,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #didf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,octob] #ca1 #bjai,mr4
 ,wel* 7= himself1 ,mr4 ,griffi?1 ,mr4  
,loebsack1 ,mr4 ,c>t] ( ,georgia1 ,mr4  
,gonzalez ( ,texas1 ,mr4 ,craw=d1 ,mr4  
,we/]man1 ,mr4 ,david ,p4 ,roe (        
,t5nessee1 ,mrs4 ,rodg]s ( ,wa%+ton1    
,mrs4 ,axne1 ,mr4 ,all51 & ,mr4         
,pet]son7 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      
,,xviii ( ! ,social ,security ,act to   
ensure equal access ( ,m$ic>e           
b5efici>ies to community ph>macies 9    
und]s]v$ areas z network ph>macies "u   
,m$ic>e prescription drug cov]age1 & =  
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,ensur+ ,s5iors ,access
 to ,local ,ph>macies ,act ( #bjai4  #b4

 ,all[+ any ,/ate lic5s$ ph>macy s]v+ an
 und]s]v$ area to become a network      
ph>macy "u ,m$ic>e prescription drug    
cov]age  7a7 ,9 g5]al ,section          
#ahfj;,d-#d7;b77#a77;,b7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;b77#a77;,b77 is am5d$--    
7#a7 by /rik+ ,disc\nts all[$ = network 
ph>macies4--,= & ins]t+ ! foll[+3       
8,disc\nts all[$ = network ph>macies4-- 
7i7 ,9 g5]al ,=  2 &  7#b7 by add+ at ! 
end ! foll[+ new clause3  7ii7          
,inclusion ( ph>macies locat$ 9 und]s]v$
 areas 9 networks ,= plan ye>s beg9n+ on
 or aft] ,janu>y #a1 #bjbj1 9 ! case ( a
 prescription drug plan t has1 9 its    
network ( ph>macies1 "o or m ph>macies  
locat$ 9 a heal? pr(essional %ortage    
area 7z def9$ 9 section                 
#ccb7;a77#a77;,a7 ( ! ,public ,heal?    
,s]vice ,act71 9 a m$ically und]s]v$    
area 7accord+ to a designation "u       
section #ccj7;b77#c77;,a7 ( ! ,public   
,heal? ,s]vice ,act71 among a m$ically  
und]s]v$ population 7z def9$ 9 su*      

section #ccj7;b77#c77;,a7 ( su* ,act71  
or 9 a rural area 7z def9$ by ! ,f$]al  
,(fice ( ,rural ,heal? ,policy71 & t    
provides a r$uction 9 co9surance or     
copaym5ts describ$ 9 clause 7i7 = cov]$ 
"p ,d drugs disp5s$ ?r\gh su* ph>macies1
 su* plan %all ext5d to any ph>macy     
locat$ 9 su* area or among su*          
population ! option to be an 9-network  
ph>macy ) respect to su* plan "u t]ms & 
conditions 7includ+ ! r$uctions describ$
 9 clause 7i77 comp>able to ^? ! plan   
has agre$ ^u ) o!r 9-network ph>macies  
locat$ 9 su* area or among su*          
population4  4  #c4 ,reasonable         
reimbursem5t requirem5ts ,section       
#ahfj;,d-#b7;d77#a77;,b7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7;d77#a77;,b77 is am5d$--    
7#a7 by /rik+ ,prices4--,= purposes &   
ins]t+ 8,prices4--  7i7 ,9 g5]al ,=     
purposes  2 &  7#b7 by add+ at ! end !  
foll[+ new clauses3  7ii7 ,reasonable   
reimbursem5t ,= plan ye>s beg9n+ on or  
aft] ,janu>y #a1 #bjbj1 a ,,pdp sponsor 

& a ,m$ic>e ,advantage organization %all
 ensure t--  7,i7 ea* prescription drug 
plan or ,,ma-,,pd plan (f]$ by ! sponsor
 or organization does n reimburse a     
ph>macy or ph>maci/ an am\nt less ?an ! 
am\nt t ! ph>macy b5efits manag]        
reimburses a ph>macy b5efits manag]     
affiliate 7z def9$ 9 clause 7iv77       
provid+ ! same ph>maci/ s]vices2 &      
7,,ii7 9 no case may ! negotiat$ price =
 a cov]$ "p ,d drug furni%$ by a ph>macy
 "u a prescription drug plan or         
,,ma-,,pd plan (f]$ by ! sponsor or     
organization1 be less ?an su* ph>macy's 
co/ ( pur*as+ & disp5s+ su* drug &      
provid+ su* o!r s]vices associat$ )     
furni%+ su* drug z may be specifi$ by ! 
,secret>y4  7iii7 ,claim reimbursem5t   
disclosure requirem5ts ,) respect to    
paym5t made by a ,,pdp sponsor or a     
,m$ic>e ,advantage organization to a    
ph>macy = a cov]$ "p ,d drug furni%$ by 
su* ph>macy dur+ a plan ye> beg9n+ on or
 aft] ,janu>y #a1 #bjbj1 su* sponsor or 
organization %all promptly furni% all   

pric+ compon5ts includ+ ! ,network      
,reimbursem5t ,,id us$ to price ! claim1
 any fees1 ph>macy price concessions1   
disc\nts1 subsidies1 rebates1 inc5tives1
 or any o!r =ms ( direct or indirect    
remun]ation t affect paym5t & pric+ ( ! 
claim z "p ( ! claim adjudication       
response at ! po9t-( sale4 ,all pric+   
compon5ts describ$ 9 ! prec$+ s5t5ce    
%all ea* be id5tifi$ 9 a pr$et]m9$ l9e  
item 9 ! remittance advice t is /&>d    
across ! indu/ry4 ,! ,,pdp sponsor or   
,m$ic>e ,advantage organization %all    
include suitable claim-level detail on !
 electronic remittance advice t         
accompanies ea* paym5t4 ,?is claim-level
 detail %all include1 9 an indu/ry      
/&>diz$ =mat1 all fields ne$$ to prop]ly
 id5tify ! claim1 includ+ ! ,claim      
,au?orization ,numb]1 date ( s]vice1    
date ( paym5t remittance1 +r$i5t co/    
reimburs$1 disp5s+ fee reimburs$1 paym5t
 am\nts includ+ ! ,network ,,id us$ to  
price ! claim1 ! specific doll> am\nts &
 ! appropriate qualifi] codes = ea*     

paym5t adju/m5t includ+ fees1 ph>macy   
price concessions1 or inc5tives4  7iv7  
,ph>macy b5efits manag] affiliate def9$ 
,= purposes ( clause 7ii71 ! t]m ph>macy
 b5efits manag] affiliate means a       
ph>macy or ph>maci/ t directly or       
indirectly1 ?r\gh "o or m int]m$i>ies1  
owns or controls1 is own$ or controll$  
by1 or is "u common own]%ip or control )
 a ph>macy b5efits manag]4  4