,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bdje  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #bj1 #bjbc ,mr4  
,?une 7= himself1 ,mr4 ,br[n1 ,mr4      
,b>rasso1 & ,ms4 ,/ab5[7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to assure ph>macy access 
& *oice = ,m$ic>e b5efici>ies4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,/r5g!n+ ,ph>macy ,access = ,s5iors     
,act4  #b4 ,assur+ ph>macy access &     
*oice = ,m$ic>e b5efici>ies ,section    
#ahfj;,d-#d7;b77#a7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7;b77#a77 is am5d$ by add+ at
 ! end ! foll[+ new subp>agraph3  7,f7  
,limit$ access drugs  7i7 ,limitation on
 re/rictions or limits on access ,= ea* 
plan ye> 7beg9n+ ) plan ye> #bjbf71 a   
,,pdp sponsor (f]+ a prescription drug  
plan or ph>macy b5efit manag]-- 7,i7 may
 n re/rict or limit access to any cov]$ 
"p ,d drug to a subset ( _! network     

ph>macies1 o!r ?an ) respect to a limit$
 access drug1 z def9$ 9 clause 7v72 &   
7,,ii7 %all record 9 writ+ ! rationale =
 :y a cov]$ "p ,d drug meets ! def9ition
 ( a limit$ access drug "u clause 7v7 & 
ma9ta9 writt5 records ( any su*         
rationales1 if su* plan re/ricts or     
limits access to a limit$ access drug to
 a subset ( network ph>macies4  7ii7    
,annual submission ( in=mation to !     
secret>y on limit$ access drugs ,= ea*  
plan ye> 7beg9n+ ) plan ye> #bjbf71 ea* 
,,pdp sponsor (f]+ a prescription drug  
plan %all submit to ! ,secret>y1 at a "t
 & 9 a mann] specifi$ by ! ,secret>y1 ) 
respect to ea* prescription drug plan   
(f]$ by ! sponsor dur+ su* plan ye>--   
7,i7 a li/ ( all cov]$ "p ,d drugs t !  
,,pdp sponsor designat$ z a limit$      
access drug2  7,,ii7 ! writt5 rationales
 = :y any cov]$ "p ,d drugs li/$ "u     
subclause 7,i7 meet ! def9ition ( a     
limit$ access drug2  7,,iii7 !          
requirem5ts impos$ on network ph>macies 
to ensure appropriate h&l+ & disp5s+ ( !

 cov]$ "p ,d drugs li/$ "u subclause    
7,i72  7,,iv7 ! p]c5tages ( cov]$ "p ,d 
drugs li/$ "u subclause 7,i7 t are      
disp5s$ ?r\gh retail ph>macies1         
specialty ph>macies1 mail ord]          
ph>macies1 or o!r disp5s+ *annels z     
def9$ by ! ,,pdp sponsor1 respectively1 
dur+ ! mo/ rec5t plan ye> = :i* su* data
 are available2  7,v7 ! annual p]c5tage 
( cov]$ "p ,d drugs li/$ "u subclause   
7,i7 t are disp5s$ ?r\gh ph>macies :olly
 or p>tially own$ by1 or o!rwise        
affiliat$ ) 7su* z ?r\gh common         
own]%ip71 ! plan or ph>macy b5efit      
manag]2 &  7,,vi7 any o!r in=mation     
det]m9$ appropriate by ! ,secret>y4     
7iii7 ,ph>macy access to limit$ access  
drug in=mation ,= plan ye>s beg9n+ )    
plan ye> #bjbf1 ^u ! reque/ ( a network 
ph>macy1 a ,,pdp sponsor ( a            
prescription drug plan 7or a ph>macy    
b5efit manag] act+ on behalf ( su*      
sponsor7 %all pres5t su* ph>macy1 on a  
timely basis 7z det]m9$ by ! ,secret>y71
 ) in=mation specific to any cov]$ "p ,d

 drug li/$ "u subclause 7,,ii7 ( clause 
7i7 ( ?is subp>agraph1 along ) !        
rationale = its designation z a limit$  
access drug 7z describ$ 9 subclause     
7,,ii7 ( clause 7ii77 & ! requirem5ts   
impos$ ) respect to su* drug 7z describ$
 9 subclause 7,,iii7 ( clause 7ii774    
,any ,,pdp sponsor or ph>macy b5efit    
manag] t provides false in=mation ^u su*
 a reque/ or t fails to provide !       
in=mation reque/$ on a timely basis %all
 be f\nd 9 violation ( ?is subsection4  
7iv7 ,,hhs annual report on limit$      
access drugs ,n lat] ?an ,decemb] #ca1  
#bjbg1 & annually !reaft]1 ! ,secret>y  
%all submit to ! ,committee on ,f9ance (
 ! ,s5ate1 & ! ,committee on ,ways &    
,means & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report on compliance by ,,pdp sponsors )
 ! requirem5ts "u ?is subp>agraph4 ,ea* 
su* report %all include--  7,i7 a       
description ( ! patt]ns1 tr5ds1         
v>iations1 & rationales = ! designation 
by ,,pdp sponsors ( c]ta9 cov]$ "p ,d   

drugs z limit$ access drugs describ$ 9  
clause 7v71 & ! implications ( su*      
designations on b5efici>y access to su* 
cov]$ "p ,d drugs2  7,,ii7 a description
 ( ! in=mation submitt$ to ! ,secret>y  
"u clause 7ii7 79 a mann] t does n      
disclose ! id5tity ( a ph>macy1 a ,,pdp 
sponsor1 a prescription drug plan1 or   
ph>macy b5efit manag]1 or any propriet>y
 pric+ in=mation72 &  7,,iii7 any o!r   
in=mation det]m9$ appropriate by !      
,secret>y4  7v7 ,limit$ access drug     
def9$ ,9 ?is subp>agraph1 ! t]m limit$  
access drug means a cov]$ "p ,d drug t  
meets at lea/ "o ( ! foll[+3  7,i7 ,!   
,food & ,drug ,adm9i/ration has re/rict$
 di/ribution ( su* cov]$ "p ,d drug to  
c]ta9 facilities or physicians4  7,,ii7 
,! disp5s+ ( su* cov]$ "p ,d drug       
requires extraord9>y special h&l+1      
provid] coord9ation1 or pati5t education
 t _c be met by a network ph>macy4  4