,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #fgcc  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #g1         
#bjah,mr4 ,c>t] ( ,georgia 7= himself1  
,mr4 ,pauls51 ,mr4 ,doggett1 ,mr4 ,wel*1
 ,mrs4 ,mc,morris ,rodg]s1 ,ms4 ,e%oo1  
,mr4 ,griffi?1 ,mrs4 ,d+ell1 ,mr4       
,burgess1 & ,mr4 ,g5e ,gre5 ( ,texas7   
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 gr\p heal? plans1 heal?        
insurance issu]s1 prescription drug plan
 sponsors1 & ,m$ic>e ,advantage         
organizations f limit+ c]ta9 in=mation  
on drug prices4  #a4 ,%ort title ,?is   
,act may be cit$ z ! ,"k ! ,co/ ,act (  
#bjah4  #b4 ,prohibition on limit+ c]ta9

 in=mation on drug prices  7a7 ,9 g5]al 
7#a7 ,gr\p heal? plans & heal? insurance
 issu]s ,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[+3  #bgbi4
 ,in=mation on prescription drugs  7a7  
,9 g5]al ,a gr\p heal? plan or a heal?  
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age %all--  7#a7 n  
re/rict1 directly or indirectly1 any    
ph>macy t disp5ses a prescription drug  
to an enrollee 9 ! plan or cov]age f    
in=m+ 7or p5alize su* ph>macy = in=m+7  
an enrollee ( any diff]5tial betwe5 !   
enrollee's out-(-pocket co/ "u ! plan or
 cov]age ) respect to acquisition ( !   
drug & ! am\nt an individual w\ld pay = 
acquisition ( ! drug )\t us+ any heal?  
plan or heal? insurance cov]age2 &  7#b7
 ensure t any entity t provides ph>macy 
b5efits managem5t s]vices "u a contract 
) any su* heal? plan or heal? insurance 
cov]age does n1 ) respect to su* plan or
 cov]age1 re/rict1 directly or          

indirectly1 a ph>macy t disp5ses a      
prescription drug f in=m+ 7or p5alize   
su* ph>macy = in=m+7 an enrollee ( any  
diff]5tial betwe5 ! enrollee's          
out-(-pocket co/ "u ! plan or cov]age ) 
respect to acquisition ( ! drug & !     
am\nt an individual w\ld pay =          
acquisition ( ! drug )\t us+ any heal?  
plan or heal? insurance cov]age4  7b7   
,def9ition ,= purposes ( ?is section1 ! 
t]m out-(-pocket co/1 ) respect to      
acquisition ( a drug1 means ! am\nt to  
be paid by ! enrollee "u ! plan or      
cov]age1 includ+ any co/-%>+ 7includ+   
any d$uctible1 copaym5t1 or co9surance7 
&1 z det]m9$ by ! ,secret>y1 any o!r    
exp5diture4  4  7#b7 ,prescription drug 
plan sponsors & ,m$ic>e ,advantage      
organizations ,section #ahfj;,d-#d ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#ajd7 is am5d$ by add+ at ! end !
 foll[+ new subsection3  7m7            
,prohibition on limit+ c]ta9 in=mation  
on drug prices ,a ,,pdp sponsor & a     
,m$ic>e ,advantage organization %all    

ensure t ea* prescription drug plan or  
,,ma-,,pd plan (f]$ by ! sponsor or     
organization does n re/rict a ph>macy t 
disp5ses a prescription drug or         
biological f in=m+1 nor p5alize su*     
ph>macy = in=m+1 an enrollee 9 su* plan 
( any diff]5tial betwe5 ! negotiat$     
price (1 or copaym5t or co9surance =1 ! 
drug or biological to ! enrollee "u !   
plan & a l[] price ! individual w\ld pay
 = ! drug or biological if ! enrollee   
obta9$ ! drug )\t us+ any heal?         
insurance cov]age4  4  7#c7 ,effective  
date ,! am5dm5ts made by ?is subsection 
%all apply ) respect to plan ye>s beg9n+
 on or aft] ,janu>y #a1 #bjbj4  7b7     
,m$ic>e b5efici>y notice requirem5ts    
7#a7 ,annual notice requirem5t ,section 
#ahjd7;c7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;b-#b7;c77 is       
am5d$-- 7,a7 9 p>agraph 7#c71 by /rik+ &
 at ! end2  7,b7 9 p>agraph 7#d71 by    
/rik+ ! p]iod at ! end & ins]t+ 2 &2 &  
7,c7 by add+ at ! end ! foll[+ new      
p>agraph3  7#e7 ) respect to a notice   

provid$ on or aft] ,janu>y #a1 #bjbj1 & 
an individual enroll$ 9 a prescription  
drug plan "u "p ,d or an ,,ma-,,pd plan 
"u "p ,c1 in=mation on ! pot5tial       
effects pur*as+ a drug )\t us+ b5efits  
provid$ "u su* prescription drug plan or
 ,,ma-,,pd plan may h on su*            
individual's d$uctible & future co/-%>+ 
obligations "u su* prescription drug    
plan or ,,ma-,,pd plan4  4  7#b7 ,,ma   
organization & ,,pdp sponsor disclosures
  7,a7 ,9 g5]al ,section #aheb7;c77#a7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciew-#bb7;c77#a77 is am5d$ by add+ at
 ! end ! foll[+ new subp>agraph3  7,j7  
,drug pur*as+ in=mation ,) respect to an
 enrollee 9 an ,,ma-,,pd plan1 in=mation
 9 a =m & mann] specifi$ by ! ,secret>y 
on ! pot5tial effects pur*as+ a drug )\t
 us+ b5efits provid$ "u su* plan may h  
on su* individual's d$uctible & future  
co/-%>+ obligations "u su* plan4  4     
7,b7 ,effective date ,! am5dm5t made by 
?is p>agraph %all apply ) respect to    
disclosures made on or aft] ,janu>y #a1 

#bjbj4