,i #aai? ,,congress #a/ ,session ,h4 ,r4 #bdhd ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,m>* #ca1 #bjbe,mrs4 ,h>%b>g] 7= h]self1 ,ms4 ,wass]man ,s*ultz1 ,mrs4 ,mill] ( ,we/ ,virg9ia1 ,mr4 ,soto1 ,mr4 ,cr5%aw1 & ,mr4 ,davis ( ,nor? ,c>ol9a7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to e/abli% an exception to ! physician self-ref]ral prohibition = c]ta9 outpati5t prescription drugs furni%$ by a physician practice "u ! ,m$ic>e program4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,s5iors' ,access to ,critical ,m$ications ,act ( #bjbe4 #b4 ,e/abli%+ an exception to ! physician self-ref]ral prohibition = c]ta9 outpati5t prescription drugs furni%$ by a physician practice "u ! ,m$ic>e program 7a7 ,9 g5]al ,section #ahgg7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acienn7b77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,c]ta9 outpati5t prescription drugs 7,a7 ,9 g5]al ,9 ! case ( designat$ heal? s]vices describ$ 9 subsection 7h77#f77;,j7 t are cov]$ "p ,d drugs 7z def9$ 9 section #ahfj;,d-#b7;e77 & furni%$ to an individual dur+ ! p]iod beg9n+ on ,janu>y #a1 #bjbf1 & end+ on ,decemb] #ca1 #bjcj1 if-- 7i7 su* drugs are prescrib$ by ! ref]r+ physician 7or by ano!r physician or practition] 7z describ$ 9 section #ahdb7;b77#ah77;,c77 )9 ! same gr\p practice z su* physician72 7ii7 su* individual has an ongo+ relation%ip 7z def9$ by ! ,secret>y7 ) su* physician or practition] :o prescrib$ su* drugs 7or ) ano!r physician or practition] )9 ! same gr\p practice z su* physician or practition]72 7iii7 )9 ! #a-ye> p]iod prior to ! disp5s+ ( su* drugs1 su* individual _h at lea/ #a face-to-face1 9-p]son enc\nt] ) su* ref]r+ physician 7or ) ano!r physician or practition] )9 ! same gr\p practice z su* physician1 z det]m9$ by tax id5tification numb]7 dur+ :i* items or s]vices t are n designat$ heal? s]vices & = :i* paym5t 0 made "u ?is title 7 furni%$ to su* individual2 7iv7 su* drugs are disp5s$ by ! ref]r+ physician1 a physician :o is a memb] ( ! same gr\p practice z ! ref]r+ physician1 or an individual :o is directly sup]vis$ by su* a physician1 f a build+ describ$ 9 p>agraph 7#b77;,a77ii71 includ+ ?r\gh-- 7,i7 9-p]son pickup by ! individual or a c>egiv] or family memb] ( su* individual2 or 7,,ii7 a mail1 deliv]y1 or c\ri] s]vice2 & 7v7 su* drugs are bill$ = by ! physician disp5s+ or sup]vis+ ! disp5s+ ( su* drugs1 by a gr\p practice ( :i* su* physician is a memb] "u a bill+ numb] assign$ to su* gr\p practice1 or by an entity t is :olly own$ by su* physician or su* gr\p practice4 7,b7 ,rule ( ,con/ruction ,no?+ 9 subp>agraph 7,a7 %all be con/ru$ z modify+ any program requirem5ts "u "p ,d4 4 7b7 ,,gao /udy & report 7#a7 ,/udy ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates 79 ?is section ref]r$ to z ! ,comptroll] ,g5]al7 %all conduct a /udy exam9+-- 7,a7 ph>macies or ph>macy networks p>ticipat+ "u "p ,d ( title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aja et seq47 t1 aft] ! date ( ! enactm5t ( ?is section1 disp5se significantly m 7z det]m9$ by ! ,comptroll] ,g5]al7 cov]$ "p ,d drugs 7z def9$ 9 section #ahfj;,d-#b ( su* ,act 7#db ,u4,s4,c4 #acie;e-#ajb77 comp>$ to ! am\nt ( su* drugs disp5s$ prior to su* date2 7,b7 common *>act]i/ics ( ! ph>macies & ph>macy networks id5tifi$ "u subp>agraph 7,a71 includ+1 to ! ext5t id5tifiable1 ! ext5t to :i* su* ph>macies & ph>macy networks are own$ by a physician or gr\p practice 7z def9$ 9 section #ahgg7;h7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acienn7h77 or o!rwise integrat$ into a physician's practice or gr\p practice2 & 7,c7 common *>act]i/ics ( arrangem5ts ent]$ into by physicians or gr\p practices = purposes ( disp5s+ drugs )9 physicians' (fices or o!rwise integrat+ ph>macies or ! disp5s+ ( drugs into a physician's practice or gr\p practice1 includ+1 to ! ext5t feasible & id5tifiable1 an analysis (-- 7i7 specific physician specialties or subspecialties = :i* su* arrangem5ts are especially common or h %[n sub/antial gr[?2 7ii7 ! ext5t to :i* physicians & gr\p practices p>ticipat+ 9 su* arrangem5ts h su* arrangem5ts or integration ) o!r physicians or gr\p practices or o!r drug supply *a9 p>ticipants 7includ+ ph>macy b5efit manag]s1 insur]s1 :olesal]s1 di/ributors1 or managem5t s]vices organizations72 7iii7 common contract+ features ( su* arrangem5ts relat+ to ! utilization ( cov]$ "p ,d drugs or s]vices provid$ 9 connection ) su* drugs1 includ+ contract t]ms relat$ to adm9i/rative or disp5s+ fees = su* drugs & ! types ( paym5ts provid$ 9 connection ) su* s]vices2 7iv7 common measures1 includ+ notices or disclosures1 tak5 by physicians & gr\p practices p>ticipat+ 9 su* arrangem5ts 9 ord] to mitigate or o!rwise address pot5tial conflicts ( int]e/ pos$ by su* arrangem5ts2 & 7v7 any compon5ts or features ( su* arrangem5ts t may influ5ce prescrib+ decisions or patt]ns among physicians & gr\p practices p>ticipat+ 9 su* arrangem5ts4 7#b7 ,report ,n lat] ?an #c ye>s aft] ! date ( ! enactm5t ( ?is section1 ! ,comptroll] ,g5]al %all submit to ,congress a report on ! f9d+s ( ! /udy requir$ "u p>agraph 7#a71 :i* %all n include id5tify+ or propriet>y in=mation ) respect to ! ph>macies or ph>macy networks exam9$4 #c4 ,m$ic>e improvem5t fund ,section #ahih7;b77#a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;iii7b77#a77 is am5d$ by /rik+ #a1hjd1jjj1jjj & ins]t+ #a1ghf1jjj1jjj4