,,ii  #aah? ,,congress  #a/ ,session    
,s4 #aifg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #ad1 #bjbc,mr4   
,m55dez 7= himself1 ,mrs4 ,blackburn1   
,mr4 ,te/]1 ,mr4 ,m>%all1 ,mr4 ,wyd51 & 
,mr4 ,crapo7 introduc$ ! foll[+ bill2   
:i* 0 read twice & ref]r$ to !          
,committee on ,f9ance  ,a ,,bill  ,to   
am5d title ,,xviii ( ! ,social ,security
 ,act to e/abli% requirem5ts relat+ to !
 responsibility ( ph>macy b5efit manag]s
 "u ,m$ic>e "p ,d4  #a4 ,%ort title ,?is
 ,act may be cit$ z ! ,pati5ts ,be=e    
,middlem5 ,act or ! ,,pbm ,act4  #b4    
,responsibility ( ph>macy b5efit manag]s
 "u ,m$ic>e "p ,d  7a7 ,prescription    
drug plans ,section #ahfj;,d-#ab7;b7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciew-#aab7;b77 is am5d$ by add+ at !  
end ! foll[+ new p>agraph3  7#i7        
,responsibility ( ph>macy b5efit manag]s
  7,a7 ,9 g5]al ,ea* contract ent]$ into
 ) a ,,pdp sponsor "u ?is "p ) respect  
to a prescription drug plan (f]$ by su* 
sponsor %all provide t any ph>macy      

b5efit manag] 7or affiliate1 subsidi>y1 
or ag5t ( a ph>macy b5efit manag]7 act+ 
on behalf ( su* sponsor-- 7i7 d]ives no 
income ) respect to any s]vices provid$ 
9 connection ) "p ,d utilization f any  
entity or individual o!r ?an bona fide  
s]vice fees2 &  7ii7 sets =? 9 an       
agreem5t betwe5 ! ph>macy b5efit manag] 
& ! ,,pdp sponsor ! am\nt ( any bona    
fide s]vice fee4 ,! bona fide s]vice fee
 mu/ be a flat doll> am\nt1 _c be pass$ 
on 9 :ole or 9 "p to ano!r p>ty :e!r or 
n ! ph>macy b5efit manag] takes title to
 ! drug1 & %all n be directly or        
indirectly bas$ on1 or cont+5t ^u-- 7,i7
 drug price1 su* z :olesale acquisition 
co/ or drug b5*m>k price 7su* z av]age  
:olesale price72  7,,ii7 disc\nts1      
rebates1 fees1 or o!r remun]ation )     
respect to prescription drugs prescrib$ 
to enrollees 9 ! plan2 or  7,,iii7 any  
o!r am\nts prohibit$ by ! ,secret>y4    
7,b7 ,cl>ification reg>d+ ,,pdp sponsor 
act+ z ,,pbm ,9 ! case :]e a ,,pdp      
sponsor is act+ z a ph>macy b5efit      

manag] on behalf ( a prescription drug  
plan (f]$ by ! ,,pdp sponsor1 !         
requirem5ts "u subp>agraph 7,a7 %all n  
be con/ru$ z prev5t+ ! ,,pdp sponsor f  
accept+ any rebates1 disc\nts1 or price 
concessions t l[] net co/s = cov]$ "p ,d
 drugs4  7,c7 ,c]tification ( compliance
 ,! ,,pdp sponsor & ph>macy b5efit      
manag] %all furni% to ! ,secret>y 79 a  
"t & mann] specifi$ by ! ,secret>y7 an  
annual c]tification ( compliance ) ?is  
p>agraph1 z well z su* in=mation z !    
,secret>y det]m9es necess>y to c>ry out 
?is p>agraph4  7,d7 ,disgorgem5t (      
excess am\nts receiv$ ,a ph>macy b5efit 
manag] 7or affiliate1 subsidi>y1 or ag5t
 ( a ph>macy b5efit manag]7 %all        
disgorge to ! ,secret>y any paym5t1     
remun]ation1 or o!r am\nt receiv$ 9     
violation ( ?is p>agraph or ! contract  
ent]$ into ) a ,,pdp sponsor "u ?is "p )
 respect to a prescription drug plan4   
7,e7 ,cl>ification ,! requirem5ts ( ?is 
p>agraph %all apply reg>dless ( :e!r !  
ph>macy b5efit manag] is a fir/-ti]1    

d[n/ream1 or relat$ entity to ! ,,pdp   
sponsor4  7,f7 ,rule ( con/ruction ,no?+
 9 ?is p>agraph %all be con/ru$ z       
prohibit+ paym5ts relat$ to reimbursem5t
 = +r$i5t co/s to entities t acquire    
prescription drugs or ph>macy disp5s+   
fees4  7,g7 ,def9itions ,= purposes (   
?is p>agraph3 7i7 ,bona fide s]vice fee 
,! t]m bona fide s]vice fee means fair  
m>ket value = a bona fide1 itemiz$      
s]vice actually p]=m$ on behalf ( an    
entity1 t ! entity w\ld o!rwise p]=m 7or
 contract =7 9 ! abs5ce ( ! s]vice      
arrangem5t & t are n pass$ on 9 :ole to 
a cli5t or cu/om]1 :e!r or n ! entity   
takes title to ! drug4  7ii7 ,ph>macy   
b5efit manag] ,! t]m ph>macy b5efit     
manag] means any p]son1 bus9ess1 or o!r 
entity t1 pursuant to an agreem5t ) a   
,,pdp sponsor or "p ,d plan ei!r        
directly or ?r\gh an int]m$i>y acts z a 
price negotiator or gr\p pur*as] on     
behalf ( su* sponsor or plan1 or manages
 ! prescription drug b5efits provid$ by 
su* sponsor or plan1 includ+ ! 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]$ "p ,d drugs1 or 
! provision ( s]vices relat$ !reto4 ,su*
 t]m includes-- 7,i7 any p]son1 bus9ess1
 or o!r entity t c>ries out "o or m ( ! 
activities describ$ 9 ! prec$+ s5t5ce2 &
  7,,ii7 any entity t is own$1          
affiliat$1 or relat$ "u a common own]%ip
 /ructure ) su* a p]son1 bus9ess1 or    
entity 7includ+ an entity own$ by or    
affiliat$ ) ! ,,pdp sponsor7 or t acts z
 a contractor or ag5t to su* a p]son1   
bus9ess1 or entity1  irrespective ( :e!r
 su* p]son1 bus9ess1 or entity calls    
itself a ph>macy b5efit manag]4  4  7b7 
,,ma-,,pd plans ,section #aheg7;f77#c7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #aciew-#bg7;f77#c77 is am5d$ by add+ at
 ! end ! foll[+ new subp>agraph3  7,e7  
,responsibility ( ph>macy b5efit manag]s

 ,section #ahfj;,d-#ab7;b77#i74  4