[Congressional Record Volume 169, Number 125 (Thursday, July 20, 2023)]
[Senate]
[Pages S3461-S3462]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. THUNE (for himself, Mr. Brown, Mr. Barrasso, and Ms. 
        Stabenow):
  S. 2405. A bill to amend title XVIII of the Social Security Act to 
assure pharmacy access and choice for Medicare beneficiaries; to the 
Committee on Finance.
  Mr. THUNE. Madam President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S.2405

       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 ``Strengthening Pharmacy 
     Access for Seniors Act''.

     SEC. 2. ASSURING PHARMACY ACCESS AND CHOICE FOR MEDICARE 
                   BENEFICIARIES.

       Section 1860D-4(b)(1) of the Social Security Act (42 U.S.C. 
     1395w-104(b)(1)) is amended by adding at the end the 
     following new subparagraph:
       ``(F) Limited access drugs.--
       ``(i) Limitation on restrictions or limits on access.--For 
     each plan year (beginning with plan year 2026), a PDP sponsor 
     offering a prescription drug plan or pharmacy benefit 
     manager--

       ``(I) may not restrict or limit access to any covered part 
     D drug to a subset of their network pharmacies, other than 
     with respect to a limited access drug, as defined in clause 
     (v); and
       ``(II) shall record in writing the rationale for why a 
     covered part D drug meets the definition of a limited access 
     drug under clause (v) and maintain written records of any 
     such rationales, if such plan restricts or limits access to a 
     limited access drug to a subset of network pharmacies.

       ``(ii) Annual submission of information to the secretary on 
     limited access drugs.--For each plan year (beginning with 
     plan year 2026), each PDP sponsor offering a prescription 
     drug plan shall submit to the Secretary, at a time and in a 
     manner specified by the Secretary, with respect to each 
     prescription drug plan offered by the sponsor during such 
     plan year--

       ``(I) a list of all covered part D drugs that the PDP 
     sponsor designated as a limited access drug;
       ``(II) the written rationales for why any covered part D 
     drugs listed under subclause (I) meet the definition of a 
     limited access drug;
       ``(III) the requirements imposed on network pharmacies to 
     ensure appropriate handling and dispensing of the covered 
     part D drugs listed under subclause (I);
       ``(IV) the percentages of covered part D drugs listed under 
     subclause (I) that are dispensed through retail pharmacies, 
     specialty pharmacies, mail order pharmacies, or other 
     dispensing channels as defined by the PDP sponsor, 
     respectively, during the most recent plan year for which such 
     data are available;
       ``(V) the annual percentage of covered part D drugs listed 
     under subclause (I) that are dispensed through pharmacies 
     wholly or partially owned by, or otherwise affiliated with 
     (such as through common ownership), the plan or pharmacy 
     benefit manager; and
       ``(VI) any other information determined appropriate by the 
     Secretary.

[[Page S3462]]

       ``(iii) Pharmacy access to limited access drug 
     information.--For plan years beginning with plan year 2026, 
     upon the request of a network pharmacy, a PDP sponsor of a 
     prescription drug plan (or a pharmacy benefit manager acting 
     on behalf of such sponsor) shall present such pharmacy, on a 
     timely basis (as determined by the Secretary), with 
     information specific to any covered part D drug listed under 
     subclause (II) of clause (i) of this subparagraph, along with 
     the rationale for its designation as a limited access drug 
     (as described in subclause (II) of clause (ii)) and the 
     requirements imposed with respect to such drug (as described 
     in subclause (III) of subclause (ii)). Any PDP sponsor or 
     pharmacy benefit manager that provides false information upon 
     such a request or that fails to provide the information 
     requested on a timely basis shall be found in violation of 
     this subsection.
       ``(iv) HHS annual report on limited access drugs.--Not 
     later than December 31, 2027, and annually thereafter, the 
     Secretary shall submit to the Committee on Finance of the 
     Senate, and the Committee on Ways and Means and the Committee 
     on Energy and Commerce of the House of Representatives a 
     report on compliance by PDP sponsors with the requirements 
     under this subparagraph. Each such report shall include--

       ``(I) a description of the patterns, trends, variations, 
     and rationales for the designation by PDP sponsors of certain 
     covered part D drugs as limited access drugs described in 
     clause (v), and the implications of such designations on 
     beneficiary access to such covered part D drugs;
       ``(II) a description of the information submitted to the 
     Secretary under clause (ii) (in a manner that does not 
     disclose the identity of a pharmacy, a PDP sponsor, a 
     prescription drug plan, or pharmacy benefit manager, or any 
     proprietary pricing information); and
       ``(III) any other information determined appropriate by the 
     Secretary.

       ``(v) Limited access drug defined.--In this subparagraph, 
     the term `limited access drug' means a covered part D drug 
     that meets at least one of the following:

       ``(I) The Food and Drug Administration has restricted 
     distribution of such covered part D drug to certain 
     facilities or physicians.
       ``(II) The dispensing of such covered part D drug requires 
     extraordinary special handling, provider coordination, or 
     patient education that cannot be met by a network 
     pharmacy.''.

                                 ______