[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4106 Introduced in Senate (IS)]

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119th CONGRESS
  2d Session
                                S. 4106

  To amend title 10, United States Code, to improve access to certain 
     medications under the TRICARE program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 17, 2026

 Mr. Cotton (for himself and Mr. Kaine) introduced the following bill; 
  which was read twice and referred to the Committee on Armed Services

_______________________________________________________________________

                                 A BILL


 
  To amend title 10, United States Code, to improve access to certain 
     medications under the TRICARE program, and for other purposes.

    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 ``Rx Access, Choice, Cost Equity, and 
Supply Stability Act'' or the ``Rx ACCESS Act''.

SEC. 2. IMPROVEMENTS RELATING TO ACCESS, FAIRNESS, AND TRANSPARENCY 
              UNDER TRICARE PHARMACY BENEFITS PROGRAM.

    (a) Beneficiary Election of Prescription Refill Means.--Section 
1074g(a)(9) of title 10, United States Code, is amended--
            (1) in subparagraph (A), by inserting ``, and ending on 
        October 1, 2026'' after ``Beginning on October 1, 2015''; and
            (2) by adding at the end the following new subparagraph:
    ``(D) Beginning on October 1, 2026, an eligible covered beneficiary 
may elect to receive non-generic prescription maintenance medications 
through any means described in paragraph (2)(E).''.
    (b) Pharmacy Benefit Manager Reimbursement Standards; Independent 
Audits.--Section 1074g of title 10, United States Code, as amended by 
subsection (a), is further amended--
            (1) by redesignating subsections (i) and (j) as subsections 
        (j) and (k), respectively; and
            (2) by inserting after subsection (h) the following new 
        subsection:
    ``(i) Pharmacy Benefit Manager Reimbursement Standards.--(1) The 
Secretary of Defense shall ensure that, as a condition of any contract 
entered into for the administration of the pharmacy benefits program, 
reimbursement to a retail pharmacy described in subsection 
(a)(2)(E)(ii) for a pharmaceutical agent provided under such program 
shall be an amount that is equal to not less than the sum of--
            ``(A) either--
                    ``(i) the actual cost to the pharmacy of acquiring 
                such pharmaceutical agent from a wholesaler, or
                    ``(ii) in the case of a pharmaceutical agent 
                included on the national average drug acquisition cost 
                index published by the Administrator of the Centers for 
                Medicare & Medicaid Services, a proxy amount calculated 
                at a rate that is not lower than the national average 
                acquisition cost for such pharmaceutical agent, as 
                identified on such cost index as of the date of the 
                adjudication of the claim for such reimbursement, and
            ``(B) a professional dispensing fee that is equal to the 
        professional dispensing fee paid by the State in which the 
        pharmacy is located under title XIX of the Social Security Act 
        (42 U.S.C. 1396 et seq.) for dispensing a prescription drug.
    ``(2) The contractor administering the pharmacy benefits program 
may not impose any fees on a retail pharmacy described in subsection 
(a)(2)(E)(ii), including point-of-sale fees, retroactive fees, or other 
indirect or hidden fees.
    ``(3)(A) Not less frequently than annually, the Comptroller General 
of the United States shall--
            ``(i) conduct an audit of--
                    ``(I) data reported by the contractor responsible 
                for the administration of the pharmacy benefits program 
                relating to the rates of reimbursement under paragraph 
                (1) and any price concessions; and
                    ``(II) the adequacy of the retail pharmacy network 
                under the TRICARE program and access by eligible 
                covered beneficiaries to such network, including with 
                respect to continuity of care, geographic accessibility 
                (taking into account factors in addition to travel time 
                to and from a pharmacy, with special consideration for 
                rural and underserved areas), and the extent to which 
                elections by such beneficiaries under subsection (a)(9) 
                reflect personal preference; and
            ``(ii) submit the results of such audit to the Committee on 
        Armed Services of the Senate and the Committee on Armed 
        Services of the House of Representatives.
    ``(B) The Secretary shall ensure that, as a condition of any 
contract entered into for the administration of the pharmacy benefits 
program, the contractor provides the Comptroller General information 
required to conduct the audit under subparagraph (A).''.
    (c) Report.--Not later than 90 days after the date of the enactment 
of this Act, the Secretary of Defense shall submit to the congressional 
defense committees (as defined in section 101(a)(16) of title 10, 
United States Code) a plan for the implementation of this section.
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