,,ii  #aaith ,,congress  #b;d ,session  
,s4 #dajf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #ag1    
#bjbf,mr4 ,cotton 7for himself and ,mr4 
,kaine7 introduced the following bill2  
which was read twice and referred to the
 ,committee on ,armed ,services  ,a     
,,bill  ,to amend title #aj1 ,united    
,states ,code1 to improve access to     
certain medications under the ,,tricare 
program1 and for other purposes4  #a4   
,short title ,this ,act may be cited as 
the ,rx ,access1 ,choice1 ,cost ,equity1
 and ,supply ,stability ,act or the ,rx 
,,access ,act4  #b4 ,improvements       
relating to access1 fairness1 and       
transparency under ,,tricare pharmacy   
benefits program  7a7 ,beneficiary      
election of prescription refill means   
,section #ajgd;g7a77#i7 of title #aj1   
,united ,states ,code1 is amended-- 7#a7
 in subparagraph 7,a71 by inserting 1   
and ending on ,october #a1 #bjbf after  
,beginning on ,october #a1 #bjae2 and   
7#b7 by adding at the end the following 

new subparagraph3  7,d7 ,beginning on   
,october #a1 #bjbf1 an eligible covered 
beneficiary may elect to receive        
non-generic prescription maintenance    
medications through any means described 
in paragraph 7#b77;,e74  4  7b7         
,pharmacy benefit manager reimbursement 
standards2 independent audits ,section  
#ajgd;g of title #aj1 ,united ,states   
,code1 as amended by subsection 7a71 is 
further amended-- 7#a7 by redesignating 
subsections 7i7 and 7j7 as subsections  
7j7 and 7k71 respectively2 and  7#b7 by 
inserting after subsection 7h7 the      
following new subsection3  7i7 ,pharmacy
 benefit manager reimbursement standards
  7#a7 ,the ,secretary of ,defense shall
 ensure that1 as a condition of any     
contract entered into for the           
administration of the pharmacy benefits 
program1 reimbursement to a retail      
pharmacy described in subsection        
7a77#b77;,e77ii7 for a pharmaceutical   
agent provided under such program shall 
be an amount that is equal to not less  

than the sum of-- 7,a7 either-- 7i7 the 
actual cost to the pharmacy of acquiring
 such pharmaceutical agent from a       
wholesaler1 or  7ii7 in the case of a   
pharmaceutical agent included on the    
national average drug acquisition cost  
index published by the ,administrator of
 the ,centers for ,medicare  ,medicaid  
,services1 a proxy amount calculated at 
a rate that is not lower than the       
national average acquisition cost for   
such pharmaceutical agent1 as identified
 on such cost index as of the date of   
the adjudication of the claim for such  
reimbursement1 and  7,b7 a professional 
dispensing fee that is equal to the     
professional dispensing fee paid by the 
,state in which the pharmacy is located 
under title ,,xix of the ,social        
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 for dispensing a prescription     
drug4  7#b7 ,the contractor             
administering the pharmacy benefits     
program may not impose any fees on a    
retail pharmacy described in subsection 

7a77#b77;,e77ii71 including             
point-of-sale fees1 retroactive fees1 or
 other indirect or hidden fees4  7#c7   
7,a7 ,not less frequently than annually1
 the ,comptroller ,general of the       
,united ,states shall-- 7i7 conduct an  
audit of-- 7,i7 data reported by the    
contractor responsible for the          
administration of the pharmacy benefits 
program relating to the rates of        
reimbursement under paragraph 7#a7 and  
any price concessions2 and  7,,ii7 the  
adequacy of the retail pharmacy network 
under the ,,tricare program and access  
by eligible covered beneficiaries to    
such network1 including with respect to 
continuity of care1 geographic          
accessibility 7taking into account      
factors in addition to travel time to   
and from a pharmacy1 with special       
consideration for rural and underserved 
areas71 and the extent to which         
elections by such beneficiaries under   
subsection 7a77#i7 reflect personal     
preference2 and  7ii7 submit the results

 of such audit to the ,committee on     
,armed ,services of the ,senate and the 
,committee on ,armed ,services of the   
,house of ,representatives4  7,b7 ,the  
,secretary shall ensure that1 as a      
condition of any contract entered into  
for the administration of the pharmacy  
benefits program1 the contractor        
provides the ,comptroller ,general      
information required to conduct the     
audit under subparagraph 7,a74  4  7c7  
,report ,not later than #ij days after  
the date of the enactment of this ,act1 
the ,secretary of ,defense shall submit 
to the congressional defense committees 
7as defined in section #aja7;a77#af7 of 
title #aj1 ,united ,states ,code7 a plan
 for the implementation of this section4