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107th CONGRESS
  1st Session
                                H. R. 2799

To amend title XVIII of the Social Security Act to provide for coverage 
      of pharmacist services under part B of the Medicare program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 2, 2001

Mr. Pallone (for himself and Ms. Rivers) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
    addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to provide for coverage 
      of pharmacist services under part B of the Medicare program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Pharmacist Services 
Coverage Act of 2001''.

SEC. 2. MEDICARE COVERAGE OF PHARMACIST SERVICES.

    (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)), as amended by section 105(a) of the Medicare, 
Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 
(114 Stat. 2763A-471), as enacted into law by section 1(a)(6) of Public 
Law 106-554, is amended--
            (1) in subparagraph (U), by striking ``and'' at the end;
            (2) in subparagraph (V), by inserting ``and'' at the end; 
        and
            (3) by adding at the end the following new subparagraph:
            ``(W) pharmacist services (as defined in subsection 
        (ww));''.
    (b) Services Described.--Section 1861 of the Social Security Act 
(42 U.S.C. 1395x), as amended by section 105(b) of the Medicare, 
Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 
(114 Stat. 2763A-471), as enacted into law by section 1(a)(6) of Public 
Law 106-554, is amended by adding at the end the following new 
subsection:

                         ``Pharmacist Services

    ``(ww) The term `pharmacist services' means such drug therapy 
management services furnished by a pharmacist, individually or on 
behalf of a pharmacy provider, and such services and supplies furnished 
as an incident to the pharmacist's drug therapy management service, 
which the pharmacist is legally authorized to perform (in the State in 
which the individual performs such services) in accordance with State 
law (or the State regulatory mechanism provided by State law).''.
    (c) Payment.--
            (1) In general.--Section 1833(a)(1) of the Social Security 
        Act (42 U.S.C. 1395l(a)(1)), as amended by section 223(c) of 
        the Medicare, Medicaid, and SCHIP Benefits Improvement and 
        Protection Act of 2000 (114 Stat. 2763A-489), as enacted into 
        law by section 1(a)(6) of Public Law 106-554, is amended--
                    (A) by striking ``and'' before ``(U)''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (V) with respect to pharmacist 
                services under section 1861(s)(2)(W), the amounts paid 
                shall be 80 percent of the lesser of the actual charge 
                or the amount established under section 1834(n);''.
            (2) Establishment of fee schedule; payments prior to 
        implementation of fee schedule.--Section 1834 of the Social 
        Security Act (42 U.S.C. 1395m), as amended by section 223(b) of 
        the Medicare, Medicaid, and SCHIP Benefits Improvement and 
        Protection Act of 2000 (114 Stat. 2763A-487), as enacted into 
        law by section 1(a)(6) of Public Law 106-554, is amended by 
        adding at the end the following new subsection:
    ``(n) Fee Schedules for Pharmacist Services.--
            ``(1) Development.--The Secretary shall develop--
                    ``(A) a relative value scale to serve as the basis 
                for the payment of pharmacist services (as defined in 
                section 1861(ww)) under this part; and
                    ``(B) using such scale and appropriate conversion 
                factors, fee schedules (on a regional, statewide, 
                locality, or carrier service area basis) for payment 
                for pharmacist services under this part, to be 
                implemented for such services furnished during years 
                beginning after the expiration of the 3-year period 
                which begins on the date of enactment of this 
                subsection.
            ``(2) Considerations.--In developing the relative value 
        scale and fee schedules under paragraph (1), the Secretary 
        shall consider differences in--
                    ``(A) the time required to perform types of 
                pharmacist services;
                    ``(B) the level of risk associated with the use of 
                particular out-patient prescription drugs or groups of 
                drugs; and
                    ``(C) the health status of individuals to whom 
                pharmacist services are provided.
            ``(3) Consultation.--In developing the fee schedule for 
        pharmacist services under this subsection, the Secretary shall 
        consult with various national organizations representing 
        pharmacists and pharmacies and share with such organizations 
        the relevant data and data analysis being used in establishing 
        such fee schedule, including data on variations in payments 
        under this part by geographic area and by service.
            ``(4) Payments prior to implementation of fee schedule.--In 
        the case of a pharmacist service (as defined in section 
        1861(ww)) that is furnished before the implementation of the 
        fee schedule developed under paragraph (1)(B), the Secretary 
        shall pay an amount equal to 80 percent of the amount that the 
        Secretary would pay for such service under the fee schedule 
        established under section 1848 if the service were furnished by 
        a physician or as an incident to a physician's service.''.
    (d) Report to Congress.--Not later than 3 years after the date of 
enactment of this Act, the Secretary of Health and Human Services shall 
submit to Congress a report on the relative value scale and fee 
schedules developed under section 1834(n)(1) of the Social Security Act 
(as added by subsection (c)(2)) for pharmacist services furnished under 
part B of the medicare program under title XVIII of the Social Security 
Act.
    (e) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after January 1, 2002.
                                 <all>

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