,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #ggaf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #ai1 #bjbd,mr4   
,gallego 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   
provide = en=cem5t ( /&>ds = reasonable 
& relevant contract t]ms & conditions & 
ess5tial retail ph>macy protections "u !
 ,m$ic>e program4  #a4 ,provid+ =       
en=cem5t ( /&>ds = reasonable & relevant
 contract t]ms & conditions & ess5tial  
retail ph>macy protections "u ! ,m$ic>e 
program  7a7 ,9 g5]al ,section          
#ahfj;,d-#d7;b77#a7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;b77#a77 is am5d$ by add+ at
 ! end ! foll[+ new subp>agraph3  7,f7  
,en=cem5t ( /&>ds = reasonable &        

relevant contract t]ms & conditions &   
ess5tial retail ph>macy protections  7i7
 ,allegation submission process  7,i7 ,9
 g5]al ,n lat] ?an ,janu>y #a1 #bjbh1 ! 
,secret>y %all e/abli% a process ?r\gh  
:i* a ph>macy may submit an allegation (
 a violation by a ,,pdp sponsor (f]+ a  
prescription drug plan (--  7aa7 ! /&>ds
 = reasonable & relevant contract t]ms &
 conditions "u subp>agraph 7,a77ii72 or 
7bb7 ! requirem5ts = total reimbursem5t 
= ess5tial retail ph>macies t are       
indep5d5t community ph>macies "u        
subp>agraph 7,c77v77,,ii74  7,,ii7      
,frequ5cy ( submission  7aa7 ,violations
 ( reasonable & relevant contract t]ms &
 conditions  7,,aa7 ,9 g5]al ,except z  
provid$ 9 subitem 7,,bb71 ! allegation  
submission process "u ?is clause %all   
all[ ph>macies to submit any allegations
 ( violations describ$ 9 item 7aa7 (    
subclause 7,i7 n m frequ5tly ?an once p]
 plan ye> p] contract betwe5 a ph>macy &
 a ,,pdp sponsor4 7,,bb7 ,allegations   
relat+ to contract *anges ,9 ! case :]e 

a contract is am5d$ or o!rwise updat$   
foll[+ ! submission ( allegations by a  
ph>macy ) respect to su* contract & plan
 ye>1 ! allegation submission process "u
 ?is clause %all all[ su* ph>macy to    
submit an additional allegation relat$  
to ^? *anges ) respect to su* contract &
 plan ye>4 7,,cc7 ,submissions          
,submissions ( any allegations "u ?is   
item %all be sep>ate f any submissions  
"u item 7bb7 & may include multiple     
allegations ( su* violations4  7bb7     
,violations ( ess5tial retail ph>macy   
protections 7,,aa7 ,9 g5]al ,!          
allegation submission process "u ?is    
clause %all all[ ess5tial retail        
ph>macies t are indep5d5t community     
ph>macies to submit any allegations (   
violations describ$ 9 item 7bb7 (       
subclause 7,i7 once p] cal5d> qu>t]4    
7,,bb7 ,submissions ,submissions ( any  
allegations "u ?is item %all be sep>ate 
f any submissions "u item 7aa7 & may    
include multiple allegations ( su*      
violations4  7,,iii7 ,access to relevant

 docum5ts & mat]ials ,a ,,pdp sponsor   
subject to an allegation "u ?is clause--
  7aa7 %all provide docum5ts or         
mat]ials1 z specifi$ by ! ,secret>y1    
includ+ contract (f]s made by su*       
sponsor to su* ph>macy or correspond5ce 
relat$ to su* (f]s1 to ! ,secret>y at a 
"t & 9 a =m & mann] specifi$ by !       
,secret>y2 &  7bb7 %all n prohibit or   
o!rwise limit ! ability ( a ph>macy to  
submit su* docum5ts or mat]ials to !    
,secret>y = ! purpose ( submitt+ an     
allegation or provid+ evid5ce = su* an  
allegation "u ?is clause4  7,,iv7       
,/&>diz$ template ,! ,secret>y %all     
e/abli% sep>ate /&>diz$ templates =     
ph>macies to use = ! submission (       
allegations describ$ 9 items 7aa7 & 7bb7
 ( subclause 7,i74 ,ea* su* template    
%all require t ! submission include a   
c]tification by ! ph>macy t ! in=mation 
includ$ is accurate1 complete1 & true to
 ! be/ ( ! k1 in=mation1 & belief ( su* 
ph>macy4  7,v7 ,prev5t+ frivol\s        
allegations ,9 ! case :]e ! ,secret>y   

