,,ii  #aah? ,,congress  #a/ ,session    
,s4 #aaca  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #cj1 #bjbc,mr4    
,braun 7= himself & ,mrs4 ,hyde-,smi?7  
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d title ,,xi ( !      
,social ,security ,act & title ,,xxvii (
 ! ,public ,heal? ,s]vice ,act to       
e/abli% requirem5ts ) respect to        
prescription drug b5efits4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,drug   
,price ,transp>5cy ,act ( #bjbc4  #b4   
,requirem5ts = prescription drug b5efits
  7a7 ,removal ( safe h>bor protection =
 rebates involv+ prescription drugs &   
e/abli%m5t ( new safe h>bor protections 
involv+ prescription drugs  7#a7        
,removal ( safe h>bor protection =      
rebates involv+ prescription drugs      
,section #aabh;,b7b7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#acbj;a-#g;b7b77 is am5d$-- 7,a7 9      
p>agraph 7#c77;,a71 by /rik+ a disc\nt &

 ins]t+ subject to p>agraph 7#e71 a     
disc\nt2 &  7,b7 by add+ at ! end !     
foll[+3  7#e7 ,removal ( safe h>bor     
protection = rebates involv+            
prescription drugs ,! safe h>bor        
describ$ 9 p>agraph 7#c77;,a7 %all n    
apply to a r$uction 9 price or o!r      
remun]ation f a manufactur] (           
prescription drugs to a sponsor ( a     
prescription drug plan "u "p ,d ( title 
,,xviii1 an ,,ma organization (f]+ an   
,,ma-,,pd plan "u "p ,c ( su* title1 or 
a ph>macy b5efit manag] "u contract )   
su* a sponsor or su* an organization &1 
except z provid$ 9 subp>agraphs 7,m7 &  
7,n7 ( p>agraph 7#c71 p>agraphs 7#a7 &  
7#b7 %all apply to any su* r$uction 9   
price or o!r remun]ation4  4  7#b7      
,e/abli%m5t ( new safe h>bor protections
 involv+ prescription drugs ,section    
#aabh;,b7b77#c7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #acbj;a-#g;b7b77#c77
 is am5d$-- 7,a7 9 subp>agraph 7,k71 by 
/rik+ & at ! end2  7,b7 9 subp>agraph   
7,l71 by /rik+ ! p]iod at ! end & ins]t+

 a semicolon2 &  7,c7 by add+ at ! end !
 foll[+3  7,m7 a r$uction 9 price (f]$  
by a manufactur] ( prescription drugs to
 a sponsor ( a prescription drug plan "u
 "p ,d ( title ,,xviii1 an ,,ma         
organization (f]+ an ,,ma-,,pd plan "u  
"p ,c ( su* title1 or a ph>macy b5efit  
manag] "u contract ) su* a sponsor or   
su* an organization1 t is reflect$ at ! 
po9t ( sale to ! individual & meets su* 
o!r conditions z ! ,secret>y may        
e/abli%2 &  7,n7 flat fee s]vice fees a 
manufactur] ( prescription drugs pays to
 a ph>macy b5efit manag] = s]vices r5d]$
 to ! manufactur] t relate to           
arrangem5ts by ! ph>macy b5efit manag]  
to provide ph>macy b5efit managem5t     
s]vices to a heal? plan1 if c]ta9       
conditions e/abli%$ by ! ,secret>y are  
met1 includ+ requirem5ts t ! fees are   
transp>5t to ! heal? plan4  4  7#c7     
,effective date ,! am5dm5ts made by ?is 
subsection %all take effect on ,janu>y  
#a1 #bjbd4  7b7 ,requirem5ts = private  
insurance plans  7#a7 ,9 g5]al ,"p ,d ( 

title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa et    
seq47 is am5d$ by add+ at ! end !       
foll[+3  #bgii;,a-#aa4 ,requirem5ts )   
respect to prescription drug b5efits    
7a7 ,9 g5]al ,a gr\p heal? plan or a    
heal? insurance issu] (f]+ gr\p or      
individual heal? insurance cov]age %all 
n1 & %all 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 receive f a   
drug manufactur] a r$uction 9 price or  
o!r remun]ation ) respect to any        
prescription drug receiv$ by an enrollee
 9 ! plan or cov]age & cov]$ by ! plan  
or cov]age1 unless-- 7#a7 any su*       
r$uction 9 price is reflect$ at ! po9t (
 sale to ! enrollee & meets su* o!r     
conditions z ! ,secret>y may e/abli%2 & 
7#b7 any su* o!r remun]ation is a flat  
fee-bas$ s]vice fee t a manufactur] (   
prescription drugs pays to an entity t  
provides ph>macy b5efits managem5t      
s]vices = s]vices r5d]$ to ! manufactur]

