Streamlining Part D Appeals Process Act

I 116TH CONGRESS 1ST SESSION H. R. 3924 To provide for the treatment of a pharmacy counter refusal as a coverage determination under Medicare part D. IN THE HOUSE OF REPRESENTATIVES JULY 23, 2019 Mr. SUOZZI (for himself and Mr. REED) 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 provi- sions as fall within the jurisdiction of the committee concerned 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- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Streamlining Part D 4 Appeals Process Act’’. 5 VerDate Sep 11 2014 23:48 Jul 31, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3924.IH H3924 kjohnson on DSK79L0C42 with BILLS 2 •HR 3924 IH SEC. 2. PROVIDING FOR THE TREATMENT OF A PHARMACY 1 COUNTER REFUSAL AS A COVERAGE DETER- 2 MINATION UNDER MEDICARE PART D. 3 Section 1860D–4(g) of the Social Security Act (42 4 U.S.C. 1395w–104(g)) is amended by adding at the end 5 the following new paragraph: 6 ‘‘(3) TREATMENT OF PHARMACY COUNTER RE- 7 FUSAL AS COVERAGE DETERMINATION.—For plan 8 years beginning on or after January 1, 2020, the re- 9 fusal by a pharmacy to fill a prescription for a cov- 10 ered part D drug under a prescription drug plan 11 shall be treated as a coverage determination subject 12 to reconsideration and appeal pursuant to this sub- 13 section and subsection (h).’’. 14 Æ VerDate Sep 11 2014 23:48 Jul 31, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6301 E:\BILLS\H3924.IH H3924 kjohnson on DSK79L0C42 with BILLS