det]m9es t a ph>macy has submitt$       
frivol\s allegations "u ?is clause on a 
r\t9e basis1 ! ,secret>y may tempor>ily 
prohibit su* ph>macy f us+ ! allegation 
submission process "u ?is clause1 z     
det]m9$ appropriate by ! ,secret>y4     
7,,vi7 ,exemption f fre$om ( in=mation  
act ,allegations submitt$ "u ?is clause 
%all be exempt f disclosure "u section  
#eeb ( title #e1 ,unit$ ,/ates ,code4   
7ii7 ,inve/igation ,! ,secret>y %all    
inve/igate1 z det]m9$ appropriate by !  
,secret>y1 allegations submitt$ pursuant
 to clause 7i74  7iii7 ,en=cem5t  7,i7  
,reasonable & relevant contract t]ms &  
conditions ,9 ! case :]e ! ,secret>y    
det]m9es t a ,,pdp sponsor (f]+ a       
prescription drug plan has violat$ !    
/&>ds = reasonable & relevant contract  
t]ms & conditions "u subp>agraph        
7,a77ii71 ! ,secret>y %all use exi/+    
au?orities "u sections #aheg7;g7 &      
#ahfj;,d-#ab7;b77#c77;,e7 to impose     
civil monet>y p5alties or take o!r      
en=cem5t actions4  7,,ii7 ,ess5tial     

retail ph>macy protections ,9 ! case :]e
 ! ,secret>y det]m9es t a ,,pdp sponsor 
(f]+ a prescription drug plan has       
violat$ ! requirem5ts = total           
reimbursem5t = ess5tial retail ph>macies
 t are indep5d5t community ph>macies "u 
subp>agraph 7,c77v77,,ii71 ! ,secret>y  
%all--  7aa7 if ! am\nt ( total         
reimbursem5t paid by ! sponsor to an    
ess5tial retail ph>macy t is an         
indep5d5t community ph>macy = a cov]$ "p
 ,d drug 0 less ?an ! am\nt ( total     
reimbursem5t requir$ to be paid to !    
ph>macy "u subp>agraph 7,c77v77,,ii7 =  
su* drug1 require ! ,,pdp sponsor to pay
 to ! ph>macy an am\nt equal to !       
diff]5ce betwe5 su* am\nts2 &  7bb7 use 
exi/+ au?orities "u section #aheg7;g7 & 
#ahfj;,d-#ab7;b77#c77;,e7 to impose     
civil monet>y p5alties or take o!r      
en=cem5t actions4  7,,iii7 ,application 
( civil monet>y p5alties ,! provisions (
 section #aabh;,a 7o!r ?an subsections  
7a7 & 7b77 %all apply to a civil monet>y
 p5alty "u ?is clause 9 ! same mann] z  

su* provisions apply to a p5alty or     
proce$+ "u section #aabh;,a7a74  7iv7   
,def9itions ,9 ?is subp>agraph1 ! t]ms  
ess5tial retail ph>macy1 indep5d5t      
community ph>macy1 & total reimbursem5t 
h ! mean+ giv5 ^? t]ms 9 subp>agraph    
7,c77v74  4  7b7 ,con=m+ am5dm5t        
,section #aheg7;g77#a7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#bg7;g77#a77 is am5d$-- 7#a7 9   
subp>agraph 7,j71 by /rik+ or aft] !    
semicolon2  7#b7 by r$esignat+          
subp>agraph 7,k7 z subp>agraph 7,l72    
7#c7 by ins]t+ aft] subp>agraph 7,j71 ! 
foll[+ new subp>agraph3  7,k7 fails to  
comply )-- 7i7 ! /&>ds = reasonable &   
relevant contract t]ms & conditions "u  
subp>agraph 7,a77ii7 ( section          
#ahfj;,d-#d7;b77#a72 or  7ii7 !         
requirem5ts = total reimbursem5t =      
ess5tial retail ph>macies t are         
indep5d5t community ph>macies "u        
subp>agraph 7,c77v77,,ii7 ( su* section2
 or  2  7#d7 9 subp>agraph 7,l71 z      
r$esignat$ by subp>agraph 7,b71 by /rik+

 ?r\gh 7,j7 & ins]t+ ?r\gh 7,k72 &  7#e7
 9 ! flu% matt] foll[+ subp>agraph 7,l71
 z s r$esignat$1 by /rik+ subp>agraphs  
7,a7 ?r\gh 7,k7 & ins]t+ subp>agraphs   
7,a7 ?r\gh 7,l74