[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1770 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 1770
To amend title XVIII of the Social Security Act to provide pharmacy
payment of certain services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 23, 2023
Mr. Smith of Nebraska (for himself, Mr. Schneider, Mr. Bucshon, Ms.
Matsui, Mr. Carter of Georgia, Mrs. Harshbarger, Mr. Bilirakis, Mr.
Blumenauer, Mr. Fitzpatrick, Mr. Peters, and Ms. Sewell) 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 pharmacy
payment of certain services.
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 ``Equitable Community Access to
Pharmacist Services Act''.
SEC. 2. COVERAGE OF PHARMACIST SERVICES UNDER MEDICARE PART B.
(a) Coverage.--Section 1861(s) of the Social Security Act (42
U.S.C. 1395x(s)) is amended--
(1) in paragraph (2)--
(A) in subparagraph (II), by striking ``and'' at
the end;
(B) in subparagraph (JJ), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following new
subparagraph:
``(KK) pharmacist services and such services and supplies
furnished as an incident to the pharmacist's service as would
otherwise be covered under part B if furnished by a physician
or as an incident to a physician's service that--
``(i) are furnished by a pharmacist--
``(I) as licensed under State law; or
``(II) pursuant to a Federal emergency
authority described under section 319F-3 or
section 361 of the Public Health Service Act,
or other similar Federal law;
``(ii) would otherwise be covered under part B if
furnished by a physician; and
``(iii) are services--
``(I) for encounters for the evaluation and
management of patients for testing or treatment
for COVID-19, influenza, respiratory syncytial
virus, or streptococcal pharyngitis; or
``(II) that address a public health need
related to a public health emergency under
section 319F-3 or section 361 of the Public
Health Service Act, or other similar Federal
law.''; and
(2) in paragraph (10), in each of subparagraphs (A) and
(B), by inserting ``, including when furnished by a
pharmacist'' before the semicolon in each such subparagraph.
(b) Payment.--Section 1833(a)(1) of the Social Security Act (42
U.S.C. 1395l(a)(1)) is amended--
(1) by striking ``and (HH)'' and inserting ``(HH)''; and
(2) by inserting before the semicolon at the end the
following: ``and (II) with respect to pharmacist services
described in section 1861(s)(2)(KK), the amounts paid shall be
equal to 80 percent of the lesser of (i) the actual charge for
the services or (ii) 85 percent (or 100 percent, in the case of
such services furnished pursuant to a Federal emergency
authority described in clause (i)(II) of such section) of the
amount determined under the payment basis under section 1848
for such services.''.
(c) Prohibition on Balance Billing for Pharmacist Services.--
Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following:
``(ix) A pharmacist.''.
(d) Rule of Construction.--Nothing in this section shall be
construed to restrict the ability of pharmacies and pharmacists to
enroll and obtain reimbursement under existing pathways under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) as of the
date of the enactment of this Act, including payment as mass
immunizers.
(e) Implementation Authority.--Notwithstanding any other provision
of law, the Secretary of Health and Human Services shall implement the
provisions of, and the amendments made by, this section by interim
final rule, program instruction, or otherwise not later than the date
that is 60 days after the date of the enactment of this Act.
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