I 111th CONGRESS 1st Session H. R. 806 IN THE HOUSE OF REPRESENTATIVES February 3, 2009 Mr. Bilirakis introduced the following bill; which was referred to the Committee on Armed Services A BILL To establish a mail-order pharmacy pilot program for TRICARE beneficiaries.

1.

Short title

This Act may be cited as the TRICARE Mail-Order Pharmacy Pilot Program Act.

2.

Mail-Order Pharmacy Pilot Program

(a)

Requirement

The Secretary of Defense shall conduct a pilot program to— (1)educate eligible covered beneficiaries about the mail-order pharmacy available under TRICARE; and (2)motivate such beneficiaries to voluntarily increase use of the mail-order pharmacy. (b)

Scope of Pilot Program

The pilot program shall include not less than 2,000 eligible covered beneficiaries in each TRICARE region, of whom not less than 1,000 in each TRICARE region shall be enrolled under part B of title XVIII of the Social Security Act. An eligible covered beneficiary chosen to participate in the pilot program shall be an individual who— (1)has filled a prescription in the TRICARE retail pharmacy program for a medication intended for long-term use; and (2)has not used the mail-order pharmacy. (c)

Duration of Pilot Program

The pilot program shall begin not later than October 1, 2009, and shall continue for two years. (d)

Administration of Pilot Program

In administering the pilot program, the Secretary of Defense shall— (1)offer mail-order medications within the uniform formulary to participants at no charge; (2)provide each participant a notification letter explaining the advantages of the mail-order pharmacy, including convenience and cost savings; (3)provide each participant with a personalized summary indicating the cost savings such participant would have realized had the participant used the mail-order pharmacy during the previous 12-month period; (4)provide each participant with simplified application and instruction guidelines and such other information as the Secretary considers useful to encourage use of the mail-order pharmacy; and (5)survey participants to determine— (A)the understanding of and satisfaction with the mail-order pharmacy; (B)the factors that motivated the participant to use or not use the mail-order pharmacy; (C)the specific reasons for any dissatisfaction with the mail-order pharmacy; (D)the extent to which the participant considers the information described in paragraph (4) helpful; (E)the extent to which the participant would recommend to others the use of the mail-order pharmacy; and (F)suggestions for ways to further increase use of the mail-order pharmacy. (e)

Consultation

The Secretary shall consult with representatives of beneficiary associations in— (1)designing and conducting the pilot program; and (2)evaluating the results of the pilot program. (f)

Reports

Not later than March 1, 2010, and each 180-day period thereafter for 1 year, the Secretary shall submit to the Committee on Armed Services of the House of Representatives and the Committee on Armed Services of the Senate a report on the pilot program, including— (1)the extent to which participants increased their use of the mail-order pharmacy; (2)the extent to which the use of the mail-order pharmacy affected pharmacy costs for both the Department of Defense and participants; (3)summaries of the results of participant surveys described in subsection (d)(5) (to the extent the results are available on the date of each report); (4)an assessment of the effect of eliminating the copayment for medications ordered through the mail-order pharmacy; (5)whether to expand the pilot program to include all eligible covered beneficiaries; and (6)any other analyses, observations, and recommendations the Secretary considers appropriate.

3.

Definitions

In this Act: (1)The term eligible covered beneficiaries has the meaning given such term in section 1074g(g)(1) of title 10, United States Code. (2)The term mail-order pharmacy means the national mail-order pharmacy program required by section 1074g(a)(2)(E)(iii) of title 10, United States Code. (3)The term participant means an eligible covered beneficiary described in section 2(b) that is chosen to participate in the pilot program.