,,ib ,union ,cal5d> ,no4 #fbh #aah?     
,,congress  #b;d ,session  ,h4 ,r4 #cbij
 ,report ,no4 #aah-geg ,,9 ,,! ,,h\se   
,,( ,,repres5tatives  ,may #ae1         
#bjbc,mr4 ,buc%on introduc$ ! foll[+    
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce  ,novemb] #bj1        
#bjbd,report$ ) an am5dm5t1 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 
( ! ,union1 & ord]$ to be printed,strike
 out all aft] ! enact+ clause & ins]t ! 
"p pr9t$ 9 italic,for text ( introduc$  
bill1 see copy ( bill z introduc$ on    
,may #ae1 #bjbc  ,a ,,bill  ,to am5d    
title ,,iii ( ! ,public ,heal? ,s]vice  
,act to ensure transp>5cy & ov]sight ( !
 #cdj;,b drug disc\nt program4  #a4     
,%ort title ,?is ,act may be cit$ z !   
#cdj;,b ,transp>5cy ,act4  #b4 ,ensur+  
transp>5cy & ov]sight ( ! #cdj;,b drug  
disc\nt program  7a7 ,9 g5]al ,section  
#cdj;,b7a77#e7 ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4             
#bef;b7a77#e77 is am5d$-- 7#a7 9        
subp>agraph 7,c7-- 7,a7 by /rik+ ,a     

cov]$ entity %all p]mit & ins]t+3  7i7  
,duplicate disc\nts & drug resale ,a    
cov]$ entity %all p]mit  2 &  7,b7 by   
add+ at ! end ! foll[+ new clauses3     
7ii7 ,use ( sav+s ,a cov]$ entity %all  
p]mit ! ,secret>y to audit1 at !        
,secret>y's exp5se1 ! records ( ! entity
 to det]m9e-- 7,i7 h[ sav+s 7z def9$ 9  
subp>agraph 7,e77iv77 f cov]$ outpati5t 
drugs subject to an agreem5t "u ?is     
section furni%$ by su* entity are us$ by
 su* entity2 &  7,,ii7 su* entity's     
compliance ) subp>agraph 7,e74  7iii7   
,records ret5tion ,cov]$ entities %all  
reta9 su* records & provide su* records 
& reports z det]m9$ necess>y by !       
,secret>y = c>ry+ out ?is subp>agraph4  
2 &  7#b7 by add+ at ! end ! foll[+ new 
subp>agraph3  7,e7 ,report+  7i7 ,9     
g5]al ,dur+ ! fir/ ye> beg9n+ on or aft]
 ! date t is #ad mon?s aft] ! date (    
enactm5t ( ?is subp>agraph & dur+ ea*   
subsequ5t ye>1 ea* cov]$ entity describ$
 9 subp>agraph 7,l7 ( p>agraph 7#d7 7&  
any o!r cov]$ entity specifi$ by !      

,secret>y7 %all report to ! ,secret>y   
7at a "t & 9 a =m & mann] specifi$ by ! 
,secret>y7 ! foll[+ in=mation ) respect 
to ! prec$+ ye>3 7,i7 ,) respect to su* 
cov]$ entity & ea* (f-campus outpati5t  
dep>tm5t1 z applicable1 ( su* entity--  
7aa7 ! total numb] ( individuals :o 7   
disp5s$ or adm9i/]$ cov]$ outpati5t     
drugs dur+ su* prec$+ ye> t 7 subject to
 an agreem5t "u ?is section2 &  7bb7 !  
numb] ( su* individuals describ$ 9 a    
category specifi$ 9 clause 7iv71 brok5  
d[n by ea* su* category4  7,,ii7 ,)     
respect to su* cov]$ entity & ea*       
(f-campus outpati5t dep>tm5t1 z         
applicable1 ( su* entity-- 7aa7 !       
p]c5tage ( ! total numb] ( individuals  
furni%$ items & s]vices dur+ su* prec$+ 
ye> :o 7 disp5s$ or adm9i/]$ cov]$      
outpati5t drugs dur+ su* prec$+ ye> t 7 
subject to an agreem5t "u ?is section2 &
  7bb7 = ea* category specifi$ 9 clause 
7iii71 ! p]c5tage ( ! total numb] (     
individuals describ$ 9 su* category     
furni%$ items & s]vices dur+ su* prec$+ 

ye> :o 7 disp5s$ or adm9i/]$ cov]$      
outpati5t drugs dur+ su* prec$+ ye> t 7 
subject to an agreem5t "u ?is section4  
7,,iii7 ,) respect to su* cov]$ entity &
 ea* (f-campus outpati5t dep>tm5t1 z    
applicable1 ( su* entity1 ! total co/s  
incurr$ dur+ ! ye> at ea* su* site & !  
co/ incurr$ at ea* su* site = *>ity c>e 
7z def9$ 9 l9e #bc ( work%eet ,s-#aj to 
! ,m$ic>e co/ report1 or 9 any successor
 =m74  7,,iv7 ,) respect to su* cov]$   
entity & ea* (f-campus outpati5t        
dep>tm5t1 z applicable1 ( su* entity1 ! 
co/s incurr$ dur+ ! ye> ( furni%+ items 
& s]vices at ea* su* dep>tm5t to pati5ts
 ( su* entity :o 7 entitl$ to b5efits "u
 "p ,a ( title ,,xviii ( ! ,social      
,security ,act or enroll$ "u "p ,b ( su*
 title1 enroll$ 9 a ,/ate plan "u title 
,,xix ( su* ,act 7or a waiv] ( su*      
plan71 or :o 7 un9sur$ = s]vices1 m9us !
 sum (-- 7aa7 paym5ts "u title ,,xviii (
 su* ,act = su* items & s]vices 7includ+
 any co/ %>+ = su* items & s]vices72    
7bb7 paym5ts "u title ,,xix ( su* ,act =

