,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bdjf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #bj1 #bjbc,mr4   
,c>p] 7= himself & ,mr4 ,grassley7      
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
improve ov]sight ( =mul>y developm5t &  
managem5t "u ,m$ic>e "p ,d4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,,pbm   
,ov]sight ,act ( #bjbc4  #b4 ,resolv+   
conflicts ( int]e/ & improv+ ov]sight ( 
,p,t ,committee ov]rides  7a7 ,9 g5]al  
,section #ahfj;,d-#d7;b77#c7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#ajd7;b77#c77 is am5d$-- 7#a7 9  
subp>agraph 7,a77ii77,i71 by ins]t+ !   
foll[+ be=e ! semicolon3 7&1 = #bjbe &  
ea* subsequ5t ye>1 any ph>macy b5efit   
manag]72 &  7#b7 by add+ at ! end !     
foll[+ new subp>agraph3  7,j7 ,report+  
on additional committees ) =mul>y       
decision mak+ au?ority  7i7 ,9 g5]al ,= 
#bjbf & ea* subsequ5t plan ye>1 a ,,pdp 

sponsor %all submit to ! ,secret>y !    
foll[+ in=mation1 if applicable1 )      
respect to ea* prescription drug plan   
(f]$ by ! ,,pdp sponsor3 7,i7 ,! "n & a 
description ( ! role & composition ( any
 committee1 entity1 or individual )9 or 
affiliat$ ) ! ,,pdp sponsor 7or a       
ph>macy b5efit manag]1 act+ "u contract 
) su* sponsor7 t has ! au?ority to make 
a cov]age1 =mul>y placem5t1 or          
utilization managem5t decision 7z def9$ 
9 clause 7ii77,i771 o!r ?an ! ph>macy & 
!rapeutic committee describ$ 9          
subp>agraph 7,a74  7,,ii7 ,a li/ ( drugs
 = :i* a committee1 entity1 or          
individual describ$ 9 subclause 7,i7    
made a cov]age1 =mul>y placem5t1 or     
utilization managem5t decision 7z s     
def9$7 & ! correspond+ initial          
recomm5dation 7z def9$ 9 clause         
7ii77,,ii77 made by ! ph>macy &         
!rapeutic committee4  7,,iii7 ,a brief  
ju/ification = ea* decision describ$ 9  
subclause 7,,ii74  7ii7 ,def9itions ,9  
?is subp>agraph3 7,i7 ,cov]age1 =mul>y  

placem5t1 or utilization managem5t      
decision ,! t]m cov]age1 =mul>y         
placem5t1 or utilization managem5t      
decision means a decision by a          
committee1 entity1 or individual        
describ$ 9 clause 7i77,i7 t modifies1   
adju/s1 rev]ses1 or o!rwise alt]s 7su* z
 by sub/itut+ ! =mul>y inclusion ( "o   
cov]$ "p ,d drug = ano!r or by sub/itut+
 a m g5]al initial recomm5dation = a m  
specific decision7 an initial           
recomm5dation by ! ph>macy & !rapeutic  
committee4  7,,ii7 ,initial             
recomm5dation ,! t]m initial            
recomm5dation means a cov]age1 =mul>y   
placem5t1 or utilization managem5t      
decision recomm5d$ by ! ph>macy &       
!rapeutic committee prior to ! review1  
adoption1 or modification ( su* a       
recomm5dation by a committee1 entity1 or
 individual describ$ 9 clause 7i77,i74  
,= purposes ( ?is subp>agraph1 su*      
initial recomm5dation %all be consid]$  
to be sep>ate & di/9ct f ! f9al review &
 approval ( ! =mul>y design & compon5ts 

by su* ph>macy & !rapeutic committee1 z 
requir$ "u section #dbc4abj ( title #db1
 ,code ( ,f$]al ,regulations 7or any    
successor regulation74  7iii7           
,non-application ( pap]work r$uction act
 ,*apt] #ce ( title #dd1 ,unit$ ,/ates  
,code1 %all n apply to in=mation requir$
 = purposes ( c>ry+ out ?is subp>agraph4
  4  7b7 ,implem5tation ,not)/&+ any o!r
 provision ( law1 ! ,secret>y ( ,heal? &
 ,human ,s]vices may implem5t ! am5dm5ts
 made by subsection 7a7 by program      
in/ruction or o!rwise4  7c7 ,,gao /udy &
 report  7#a7 ,/udy ,! ,comptroll]      
,g5]al %all conduct a /udy on ! use (   
committees1 entities1 or individuals    
describ$ 9 clause 7i77,i7 ( section     
#ahfj;,d-#d7;b77#c77;,j7 ( ! ,social    
,security ,act1 z add$ by subsection    
7a71 9 ! developm5t & review ( =mul>ies 
"u "p ,d ( title ,,xviii ( ! ,social    
,security ,act4 ,su* /udy %all include  
an analysis ( ! foll[+3 7,a7 ,!         
preval5ce ( su* committees1 entities1 or
 individuals4  7,b7 ,! numb]1 type1 &   

*>act]i/ics ( drugs = :i* a committee1  
entity1 or individual describ$ 9 su*    
clause 7i77,i7 made a cov]age1 =mul>y   
placem5t1 or utilization managem5t      
decision 7z def9$ 9 clause 7ii77,i7 (   
su* section #ahfj;,d-#d7;b77#c77;,j774  
7,c7 ,tr5ds 9 ! ju/ifications provid$ "u
 clause 7i77,,iii7 ( su* section        
#ahfj;,d-#d7;b77#c77;,j74  7,d7 ,tr5ds 9
 ! application ( utilization managem5t  
tools 7su* z prior au?orization1 /ep    
!rapy1 & quantity limits7 & =mul>y      
exclusions "u prescription drug plans & 
,,ma-,,pd plans & ! impact su* tools &  
exclusions h on b5efici>y access to     
cov]$ "p ,d drugs4  7#b7 ,report ,n lat]
 ?an ,janu>y #a1 #bjbi1 ! ,comptroll]   
,g5]al %all submit to ,congress a report
 conta9+ ! results ( ! /udy conduct$ "u 
p>agraph 7#a71 toge!r ) any             
recomm5dations = su* legislation &      
adm9i/rative action z ! ,comptroll]     
,g5]al det]m9es appropriate4  7#c7      
,def9itions ,9 ?is subsection3 7,a7     
,comptroll] ,g5]al ,! t]m ,comptroll]   

,g5]al means ! ,comptroll] ,g5]al ( !   
,unit$ ,/ates4  7,b7 ,o!r t]ms ,! t]ms  
cov]$ "p ,d drug1 ,,ma-,,pd plan1 &     
prescription drug plan h ! mean+ giv5 ^?
 t]ms 9 section #ahfj;,d-#da ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#aea74