,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #ddji  ,,in ,,the ,,house ,,of  
,,representatives  ,july #ae1 #bjbe,mr4 
,krishnamoorthi 7for himself and ,mrs4  
,harshbarger7 introduced the following  
bill2 which was referred to the         
,committee on ,oversight and ,government
 ,reform  ,a ,,bill  ,to prohibit the   
common ownership pharmacy benefit       
managers and pharmacies that provide    
services under contracts with ,federal  
health plans for ,federal employees4    
#a4 ,short title ,this ,act may be cited
 as the ,fair ,pharmacies for ,federal  
,employees ,act of #bjbe4  #b4          
,prohibitions relating to               
anticompetitive pharmacy ownership and  
contracts  7a7 ,prohibition on pharmacy 
or pharmacy benefit manager ownership by
 entities providing insurance under     
,federal employee health plans ,it shall
 be unlawful for the ,office of         
,personnel ,management to contract with 
a ,federal employee health benefit      
qualified carrier who--  7#a7 directly  

or indirectly owns1 operates1 controls1 
or directs the operation of the whole or
 any part of a pharmacy2 or  7#b7       
directly or indirectly owns1 operates1  
or controls the whole or any part of a  
pharmacy benefit manager1 or is directly
 or indirectly owned1 operated1 or has  
its operation directed by the whole or  
in any part by a pharmacy benefit       
manager4  7b7  ,prohibition on pharmacy 
ownership by entities providing pharmacy
 benefit management services under      
,federal employee health plans  ,it     
shall be unlawful of the ,office of     
,personnel ,management or a ,federal    
employee health benefit qualified       
carrier to contract or subcontract with 
a pharmacy benefit manager who directly 
or indirectly owns1 operates1 controls1 
or directs the operation of the whole or
 any part of a pharmacy4  7c7 ,rule of  
construction ,nothing in this section   
shall be construed to limit the         
authority of the ,federal ,trade        
,commission1 the ,inspector ,general of 

the ,department of ,justice1 the        
,department of ,health and ,human       
,services1 or the attorney general of a 
,state under any other provision of law4
  7d7 ,definitions ,in this section3    
7#a7 ,health plan ,the term health plan 
means a group insurance policy or       
contract1 medical or hospital service   
agreement1 membership or subscription   
contract1 or similar group arrangement  
provided by a carrier for the purpose of
 providing1 paying for1 or reimbursing  
expenses for health services4  7#b7     
,person ,the term person has the meaning
 given the term in section #h of the    
,sherman ,act 7#ae ,u4,s4,c4 #g74  7#c7 
,pharmacy  7,a7 ,in general ,the term   
pharmacy means any person1 business1 or 
entity licensed1 registered1 or         
otherwise permitted by a ,state or a    
territory of the ,united ,states to     
dispense1 deliver1 or distribute a      
controlled substance1 prescription drug1
 or other medication-- 7i7 to the       
general public2 or  7ii7 to a bed       

patient for immediate administration4   
7,b7 ,inclusions ,the term pharmacy     
includes--  7i7 a mail-order pharmacy2  
7ii7 a specialty pharmacy2  7iii7 a     
retail pharmacy2  7iv7 a nursing home   
pharmacy2  7v7 a long-term care         
pharmacy2  7vi7 a hospital pharmacy2    
7vii7 an infusion or other outpatient   
treatment pharmacy2  7viii7 any         
organization the ,national ,provider    
,identifier 7,,npi7 registration of     
which has #a or more taxonomy codes     
under the pharmacy section of the       
,national ,uniform ,claim ,committee 7or
 a subsequent organization72 and  7ix7  
any other type of pharmacy4  7#d7       
,pharmacy benefit manager ,the term     
pharmacy benefit manager means any      
person1 business1 or other entity1 such 
as a third-party administrator1         
regardless of whether such person1      
business1 or entity identifies itself as
 a pharmacy benefit manager1 that1      
either directly or indirectly through an
 intermediary 7including an affiliate1  

subsidiary1 or agent7 or an arrangement 
with a third party--  7,a7 acts as a    
negotiator of prices1 rebates1 fees1 or 
discounts for prescription drugs on     
behalf of a health plan or health plan  
sponsor2  7,b7 contracts with pharmacies
 to create pharmacy networks and designs
 and manages such networks2 or  7,c7    
manages or administers the prescription 
drug benefits provided by a health plan1
 including the processing and payment of
 claims for prescription drugs1         
arranging alternative access to or      
funding for prescription drugs1 the     
performance of utilization management   
services1 including drug utilization    
review1 the processing of drug prior    
authorization requests1 the adjudication
 of appeals or grievances related to the
 prescription drug benefit1 contracting 
with network pharmacies1 controlling the
 cost of covered prescription drugs1 or 
the provision of related services4  7#e7
 ,qualified carrier ,the term qualified 
carrier means a voluntary association1  

corporation1 partnership1 or other      
nongovernmental organization which is   
lawfully engaged in providing1 paying   
for1 or reimbursing the cost of1 health 
services under group insurance policies 
or contracts1 medical or hospital       
service agreements1 membership or       
subscription contracts1 or similar group
 arrangements1 in consideration of      
premiums or other periodic charges      
payable to the carrier1 including a     
health benefits plan duly sponsored or  
underwritten by an employee organization
 and an association of organizations or 
other entities described in this        
paragraph sponsoring a health benefits  
plan4