Pharmacy and Medically Underserved Areas Enhancement Act

I 117TH CONGRESS 1ST SESSION H. R. 2759 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. IN THE HOUSE OF REPRESENTATIVES APRIL 22, 2021 Mr. BUTTERFIELD (for himself, Mr. MCKINLEY, Mr. BILIRAKIS, Mr. CARTER of Georgia, Mr. CICILLINE, Ms. CLARKE of New York, Mr. COHEN, Mr. CRAWFORD, Ms. DEGETTE, Mrs. DEMINGS, Mr. FITZPATRICK, Mr. FOS- TER, Mr. GOHMERT, Mr. LYNCH, Ms. MOORE of Wisconsin, Mr. O’HALLERAN, Ms. PINGREE, Mr. PRICE of North Carolina, Ms. ROSS, Mr. SMITH of Missouri, Mr. TONKO, Mr. WESTERMAN, and Mr. GUEST) introduced the following bill; which was referred to the Committee on En- ergy 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 jurisdic- tion of the committee concerned A BILL To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Pharmacy and Medi- 4 cally Underserved Areas Enhancement Act’’. 5 VerDate Sep 11 2014 23:04 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2759.IH H2759 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2759 IH SEC. 2. MEDICARE COVERAGE OF PHARMACIST SERVICES. 1 (a) COVERAGE.—Section 1861(s)(2) of the Social Se- 2 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 3 (1) by striking ‘‘and’’ at the end of subpara- 4 graph (GG); 5 (2) by striking the period at the end and insert- 6 ing ‘‘; and’’ at the end of subparagraph (HH); and 7 (3) by inserting after subparagraph (HH) the 8 following new subparagraph at the end: 9 ‘‘(II) pharmacist services furnished by a 10 pharmacist, as licensed by State law, individ- 11 ually or on behalf of a pharmacy provider— 12 ‘‘(i) which the pharmacist is legally 13 authorized to perform in the State in 14 which the individual performs such serv- 15 ices; 16 ‘‘(ii) as would otherwise be covered 17 under this part if furnished by a physician, 18 or as an incident to a physician’s service; 19 and 20 ‘‘(iii) in a setting located in a health 21 professional shortage area (as defined in 22 section 332(a)(1)(A) of the Public Health 23 Service Act), medically underserved area, 24 or medically underserved population (as 25 defined in section 330(b)(3) of such Act).’’. 26 VerDate Sep 11 2014 23:04 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2759.IH H2759 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2759 IH (b) PAYMENT.—Section 1833(a)(1) of the Social Se- 1 curity Act (42 U.S.C. 1395l(a)(1)) is amended— 2 (1) by striking ‘‘and (DD)’’ and inserting 3 ‘‘(DD)’’; and 4 (2) by inserting before the semicolon at the end 5 the following: ‘‘and (EE) with respect to pharmacist 6 services (as defined in section 1861(s)(2)(II)), the 7 amounts paid shall be equal to 80 percent of the 8 lesser of the actual charge or 85 percent of the fee 9 schedule amount provided under section 1848 if 10 such services had been furnished by a physician’’. 11 (c) EFFECTIVE DATE; PHARMACIST SPECIFIC 12 CODES.— 13 (1) EFFECTIVE DATE.—The amendments made 14 by subsections (a) and (b) shall apply with respect 15 to services furnished on or after January 1, 2022. 16 (2) PHARMACIST SPECIFIC CODES.—The Sec- 17 retary of Health and Human Services shall develop 18 pharmacist specific codes, as necessary, under the 19 physician fee schedule under section 1848 of the So- 20 cial Security Act (42 U.S.C. 1395w–4). 21 Æ VerDate Sep 11 2014 23:04 Jun 04, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6301 E:\BILLS\H2759.IH H2759 kjohnson on DSK79L0C42PROD with BILLS