,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #ffda  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #ca1 #bjah,mr4  
,pauls5 7= himself & ,ms4 ,e%oo7        
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 am5d title ,,xxvii ( !     
,public ,heal? ,s]vice ,act & title     
,,xviii ( ! ,social ,security ,act to   
prohibit heal? insurance issu]s1 gr\p   
heal? plans1 ,m$ic>e ,advantage         
organizations1 & prescription drug plan 
sponsors f limit+ drug price in=mation a
 ph>macy may give to a consum]4  #a4    
,%ort title ,?is ,act may be cit$ z !   
,true ,co/-%>+ ,( ,s5iors' drugs        
,transp>5cy ,act or ! ,,co/ ,act4  #b4  
,prohibit+ heal? insurance issu]s1 gr\p 
heal? plans1 ,m$ic>e ,advantage         
organizations1 & prescription drug plan 

sponsors f limit+ drug price in=mation a
 ph>macy may give to a consum]  7a7     
,heal? insurance issu]s & gr\p heal?    
plans ,! fir/ subp>t ,,ii ( "p ,a (     
title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg-#aa et     
seq47 is am5d$ by add+ at ! end ! foll[+
 new section3  #bgbi4 ,prohibition on   
provisions relat+ to ! communication (  
c]ta9 prescription drug price in=mation 
7a7 ,9 g5]al ,a gr\p heal? plan & a     
heal? insurance issu] (f]+ gr\p or      
individual heal? insurance cov]age may  
n1 ) respect to plan ye>s beg9n+ aft] ! 
date ! ,secret>y makes a det]m9ation    
specifi$ 9 subsection 7c71 prohibit a   
ph>macy f disclos+1 or p5alize su*      
ph>macy 7includ+ ?r\gh increas$         
utilization review1 r$uc$ paym5ts1 or   
o!r f9ancial dis9c5tives7 = disclos+1 to
 an individual pur*as+ a prescription   
drug us+ b5efits provid$ "u su* plan or 
su* cov]age alt]native me?ods ( pur*as+ 
su* drug1 includ+ pay+ a ca% price1 t   
may be *eap] ?an pay+ ! price ( a drug  

us+ su* b5efits4  7b7 ,consum] in=mation
  7#a7 ,9 g5]al ,a gr\p heal? plan & a  
heal? insurance issu] (f]+ gr\p or      
individual heal? insurance cov]age %all 
ensure t1 9 ! case t an applicable      
ph>macy 7z def9$ 9 p>agraph 7#b77 in=ms 
an individual ) heal? b5efits "u su*    
plan or su* cov]age ( alt]native me?ods 
( pur*as+ a drug1 includ+ pay+ a ca%    
price1 t may be *eap] ?an pay+ ! price (
 a drug us+ su* b5efits1 su* ph>macy    
also--  7,a7 in=ms su* individual (--   
7i7 ! effect s pur*as+ su* drug w\ld h  
on su* individual's d$uctible ) respect 
to su* plan or su* cov]age2 &  7ii7 o!r 
in=mation det]m9$ appropriate by !      
,secret>y = purposes ( enabl+ su*       
individual to make an in=m$ decision )  
respect to ! effects ( us+ su* b5efits  
or su* alt]native me?ods to pur*ase su* 
drug2 &  7,b7 9 ! case t su* individual 
pur*ases su* drug us+ su* alt]native    
me?ods1 reports to su* plan or su* issu]
 ! am\nt su* individual paid = su* drug 
us+ su* alt]native me?ods4  7#b7        

,def9ition ,9 ?is subsection1 ! t]m     
applicable ph>macy means1 ) respect to a
 gr\p heal? plan & a heal? insurance    
issu] (f]+ gr\p or individual heal?     
insurance cov]age1 a ph>macy ) :i* su*  
plan or su* issu] contracts ) "u su*    
plan or su* cov]age or t is o!rwise an  
9-network ph>macy "u su* plan or su*    
cov]age4  7c7 ,det]m9ation ,a           
det]m9ation specifi$ 9 ?is subsection is
 a det]m9ation by ! ,secret>y t a       
prohibition or p5alty describ$ 9        
subsection 7a7 is be+ us$ by a gr\p     
heal? plan or a heal? insurance issu]   
(f]+ gr\p or individual heal? insurance 
cov]age4  4  7b7 ,,ma organizations &   
,,pdp sponsors ,section #ahfj;,d-#d ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#ajd7 is am5d$ by add+ at ! end !
 foll[+ new subsection3  7m7            
,prohibition on limit+ c]ta9 in=mation  
on prescription drug prices  7#a7 ,9    
g5]al ,a ,,pdp sponsor ( a prescription 
drug plan & a ,m$ic>e ,advantage        
organization (f]+ an ,,ma-,,pd plan may 

