,,ii #aah? ,,congress #b;d ,session ,s4 #ejba ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,septemb] #aa1 #bjbd,mr4 ,wel* introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to ensure ! accessibility ( drugs furni%$ ?r\gh ! drug disc\nt program "u section #cdj;,b ( ! ,public ,heal? ,s]vice ,act4 #a4 ,%ort title ,?is ,act may be cit$ z ! #cdj;,b ,ph>maceutical ,access ,to ,inve/ 9 ,ess5tial1 ,ne$$ ,treatm5ts ,support ,act ( #bjbd or ! #cdj;,b ,,pati5ts ,act ( #bjbd4 #b4 ,f9d+s & purposes 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,section #cdj;,b ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;b7 enables cov]$ entities to /ret* sc>ce res\rces z f> z possible1 rea*+ m pati5ts & provid+ m compreh5sive s]vices ?an w\ld be possible )\t su* program4 7#b7 ,su* section #cdj;,b requires drug manufactur]s to (f] disc\nt$ prices on cov]$ outpati5t drugs to cov]$ entities p>ticipat+ 9 ! program1 z a condition ( p>ticipat+ 9 ! ,m$icaid program & "p ,b ( ! ,m$ic>e program1 & drug manufactur]s are requir$ to (f] drug disc\nt pric+ to cov]$ entities :5 reque/$4 7#c7 ,sav+s on ! pur*ase ( drugs ?r\gh ! program "u section #cdj;,b ( ! ,public ,heal? ,s]vice ,act enables hospitals1 cl9ics1 & heal? c5t]s to provide compreh5sive s]vices to ! communities !y s]ve1 & cov]$ entities are 9 ! be/ position to assess ! use ( _! sav+s = community ne$s4 7#d7 ,s9ce ! e>ly ye>s ( su* program1 cov]$ entities h contract$ ) ph>macies to disp5se cov]$ outpati5t drugs pur*as$ by a cov]$ entity at drug disc\nt program pric+ to pati5ts ( ! cov]$ entity1 consi/5t ) h[ ,congress int5d$ = cov]$ entities to use ! program4 7#e7 ,cov]$ entities use sav+s g5]at$ ?r\gh contract ph>macy relation%ips to /ret* sc>ce res\rces & support pati5t c>e1 consi/5t ) ! purpose ( ! program4 7#f7 ,section #cdj;,b ( ! ,public ,heal? ,s]vice ,act requires drug manufactur]s to (f] drug disc\nt pric+ = drugs pur*as$ by cov]$ entities reg>dless ( ! mann] or location 9 :i* a drug is disp5s$1 includ+ drugs disp5s$ ?r\gh contract ph>macies4 7#g7 ,section #cdj;,b ( ! ,public ,heal? ,s]vice ,act does n all[ drug manufactur]s to place conditions on ! ability ( a cov]$ entity to pur*ase or use a cov]$ outpati5t drug at drug disc\nt program pric+ reg>dless ( ! mann] or location 9 :i* a drug is disp5s$1 includ+ by re/rict+ a cov]$ entity's ability to disp5se drugs pur*as$ ?r\gh su* program to pati5ts ?r\gh a contractual relation%ip ) a contract$ ph>macy or refus+ to %ip cov]$ outpati5t drugs to a ph>macy or location id5tifi$ by a cov]$ entity4 7#h7 ,su* section #cdj;,b's inflation>y p5alty provisions1 :i* h sav$ "p ,d ( ! ,m$ic>e program #g1jjj1jjj1jjj betwe5 #bjac & #bjag1 h a prov5 record ( r$uc+ drug price increases1 & use ( contract ph>macies contributes to ^! sav+s4 7#i7 ,specialty drugs1 :i* are (t5 us$ to treat *ronic1 s]i\s1 or life-?reat5+ conditions su* z canc]1 rheumatoid ar?ritis1 gr[? hormone defici5cy1 & multiple scl]osis1 play a critical role 9 ! c>e provid$ by cov]$ entities4 ,^! drugs (t5 require specializ$ h&l+1 are n usually available to walk-9 cu/om]s1 & are typically available only ?r\gh specialty or mail ord] ph>macies t are locat$ hundr$s ( miles f a cov]$ entity4 ,! use ( contract ph>macy arrangem5ts "u section #cdj;,b ( ! ,public ,heal? ,s]vice ,act is (t5 ! only means by :i* cov]$ entities c access ^! vital drugs4 7b7 ,purposes ,! purposes ( ?is ,act are ! foll[+3 7#a7 ,to cl>ify t section #cdj;,b ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;b7-- 7,a7 requires drug manufactur]s to (f] drug disc\nt pric+ pursuant to an agreem5t "u subsection 7a7 ( su* section ) respect to drugs pur*as$ by a cov]$ entity reg>dless ( ! mann] or location 9 :i* ! drug is disp5s$2 & 7,b7 prohibits drug manufactur]s f plac+ conditions on ! ability ( cov]$ entities to pur*ase drugs pursuant to an agreem5t "u subsection 7a7 ( su* section1 reg>dless ( ! mann] or