TRICARE Retail Pharmacy Prescription Medication Expansion Act of 2020

II 116TH CONGRESS 2D SESSION S. 3932 To direct the Secretary of Defense to carry out a pilot program under the TRICARE pharmacy benefits program. IN THE SENATE OF THE UNITED STATES JUNE 10, 2020 Mr. ROUNDS introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To direct the Secretary of Defense to carry out a pilot program under the TRICARE pharmacy benefits program. 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 ‘‘TRICARE Retail 4 Pharmacy Prescription Medication Expansion Act of 5 2020’’. 6 VerDate Sep 11 2014 04:34 Jun 25, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3932.IS S3932 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 3932 IS SEC. 2. PILOT PROGRAM ON RECEIPT OF NON-GENERIC 1 PRESCRIPTION MAINTENANCE MEDICATIONS 2 UNDER TRICARE PHARMACY BENEFITS PRO- 3 GRAM. 4 (a) REQUIREMENT.—The Secretary of Defense shall 5 carry out a pilot program under which eligible covered 6 beneficiaries may elect to receive non-generic prescription 7 maintenance medications selected under subsection (c) 8 through military treatment facility pharmacies, retail 9 pharmacies, or the national mail-order pharmacy program, 10 notwithstanding section 1074g(a)(9) of title 10, United 11 States Code. 12 (b) DURATION.—The Secretary shall carry out the 13 pilot program for a three-year period beginning not later 14 than March 1, 2021. 15 (c) SELECTION OF MEDICATION.—The Secretary 16 shall select non-generic prescription maintenance medica- 17 tions described in section 1074g(a)(9)(C)(i) of title 10, 18 United States Code, to be covered by the pilot program. 19 (d) USE OF VOLUNTARY REBATES.— 20 (1) REQUIREMENT.—In carrying out the pilot 21 program, the Secretary shall seek to renew and mod- 22 ify contracts described in paragraph (2) in a manner 23 that— 24 (A) includes for purposes of the pilot pro- 25 gram retail pharmacies as a point of sale for 26 VerDate Sep 11 2014 04:34 Jun 25, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3932.IS S3932 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 3932 IS the non-generic prescription maintenance medi- 1 cation covered by the contract; and 2 (B) provides the manufacturer with the op- 3 tion to provide voluntary rebates for such medi- 4 cations at retail pharmacies. 5 (2) CONTRACTS DESCRIBED.—The contracts 6 described in this paragraph are contracts for the 7 procurement of non-generic prescription mainte- 8 nance medications selected under subsection (c) that 9 are eligible for renewal during the period in which 10 the pilot program is carried out. 11 (e) NOTIFICATION.—In providing each eligible cov- 12 ered beneficiary with an explanation of benefits, the Sec- 13 retary shall notify the beneficiary of whether the medica- 14 tion that the beneficiary is prescribed is covered by the 15 pilot program. 16 (f) BRIEFING AND REPORTS.— 17 (1) BRIEFING.—Not later than 90 days after 18 the date of the enactment of this Act, the Secretary 19 shall brief the congressional defense committees on 20 the implementation of the pilot program. 21 (2) INTERIM REPORT.—Not later than 18 22 months after the commencement of the pilot pro- 23 gram, the Secretary shall submit to the congres- 24 VerDate Sep 11 2014 04:34 Jun 25, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3932.IS S3932 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 3932 IS sional defense committees a report on the pilot pro- 1 gram. 2 (3) COMPTROLLER GENERAL REPORT.— 3 (A) IN GENERAL.—Not later than March 4 1, 2024, the Comptroller General of the United 5 States shall submit to the congressional defense 6 committees a report on the pilot program. 7 (B) ELEMENTS.—The report required by 8 subparagraph (A) shall include the following: 9 (i) The number of eligible covered 10 beneficiaries who participated in the pilot 11 program and an assessment of the satisfac- 12 tion of such beneficiaries with the pilot 13 program. 14 (ii) The rate by which eligible covered 15 beneficiaries elected to receive non-generic 16 prescription maintenance medications at a 17 retail pharmacy pursuant to the pilot pro- 18 gram, and how such rate affected military 19 treatment facility pharmacies and the na- 20 tional mail-order pharmacy program. 21 (iii) The amount of cost savings real- 22 ized by the pilot program, including with 23 respect to— 24 VerDate Sep 11 2014 04:34 Jun 25, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3932.IS S3932 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 3932 IS (I) dispensing fees incurred at re- 1 tail pharmacies compared to the na- 2 tional mail-order pharmacy program 3 for brand name prescription drugs; 4 (II) administrative fees; 5 (III) any costs paid by the 6 United States for the drugs in addi- 7 tion to the procurement costs; 8 (IV) the use of military treat- 9 ment facilities; and 10 (V) copayments paid by eligible 11 covered beneficiaries. 12 (iv) A comparison of supplemental re- 13 bates between retail pharmacies and other 14 points of sale. 15 (g) RULE OF CONSTRUCTION.—Nothing in this sec- 16 tion may be construed to affect the ability of the Secretary 17 to carry out section 1074g(a)(9)(C) of title 10, United 18 States Code, after the date on which the pilot program 19 is completed. 20 (h) DEFINITIONS.—In this section: 21 (1) The term ‘‘eligible covered beneficiary’’ has 22 the meaning given that term in section 1074g(i) of 23 title 10, United States Code. 24 VerDate Sep 11 2014 04:34 Jun 25, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3932.IS S3932 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 3932 IS (2) The terms ‘‘military treatment facility phar- 1 macies’’, ‘‘retail pharmacies’’, and ‘‘the national 2 mail-order pharmacy program’’ mean the methods 3 for receiving prescription drugs as described in 4 clauses (i), (ii), and (iii), respectively, of section 5 1074g(a)(2)(E) of title 10, United States Code. 6 Æ VerDate Sep 11 2014 04:34 Jun 25, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S3932.IS S3932 pbinns on DSKJLVW7X2PROD with BILLS