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II
116TH CONGRESS
1ST SESSION
S. 1861
To provide for the treatment of a pharmacy counter refusal as a coverage
determination under Medicare part D.
IN THE SENATE OF THE UNITED STATES
JUNE 13, 2019
Mr. CARDIN (for himself and Mr. CORNYN) introduced the following bill;
which was read twice and referred to the Committee on Finance
A BILL
To provide for the treatment of a pharmacy counter refusal
as a coverage determination under Medicare part D.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Streamlining Part D
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Appeals Process Act’’.
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•S 1861 IS
SEC. 2. PROVIDING FOR THE TREATMENT OF A PHARMACY
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COUNTER REFUSAL AS A COVERAGE DETER-
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MINATION UNDER MEDICARE PART D.
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Section 1860D–4(g) of the Social Security Act (42
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U.S.C. 1395w–104(g)) is amended by adding at the end
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the following new paragraph:
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‘‘(3) TREATMENT OF PHARMACY COUNTER RE-
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FUSAL
AS
COVERAGE
DETERMINATION.—For plan
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years beginning on or after January 1, 2020, the re-
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fusal by a pharmacy to fill a prescription for a cov-
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ered part D drug under a prescription drug plan
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shall be treated as a coverage determination subject
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to reconsideration and appeal pursuant to this sub-
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section and subsection (h).’’.
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Æ
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