location 9 :i* su* drugs are disp5s$4 7#b7 ,to cl>ify t-- 7,a7 cov]$ entities may contract ) ph>macies to disp5se drugs pur*as$ pursuant to an agreem5t "u section #cdj;,b7a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;b7a77 on a cov]$ entity's behalf1 to assi/ cov]$ entities 9 /ret*+ res\rces to provide c>e to m pati5ts & provide m compreh5sive s]vices2 & 7,b7 ! requirem5ts & prohibitions t apply to manufactur]s "u section #cdj;,b ( su* ,act apply 9 ! case ( a cov]$ entity t elects to contract ) a ph>macy to disp5se #cdj;,b drugs4 #c4 ,ensur+ ! accessibility ( drugs furni%$ "u ! drug disc\nt program 7a7 ,9 g5]al ,section #cdj;,b7a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;b7a77 is am5d$-- 7#a7 9 p>agraph 7#a7-- 7,a7 by /rik+ t ! manufactur] furni% & ins]t+ ! foll[+3 t-- 7,a7 ! manufactur] furni% 2 7,b7 by /rik+ ceil+ price71 & & ins]t+ ceil+ price722 7,c7 by /rik+ %all require t ! manufactur] (f] & ins]t+ ! foll[+3 7,b7 ! manufactur] (f] 2 & 7,d7 by /rik+ ! p]iod at ! end & ins]t+ ! foll[+3 1 reg>dless ( ! mann] or location 9 :i* ! drug is disp5s$2 & 7,c7 ! manufactur] n place conditions on ! ability ( a cov]$ entity to pur*ase & use a cov]$ outpati5t drug at or bel[ ! applicable ceil+ price1 reg>dless ( ! mann] or location 9 :i* ! drug is disp5s$1 includ+ by plac+ limits on ! deliv]y ( drugs1 plac+ limits on ! me*anisms ?r\gh :i* drugs may be pur*as$1 plac+ limits on :]e su* drugs may be deliv]$1 adm9i/]$1 or disp5s$1 requir+ a cov]$ entity's assurance ( compliance ) requirem5ts "u ?is section1 or requir+ ! submission ( claims data or o!r in=mation1 except t ! manufactur] may impose conditions describ$ 9 ?is subp>agraph aft] receiv+ advance approval f ! ,secret>y 7or1 ) respect to conditions specifi$ by ! ,secret>y1 )\t su* advance approval7 if su* conditions w\ld n disc\rage cov]$ entities f pur*as+ ! manufactur]'s drugs ?r\gh ! drug disc\nt program "u ?is section or o!rwise und]m9e ! objective ( ?is section1 ei!r by s+l+ out cov]$ entities f o!r cu/om]s = su* conditions or by impos+ conditions t disproportionately impact cov]$ entities4 2 & 7#b7 by add+ at ! end ! foll[+3 7#aa7 ,contract ,ph>macies ,! requirem5ts & prohibitions "u p>agraph 7#a7 %all apply 9 ! case ( a cov]$ entity t elects to contract ) "o or m ph>macies to disp5se1 to pati5ts ( ! cov]$ entity1 cov]$ outpati5t drugs pur*as$ by ! cov]$ entity at or bel[ ! applicable ceil+ price describ$ 9 p>agraph 7#a74 4 7b7 ,manufactur] compliance ,section #cdj;,b7d7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bef;b7 is am5d$-- 7#a7 9 p>agraph 7#a77;,b77vi71 9 ! matt] prec$+ subclause 7,i71 by ins]t+ 1 9 ! case ( an ov]*>ge aft] p5alties2 7#b7 9 p>agraph 7#a77;,b71 by add+ at ! end ! foll[+3 7vii7 ,! imposition ( sanctions 9 ! =m ( civil monet>y p5alties 9 ! case ( a violation ( subsection 7a77#a7 or 7a77#aa71 o!r ?an an ov]*>ge1 :i*-- 7,i7 %all be assess$ accord+ to /&>ds e/abli%$ 9 regulations to be promulgat$ by ! ,secret>y n lat] ?an #ahj days aft] ! date ( enactm5t2 7,,ii7 %all apply to any manufactur] ) an agreem5t "u ?is section t kn[+ly & int5tionally violates a requirem5t "u subsection 7a77#a7 or 7a77#aa71 o!r ?an an ov]*>ge2 7,,iii7 %all n exce$ #b1jjj1jjj = ea* day ( su* violation2 7,,iv7 %all be 9 an am\nt det]m9$ by ! ,secret>y1 tak+ into acc\nt factors su* z ! nature & ext5t ( ! violation & h>m result+ f su* violation1 includ+1 :]e applicable1 ! numb] ( drugs affect$ & ! numb] ( cov]$ entities affect$2 & 7,v7 %all cont9ue to be impos$ ea* day until su* manufactur] is no long] 9 violation ( a requirem5t "u subsection 7a77#a7 or 7a77#aa74 2 & 7#c7 9 p>agraph 7#c71 by add+ at ! end ! foll[+3 7,d7 ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is subp>agraph1 ! ,secret>y %all promulgate regulations to p]mit cov]$ entities to ass]t claims ( violations ( subsections 7a77#a7 & 7a77#aa7 "u ! process promulgat$ "u subp>agraph 7,a74 4