HR 3193 IH
110th CONGRESS
1st Session
H. R. 3193
To amend title XIX of the Social Security Act to establish a minimum State dispensing fee for covered outpatient multiple source drugs under the Medicaid Program, to modify the application of the average manufacturer price (AMP) methodology to drug rebates, to eliminate the State option to increase the cap amount on the equity asset test for individuals' eligibility for long-term care assistance under such program, and to extend an SSI asset verification demonstration to Medicaid.
IN THE HOUSE OF REPRESENTATIVES
July 26, 2007
Mr. DEAL of Georgia (for himself, Mr. BARTON of Texas, and Mr. BUYER) introduced the following bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend title XIX of the Social Security Act to establish a minimum State dispensing fee for covered outpatient multiple source drugs under the Medicaid Program, to modify the application of the average manufacturer price (AMP) methodology to drug rebates, to eliminate the State option to increase the cap amount on the equity asset test for individuals' eligibility for long-term care assistance under such program, and to extend an SSI asset verification demonstration to Medicaid.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
SEC. 2. DISPENSING FEES FOR MEDICAID COVERED OUTPATIENT DRUGS.
(a) In General- Section 1927(e) of the Social Security Act (42 U.S.C. 1396r-8(e)) is amended by adding at the end the following new paragraph:
`(6) DISPENSING FEES-
`(A) IN GENERAL- A State which provides medical assistance for covered outpatient drugs shall pay a dispensing fee for each covered outpatient drug that is dispensed, in accordance with this paragraph. A State may vary the amount of such dispensing fees, including taking into account the special circumstances of pharmacies that are serving rural or underserved areas or that are sole community pharmacies, so long as such variation is consistent with subparagraph (B).
`(B) MINIMUM DISPENSING FEE PAYMENT FOR MULTIPLE SOURCE DRUGS- A State shall establish a dispensing fee under this title for a covered outpatient drug that is a multiple source drug described in paragraph (4) (whether or not it may be an innovator multiple source drug) in an amount that is not less than $8 per prescription unit. The Secretary shall define what constitutes a prescription unit for purposes of the previous sentence.'.
(b) Effective Date- The amendment made by subsection (a) shall take effect with respect to a State on the later of (1)--
(1) the date that is 3 months after the date of the enactment of this Act; or
(2) the date that is 3 months after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act.
SEC. 3. IMPROVING STATE FLEXIBILITY IN PHARMACY REIMBURSEMENT.
(a) In General- Section 1927(e)(5) of the Social Security Act (42 U.S.C. 1396r-8(e)(5)) is amended by striking `250 percent' and inserting `300 percent'.
(b) Variance Permitted in Application of Average Manufacturer Price- Such section is further amended by adding at the end the following: `Nothing in this paragraph shall be construed as preventing a State from varying the amount paid different pharmacies for such a product, including taking into account the special circumstances of pharmacies that are serving rural or underserved areas or that are sole community pharmacies.'.
(c) Effective Date- The amendments made by this section shall take effect on January 1, 2008.
SEC. 4. ELIMINATION OF STATE OPTION TO INCREASE CAP AMOUNT ON INDIVIDUALS' EQUITY ASSET TEST FOR ELIGIBILITY FOR LONG-TERM CARE ASSISTANCE UNDER MEDICAID.
(a) In General- Section 1917(f)(1) of the Social Security Act (42 U.S.C. 1396p(f)(1)) is amended by striking subparagraph (B).
(b) Conforming Amendments- Such section is further amended--
(1) in subparagraph (A), by striking `subparagraphs (B) and (C)' and inserting `subparagraph (B)';
(2) by redesignating subparagraph (C) as subparagraph (B); and
(3) in subparagraph (B), as so redesignated, by striking `dollar amounts' and inserting `dollar amount'.
(c) Effective Date- The amendments made by this section shall apply to individuals who are determined eligible for medical assistance with respect to nursing facility services or other long-term care services based on an application filed on or after the date of the enactment of this section.
SEC. 5. EXTENSION OF SSI ASSET VERIFICATION DEMONSTRATION TO MEDICAID.
(a) In General- Subject to subsection (b), the Secretary of Health and Human Services shall collaborate with the Commissioner of Social Security to provide for the use, for purposes of verifying financial eligibility for medical assistance under State plans under title XIX of the Social Security Act, of the system administered by the Commissioner (under section 1631(e)(1)(B)(ii) of such Act, 42 U.S.C. 1383(e)(1)(B)(ii)) under which the Commissioner may obtain information held by financial institutions in order to verify eligibility for benefits under title XVI of such Act.
(b) Limitation- For purposes of this section, use of the system described in subsection (a), and the information obtained through such system, shall be limited to determinations of eligibility for medical assistance in States in which such system is being used by the Commissioner to verify eligibility for benefits under such title XVI.
(c) Sharing by Commissioner of Information Obtained From Financial Institutions- Notwithstanding the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401 et seq.) or any other provision of law, information obtained by the Commissioner from financial institutions under the system described in subsection (a) may, for purposes of carrying out this section, be shared with the agencies of the State specified in subsection (b) which are administering the plans of such States under title XIX of the Social Security Act.
U.S. Congress - Text of H.R.3193 as Introduced in House Access to Community Pharmacy Preservation Act of 2007
