1 ,unit$ ,/ates    
,code4  7#e7 ,hospital c>e & m$ical     
s]vices furni%$ by ! ,dep>tm5t (        
,vet]ans ,affairs "u *apt]s #ag & #ah ( 
title #ch1 ,unit$ ,/ates ,code4  7c7    
,def9itions ,9 ?is section3 7#a7 ,! t]m 
m$ication adh]5ce means a pati5t tak+   
m$ications z prescrib$ by _! heal? c>e  
provid]1 :i* may include ! prescrib$    
dosage1 "t1 frequ5cy1 & direction4  7#b7
 ,! t]m m$ication p]si/5ce means ! act (
 cont9u+ treatm5t ) a m$ication = !     
prescrib$ duration4  7#c7 ,! t]m prim>y 
nonadh]5ce means ! failure to fill a    
newly prescrib$ m$ication4  7#d7 ,! t]m 
m$ication managem5t means m$ical c>e    
provid$ by a heal? c>e pr(essional to   

optimize drug !rapy & improve !rapeutic 
outcomes = pati5ts1 includ+ m$ication   
!rapy managem5t4  7d7 ,reports to       
,congress ,! ,secret>y %all submit to   
,congress an initial report on ! rese>* 
conduct$ "u ?is section n lat] ?an #a   
ye> aft] ! date ( enactm5t ( ?is        
section1 & an updat$ report n lat] ?an  
#e ye>s aft] submission ( su* initial   
report4  4  #c4 ,l9k+ ,m$ic>e           
prescription drug & p>ts ,a & ,b claims 
data ,section #ahfj;,d-#d7;c7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#ajd7;c77 is am5d$ by add+ at !  
end ! foll[+ new p>agraph3  7#e7 ,l9k+  
prescription drug & p>ts ,a & ,b claims 
data  7,a7 ,9 g5]al ,not)/&+ any o!r    
provision ( law1 subject to subp>agraph 
7,b71 effective = plan ye> #bjah & ea*  
subsequ5t plan ye>1 ! ,secret>y %all1 ^u
 reque/ by ! ,,pdp sponsor ( a          
prescription drug plan1 provide ! plan )
 enrollee claims data "u p>ts ,a & ,b1 9
 ord] to enable ! plan to see ! items & 
s]vices furni%$ to an enrollee "u su*   

p>ts & to provide great] context = !    
m$ication regim5 ( ! enrollee4  7,b7    
,requirem5ts ,! data describ$ 9         
subp>agraph 7,a7 %all1 z det]m9$ by !   
,secret>y1 be provid$ to a prescription 
drug plan on a regul> basis & 9 a =mat t
 is computable & accessible to assi/    
plan ef=ts 9 id5tify+ & support+ at-risk
 enrollees4  4  #d4 ,recogniz+ m$ication
 managem5t improves quality "u ,m$ic>e  
,advantage & ,prescription ,drug ,plans 
,section #aheg7;e7 ( ! ,social ,security
 ,act is am5d$-- 7#a7 9 p>agraph 7#d71  
by /rik+ ,if ! ,secret>y & ins]t+       
,subject to p>agraph 7#e71 if !         
,secret>y2 &  7#b7 by add+ at ! end !   
foll[+ new p>agraph3  7#e7 ,recogniz+   
m$ication managem5t improves quality ,= 
purposes ( calculat+ ! m9imum m$ical    
loss ratio "u p>agraph 7#d7 = a contract
 ye> 7beg9n+ ) #bjah71 ! ,secret>y %all 
include m$ication managem5t 7z def9$ 9  
section #caj;,b7c7 ( ! ,public ,heal?   
,s]vice ,act7 z "p ( activities t       
improve heal? c>e quality 7z describ$ ) 

respect to ,m$ic>e ,advantage plans &   
prescription drug plans 9 sections      
#dbb4bdcj & #dbc4bdcj1 respectively1 (  
title #db1 ,code ( ,f$]al ,regulations  
7or 9 any successor regulation774  4    
#e4 ,enhanc$ m$ication !rapy managem5t  
model = ,,ma-,,pd plans  ,section       
#aaae;,a7b77#b7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #acae;a7b77#b77 is  
am5d$-- 7#a7 9 subp>agraph 7,a71 by add+
 at ! end ! foll[+ new s5t5ce3 ,! models
 select$ "u ?is subp>agraph %all include
 ! model describ$ 9 subp>agraph 7,d71   
:i* %all be implem5t$ by n lat] ?an !   
date t is #a ye> aft] ! implem5tation ( 
! ,"p ,d ,enhanc$ ,m$ication ,!rapy     
,managem5t ,model1 z conduct$ by !      
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices )   
respect to /&-alone basic prescription  
drug plans42 &  7#b7 by add+ at ! end ! 
foll[+ new subp>agraph3  7,d7 ,enhanc$  
m$ication !rapy managem5t = ,,ma-,,pd   
plans  7i7 ,9 g5]al ,subject to clause  
7ii71 ! model describ$ 9 ?is subp>agraph
 is a model to te/1 ) respect to        

,,ma-,,pd plans 7z def9$ 9 section      
#ahfj;,d-#a7;a77#c77;,c771 a model =    
enhanc$ m$ication !rapy managem5t t is  
simil> to ! ,"p ,d ,enhanc$ ,m$ication  
,!rapy ,managem5t ,model1 z conduct$ by 
! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices ) 
respect to /&-alone basic prescription  
drug plans4  7ii7 ,no additional        
p]=mance paym5t ,"u ! model describ$ 9  
?is subp>agraph1 an ,,ma-,,pd plan 7z s 
def9$7 %all n receive any additional    
p]=mance paym5t 7o!r ?an any applicable 
p]c5tage quality increase o!rwise       
applicable = ! plan "u section          
#ahec7o774  4