[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2477 Introduced in Senate (IS)]

<DOC>






118th CONGRESS
  1st Session
                                S. 2477

  To amend title XVIII of the Social Security Act to provide pharmacy 
                      payment of certain services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 25, 2023

 Mr. Thune (for himself and Mr. Warner) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to provide pharmacy 
                      payment of certain services.

    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 ``Equitable Community Access to 
Pharmacist Services Act''.

SEC. 2. COVERAGE OF PHARMACIST SERVICES UNDER MEDICARE PART B.

    (a) Coverage.--Section 1861(s) of the Social Security Act (42 
U.S.C. 1395x(s)) is amended--
            (1) in paragraph (2)--
                    (A) in subparagraph (II), by striking ``and'' at 
                the end;
                    (B) in subparagraph (JJ), by inserting ``and'' 
                after the semicolon at the end; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(KK) pharmacist services and such services and supplies 
        furnished as an incident to the pharmacist's service as would 
        otherwise be covered under part B if furnished by a physician 
        or as an incident to a physician's service that--
                    ``(i) are furnished by a pharmacist--
                            ``(I) as licensed under State law; or
                            ``(II) pursuant to a Federal emergency 
                        authority described under section 319F-3 or 
                        section 361 of the Public Health Service Act, 
                        or other similar Federal law;
                    ``(ii) would otherwise be covered under part B if 
                furnished by a physician; and
                    ``(iii) are services--
                            ``(I) for encounters for the evaluation and 
                        management of patients for testing or treatment 
                        for COVID-19, influenza, respiratory syncytial 
                        virus, or streptococcal pharyngitis; or
                            ``(II) that address a public health need 
                        related to a public health emergency under 
                        section 319F-3 or section 361 of the Public 
                        Health Service Act, or other similar Federal 
                        law.''; and
            (2) in paragraph (10), in each of subparagraphs (A) and 
        (B), by inserting ``, including when furnished by a 
        pharmacist'' before the semicolon in each such subparagraph.
    (b) Payment.--Section 1833(a)(1) of the Social Security Act (42 
U.S.C. 1395l(a)(1)) is amended--
            (1) by striking ``and (HH)'' and inserting ``(HH)''; and
            (2) by inserting before the semicolon at the end the 
        following: ``and (II) with respect to pharmacist services 
        described in section 1861(s)(2)(KK), the amounts paid shall be 
        equal to 80 percent of the lesser of (i) the actual charge for 
        the services or (ii) 85 percent (or 100 percent, in the case of 
        such services furnished pursuant to a Federal emergency 
        authority described in clause (i)(II) of such section) of the 
        amount determined under the payment basis under section 1848 
        for such services.''.
    (c) Prohibition on Balance Billing for Pharmacist Services.--
Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 
1395u(b)(18)(C)) is amended by adding at the end the following:
                            ``(ix) A pharmacist.''.
    (d) Rule of Construction.--Nothing in this section shall be 
construed to restrict the ability of pharmacies and pharmacists to 
enroll and obtain reimbursement under existing pathways under title 
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) as of the 
date of the enactment of this Act, including payment as mass 
immunizers.
    (e) Implementation Authority.--Notwithstanding any other provision 
of law, the Secretary of Health and Human Services shall implement the 
provisions of, and the amendments made by, this section by interim 
final rule, program instruction, or otherwise not later than the date 
that is 60 days after the date of the enactment of this Act.
                                 <all>