[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 778 Introduced in Senate (IS)]







109th CONGRESS
  1st Session
                                 S. 778

 To amend titles XVIII and XIX of the Social Security Act to require a 
pharmacy that receives payments or has contracts under the medicare and 
  medicaid programs to ensure that all valid prescriptions are filled 
               without unnecessary delay or interference.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 13, 2005

 Mrs. Boxer (for herself and Mr. Lautenberg) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend titles XVIII and XIX of the Social Security Act to require a 
pharmacy that receives payments or has contracts under the medicare and 
  medicaid programs to ensure that all valid prescriptions are filled 
               without unnecessary delay or interference.

    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 ``Pharmacy Consumer Protection Act of 
2005''.

SEC. 2. MEDICARE PHARMACY REQUIREMENTS.

    (a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by adding at the end the following new 
section:

                        ``pharmacy requirements

    ``Sec. 1898. (a) Requirements.--No payment (as defined in 
subsection (b)(1)) may be made to a pharmacy unless the pharmacy 
complies with the following requirements:
            ``(1) Valid prescriptions filled.--The pharmacy ensures 
        that each valid prescription is filled without unnecessary 
        delay or other interference, consistent with the normal 
        timeframe for filling prescriptions.
            ``(2) Prescribed item not in stock.--The pharmacy ensures 
        that, if the prescribed item is not in the pharmacy's stock, 
        the pharmacy will order such item without unnecessary delay or, 
        if the patient prefers, the pharmacy will transfer the 
        prescription to a local pharmacy of the patient's choice or 
        return the prescription to the patient, at the patient's 
        request.
    ``(b) Definitions.--For purposes of this section:
            ``(1) Payment.--For purposes of this section the term 
        `payment' means either of the following:
                    ``(A) Direct payment to a pharmacy.
                    ``(B) Payment to a pharmacy through a contract with 
                a PDP sponsor offering a prescription drug plan, an MA 
                organization offering an MA-PD plan, or a fallback 
                prescription drug plan.
            ``(2) Prescribed item.--The term `prescribed item' means a 
        drug or device approved by the Food and Drug Administration 
        under section 505 of the Federal Food, Drug, and Cosmetic Act 
        (21 U.S.C. 355), or a biological product licensed under section 
        351 of the Public Health Services Act (42 U.S.C. 238 et seq.).
            ``(3) Valid prescription.--The term `valid prescription' 
        means a prescription issued by a licensed health care provider 
        for a prescribed item (as defined in paragraph (2)).
    ``(c) Rule of Construction.--Nothing in this section shall prohibit 
a pharmacy from refusing to dispense a prescribed item, in accordance 
with standard pharmacy practice, if there is a valid medical concern 
that such prescribed item will cause problems due to therapeutic 
duplications, drug-disease contraindications, drug interactions 
(including serious interactions with prescription or over-the-counter 
medications), incorrect dosage or duration of drug treatment, drug-
allergy interactions, or drug abuse or misuse. Any refusal to dispense 
a prescribed item must be based on generally accepted practice among 
health care providers.''.
    (b) Conforming Amendment.--Section 1860D-4(b)(1)(A) of the Social 
Security Act (42 U.S.C. 1395w-104(b)(1)(A)) is amended by adding ``, 
such terms and conditions shall require that the pharmacy complies with 
the requirements of section 1898'' before the period at the end.

SEC. 3. MEDICAID PHARMACY REQUIREMENTS.

    Section 1902(a)(23) of the Social Security Act (42 U.S.C. 
1396a(a)(23)) is amended--
            (1) by striking ``and (B)'' and inserting ``(B)''; and
            (2) by inserting the following before the semicolon at the 
        end: ``, and (C) any pharmacy that provides services to any 
        individual eligible for medical assistance shall comply with 
        the requirements of section 1898''.

SEC. 4. EFFECTIVE DATE.

    The amendments made by this act shall apply to prescriptions issued 
or filled on or after January 1, 2006.
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