 su* items & s]vices 7includ+ any co/   
%>+ = su* items & s]vices72 &  7cc7     
paym5ts by un9sur$ pati5ts = su* items &
 s]vices4  7,v7 ,) respect to su* cov]$ 
entity & ea* (f-campus outpati5t        
dep>tm5t1 z applicable1 ( su* entity1   
sav+s 7z def9$ 9 clause 7iv77 f cov]$   
outpati5t drugs subject to an agreem5t  
"u ?is section furni%$ by su* entity or 
dep>tm5t4  7ii7 ,publication ,!         
,secret>y %all publi% data report$ "u   
clause 7i7 ) respect to a ye> annually  
on ! public website ( ! ,dep>tm5t (     
,heal? & ,human ,s]vices 9 an electronic
 & se>*able =mat1 :i* may include !     
#cdj;,b ,(fice ( ,ph>macy ,affairs      
,in=mation ,sy/em 7or a successor to su*
 sy/em71 9 a mann] t %[s ea* category ( 
data report$ 9 ! aggregate & id5tifi$ by
 ! specific cov]$ entity submitt+ su*   
data4 ,! ,secret>y %all include 9 su*   
publication ! disproportionate pati5t   
p]c5tage 7z def9$ 9 section             
#ahhf7;d77#e77;,f77vi7 ( ! ,social      
,security ,act7 ( ea* su* cov]$ entity  

7if applicable7 = ea* co/ report+ p]iod 
occurr+ dur+ su* ye>4  7iii7 ,categories
 specifi$ ,= purposes ( clause 7i71 !   
categories specifi$ 9 ?is clause are !  
foll[+3 7,i7 ,individuals cov]$ "u a    
gr\p heal? plan or gr\p or individual   
heal? insurance cov]age 7z su* t]ms are 
def9$ 9 section #bgia74  7,,ii7         
,individuals entitl$ to b5efits "u "p ,a
 or enroll$ "u "p ,b ( title ,,xviii ( !
 ,social ,security ,act4  7,,iii7       
,individuals enroll$ "u a ,/ate plan "u 
title ,,xix ( su* ,act 7or a waiv] ( su*
 plan74  7,,iv7 ,individuals enroll$ "u 
a ,/ate *ild heal? plan "u title ,,xxi (
 su* ,act 7or a waiv] ( su* plan74  7,v7
 ,individuals n describ$ 9 any prec$+   
subclause & n cov]$ "u any ,f$]al heal? 
c>e program 7z def9$ 9 section #aabh;,b 
( su* ,act b includ+ ! program e/abli%$ 
"u *apt] #hi ( title #e1 ,unit$ ,/ates  
,code74  7iv7 ,def9itions ,= purposes ( 
?is subp>agraph3 7,i7 ,(f-campus        
outpati5t dep>tm5t ,! t]m (f-campus     
outpati5t dep>tm5t means a dep>tm5t ( a 

provid] 7z def9$ 9 section #dac4fe (    
title #db1 ,code ( ,f$]al ,regulations1 
or any successor regulation7 t is n     
locat$-- 7aa7 on ! campus 7z def9$ 9 su*
 section7 ( su* provid]2 or  7bb7 )9 !  
di/ance 7describ$ 9 su* def9ition (     
campus7 f a remote location ( a hospital
 facility 7z def9$ 9 su* section74      
7,,ii7 ,sav+s ,! t]m sav+s means1 )     
respect to a cov]$ outpati5t drug       
pur*as$ by a cov]$ entity1 ! diff]5ce   
betwe5-- 7aa7 ! price = su* drug t su*  
entity w\ld h o!rwise paid = su* drug   
obta9$ ?r\gh a gr\p pur*as+ organization
 or o!r gr\p pur*as+ arrangem5t _h !    
requirem5t describ$ 9 p>agraph          
7#d77,l77iii7 n appli$ 7or1 9 ! case su*
 entity w\ld n h obta9$ cov]$ outpati5t 
drugs ?r\gh su* an organization or      
arrangem5t _h su* requirem5t n appli$ or
 in=mation to det]m9e su* price t su*   
entity w\ld h s o!rwise paid is n       
available1 ! :olesale acquisition co/ 7z
 def9$ 9 section #ahdg;,a7c77#f77;,b7 ( 
! ,social ,security ,act7 = su* drug72 &

  7bb7 ! ceil+ price = su* drug4  4  7b7
 ,en=cem5t ,section #cdj;,b7d77#b77;,b7 
( ! ,public ,heal? ,s]vice ,act 7#db    
,u4,s4,c4 #bef;b7d77#b77;,b77 is am5d$  
by add+ at ! end ! foll[+ new clause3   
7vi7 ,! imposition ( civil monet>y      
p5alties 9 am\nts det]m9$ appropriate by
 ! ,secret>y 9 ! case t ! ,secret>y     
det]m9es t a cov]$ entity is n 9        
compliance ) subsection 7a77#e77;,e7 4  
4  7c7 ,rulemak+ ,n lat] ?an #ahj days  
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,heal? & ,human ,s]vices    
%all issue an int]im f9al rule to c>ry  
out section #cdj;,b7a77#e77;,e7 ( !     
,public ,heal? ,s]vice ,act1 z add$ by  
subsection 7a77#b74  ,novemb] #bj1      
#bjbd,report$ ) an am5dm5t1 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 
( ! ,union1 & ord]$ to be pr9t$