 t relate to arrangem5ts by ! ph>macy   
b5efit manag] to provide ph>macy b5efit 
managem5t s]vices to a heal? plan or    
heal? insurance issu]1 if c]ta9         
conditions e/abli%$ by ! ,secret>y are  
met1 includ+ requirem5ts t ! fees are   
transp>5t to ! heal? plan or heal?      
insurance issu]4  7b7 ,entity t provides
 ph>macy b5efits managem5t s]vices ,=   
purposes ( ?is section1 ! t]m entity t  
provides ph>macy b5efits managem5t      
s]vices means-- 7#a7 any p]son1 bus9ess1
 or o!r entity t1 pursuant to a writt5  
agreem5t ) a gr\p heal? plan or a heal? 
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age1 directly or    
?r\gh an int]m$i>y-- 7,a7 acts z a price
 negotiator on behalf ( ! plan or       
cov]age2 or  7,b7 manages ! prescription
 drug b5efits provid$ by ! plan or      
cov]age1 :i* may include ! process+ &   
paym5t ( claims = prescription drugs1 ! 
p]=mance ( drug utilization review1 !   
process+ ( drug prior au?orization      
reque/s1 ! adjudication ( appeals or    

grievances relat$ to ! prescription drug
 b5efit1 contract+ ) network ph>macies1 
controll+ ! co/ ( cov]$ prescription    
drugs1 or ! provision ( relat$ s]vices2 
or  7#b7 any entity t is own$1          
affiliat$1 or relat$ "u a common own]%ip
 /ructure ) a p]son1 bus9ess1 or entity 
describ$ 9 p>agraph 7#a74  4  7#b7      
,,erisa  7,a7 ,9 g5]al ,subp>t ,b ( "p  
#g ( subtitle ,b ( title ,i ( !         
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe et    
seq47 is am5d$ by add+ at ! end !       
foll[+3  #gbf4 ,requirem5ts ) respect to
 prescription drug b5efits  7a7 ,9 g5]al
 ,a gr\p heal? plan or a heal? insurance
 issu] (f]+ gr\p heal? insurance cov]age
 %all n1 & %all 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 
receive f a drug manufactur] a r$uction 
9 price or o!r remun]ation ) respect to 
any prescription drug receiv$ by an     
enrollee 9 ! plan or cov]age & cov]$ by 

! plan or cov]age1 unless-- 7#a7 any su*
 r$uction 9 price is reflect$ at ! po9t 
( sale to ! enrollee & meets su* o!r    
conditions z ! ,secret>y may e/abli%2 & 
7#b7 any su* o!r remun]ation is a flat  
fee-bas$ s]vice fee t a manufactur] (   
prescription drugs pays to an entity t  
provides ph>macy b5efits managem5t      
s]vices = s]vices r5d]$ to ! manufactur]
 t relate to arrangem5ts by ! ph>macy   
b5efit manag] to provide ph>macy b5efit 
managem5t s]vices to a heal? plan or    
heal? insurance issu]1 if c]ta9         
conditions e/abli%$ by ! ,secret>y are  
met1 includ+ requirem5ts t ! fees are   
transp>5t to ! heal? plan or heal?      
insurance issu]4  7b7 ,entity t provides
 ph>macy b5efits managem5t s]vices ,=   
purposes ( ?is section1 ! t]m entity t  
provides ph>macy b5efits managem5t      
s]vices means-- 7#a7 any p]son1 bus9ess1
 or o!r entity t1 pursuant to a writt5  
agreem5t ) a gr\p heal? plan or a heal? 
insurance issu] (f]+ gr\p heal?         
insurance cov]age1 directly or ?r\gh an 

