[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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