n1 ) respect to plan ye>s beg9n+ aft] ! 
date ! ,secret>y makes a det]m9ation    
specifi$ 9 p>agraph 7#c71 prohibit a    
ph>macy f disclos+1 or p5alize su*      
ph>macy 7includ+ ?r\gh increas$         
utilization review1 r$uc$ paym5ts1 or   
o!r f9ancial dis9c5tives7 = disclos+1 to
 an individual pur*as+ a prescription   
drug us+ b5efits provid$ "u su*         
prescription drug plan or su* ,,ma-,,pd 
plan alt]native me?ods ( pur*as+ su*    
drug1 includ+ pay+ a ca% price1 t may be
 *eap] ?an pay+ ! price ( a drug us+ su*
 b5efits4  7#b7 ,consum] in=mation  7,a7
 ,9 g5]al ,a ,,pdp sponsor ( a          
prescription drug plan & a ,m$ic>e      
,advantage organization (f]+ an         
,,ma-,,pd plan %all ensure t1 9 ! case t
 an applicable ph>macy 7z def9$ 9       
subp>agraph 7,b77 in=ms an individual ) 
heal? b5efits "u su* prescription drug  
plan or su* ,,ma-,,pd plan ( alt]native 
me?ods ( pur*as+ a drug1 includ+ pay+ a 
ca% price1 t may be *eap] ?an pay+ !    
price ( a drug us+ su* b5efits1 su*     

ph>macy also--  7i7 in=ms su* individual
 (-- 7,i7 ! effect s pur*as+ su* drug   
w\ld h on su* individual's d$uctible )  
respect to su* prescription drug plan or
 su* ,,ma-,,pd plan2 &  7,,ii7 o!r      
in=mation det]m9$ appropriate by !      
,secret>y = purposes ( enabl+ su*       
individual to make an in=m$ decision )  
respect to ! effects ( us+ su* b5efits  
or su* alt]native me?ods to pur*ase su* 
drug2 &  7ii7 9 ! case t su* individual 
pur*ases su* drug us+ su* alt]native    
me?ods1 reports to su* sponsor or su*   
organization ! am\nt su* individual paid
 = su* drug us+ su* alt]native me?ods4  
7,b7 ,def9ition ,= purposes ( ?is       
p>agraph1 ! t]m applicable ph>macy      
means1 ) respect to a ,,pdp sponsor ( a 
prescription drug plan & a ,m$ic>e      
,advantage organization (f]+ an         
,,ma-,,pd plan1 a ph>macy ) :i* su*     
sponsor or su* organization contracts ) 
"u su* prescription drug plan or su*    
,,ma-,,pd plan or t is o!rwise an       
9-network ph>macy "u su* prescription   

drug plan or su* ,,ma-,,pd plan4  7#c7  
,det]m9ation ,a det]m9ation specifi$ 9  
?is p>agraph is a det]m9ation by !      
,secret>y t a prohibition or p5alty     
describ$ 9 p>agraph 7#a7 is be+ us$ by a
 ,,pdp sponsor ( a prescription drug    
plan or a ,m$ic>e ,advantage            
organization (f]+ an ,,ma-,,pd plan )   
respect to su* prescription drug plan or
 ,,ma-,,pd plan4  4  7c7 ,/udy (        
preval5ce ( ph>macy provision (         
in=mation prohibitions ,n lat] ?an #a   
ye> aft] ! date ( ! enactm5t ( ?is ,act1
 ! ,secret>y ( ,heal? & ,human ,s]vices 
79 ?is section ref]r$ to z ! ,secret>y7 
%all conduct a /udy & submit to         
,congress a report on ! preval5ce (     
prohibitions by--  7#a7 gr\p heal? plans
 & heal? insurance issu]s 7z su* t]ms   
are def9$ 9 section #bgia ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg-#ia772 &  7#b7 ,,ma             
organizations (f]+ ,,ma-,,pd plans &    
sponsors ( prescription drug plans2  on 
ph>macies f disclos+ alt]native prices (

 a drug to an individual pur*as+ su*    
drug at su* ph>macy us+ b5efits "u su*  
gr\p heal? plan1 su* heal? insurance    
cov]age1 su* ,,ma-,,pd plan1 or su*     
prescription drug plan 7z applicable74