int]m$i>y-- 7,a7 acts z a price         
negotiator on behalf ( ! plan or        
cov]age2 or  7,b7 manages ! prescription
 drug b5efits provid$ by ! plan or      
cov]age1 :i* may include ! process+ &   
paym5t ( claims = prescription drugs1 ! 
p]=mance ( drug utilization review1 !   
process+ ( drug prior au?orization      
reque/s1 ! adjudication ( appeals or    
grievances relat$ to ! prescription drug
 b5efit1 contract+ ) network ph>macies1 
controll+ ! co/ ( cov]$ prescription    
drugs1 or ! provision ( relat$ s]vices2 
or  7#b7 any entity t is own$1          
affiliat$1 or relat$ "u a common own]%ip
 /ructure ) a p]son1 bus9ess1 or entity 
describ$ 9 p>agraph 7#a74  4  7,b7      
,cl]ical am5dm5t ,! table ( cont5ts ( ! 
,employee ,retirem5t ,income ,security  
,act ( #aigd is am5d$ by ins]t+ aft] !  
item relat+ to section #gbe ! foll[+3   
,sec4 #gbe4 ,requirem5ts ) respect to   
prescription drug b5efits4  4  7#c7     
,,irc  7,a7 ,9 g5]al ,sub*apt] ,b (     
*apt] #ajj ( ! ,int]nal ,rev5ue ,code ( 

#aihf is am5d$ by add+ at ! end !       
foll[+3  #ihbf4 ,requirem5ts ) respect  
to prescription drug b5efits  7a7 ,9    
g5]al ,a gr\p heal? plan %all n1 & %all 
ensure t any entity t provides ph>macy  
b5efits managem5t s]vices "u a contract 
) any su* heal? plan does n1 receive f a
 drug manufactur] a r$uction 9 price or 
o!r remun]ation ) respect to any        
prescription drug receiv$ by an enrollee
 9 ! plan & cov]$ by ! plan1 unless--   
7#a7 any su* r$uction 9 price is        
reflect$ at ! po9t ( sale to ! enrollee 
& meets su* o!r conditions z ! ,secret>y
 may e/abli%2 &  7#b7 any su* o!r       
remun]ation is a flat fee-bas$ s]vice   
fee t a manufactur] ( prescription drugs
 pays to an entity t provides ph>macy   
b5efits managem5t s]vices = s]vices     
r5d]$ to ! manufactur] t relate to      
arrangem5ts by ! ph>macy b5efit manag]  
to provide ph>macy b5efit managem5t     
s]vices to a heal? plan1 if c]ta9       
conditions e/abli%$ by ! ,secret>y are  
met1 includ+ requirem5ts t ! fees are   

transp>5t to ! heal? plan4  7b7 ,entity 
t provides ph>macy b5efits managem5t    
s]vices ,= purposes ( ?is section1 ! t]m
 entity t provides ph>macy b5efits      
managem5t s]vices means-- 7#a7 any      
p]son1 bus9ess1 or o!r entity t1        
pursuant to a writt5 agreem5t ) a gr\p  
heal? plan1 directly or ?r\gh an        
int]m$i>y-- 7,a7 acts z a price         
negotiator on behalf ( ! plan2 or  7,b7 
manages ! prescription drug b5efits     
provid$ by ! plan1 :i* may include !    
process+ & paym5t ( claims =            
prescription drugs1 ! p]=mance ( drug   
utilization review1 ! process+ ( drug   
prior au?orization reque/s1 !           
adjudication ( appeals or grievances    
relat$ to ! prescription drug b5efit1   
contract+ ) network ph>macies1 controll+
 ! co/ ( cov]$ prescription drugs1 or ! 
provision ( relat$ s]vices2 or  7#b7 any
 entity t is own$1 affiliat$1 or relat$ 
"u a common own]%ip /ructure ) a p]son1 
bus9ess1 or entity describ$ 9 p>agraph  
7#a74  4  7,b7 ,cl]ical am5dm5t ,! table

 ( sections = sub*apt] ,b ( *apt] #ajj (
 ! ,int]nal ,rev5ue ,code ( #aihf is    
am5d$ by add+ at ! end ! foll[+3  ,sec4 
#ihaf4 ,requirem5ts ) respect to        
prescription drug b5efits4  4  7#d7     
,effective date ,! am5dm5ts made by     
p>agraphs 7#a71 7#b71 & 7#c7 %all take  
effect on ,janu>y #a1 4