II 

115TH CONGRESS 

1ST SESSION S. 1003 

To amend title XIX of the Social Security Act to add standards for drug 

compendia for physician use for purposes of Medicaid payment for certain 

drugs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 2, 2017 

Mr. GRASSLEY (for himself and Mr. CASEY) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to add standards for drug compendia for physician use for purposes 

of Medicaid payment for certain drugs, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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•S 1003 IS

1 SECTION 1. ADDING STANDARDS FOR DRUG COMPENDIA 

2 FOR PHYSICIAN USE FOR PURPOSES OF PAY3 MENT UNDER MEDICAID FOR CERTAIN 

4 DRUGS. 

5 (a) IN GENERAL.—Section 1927(g)(1)(B)(i) of the 

6 Social Security Act (42 U.S.C. 1396r–8(g)(1)(B)(i)) is 

7 amended— 

8 (1) in subclause (I), by striking the semicolon 

9 at the end and inserting a period; 

10 (2) in subclause (II), by striking ‘‘); and’’ at 

11 the end and inserting ‘‘).’’; 

12 (3) in subclause (III)— 

13 (A) by striking ‘‘the DRUGDEX’’ and in14 serting ‘‘The DRUGDEX’’; and 

15 (B) by striking ‘‘; and’’ at the end and in16 serting a period; and 

17 (4) by adding at the end the following: 

18 ‘‘(IV) Other compendia, as deter19 mined by the Secretary in a manner 

20 consistent with the revision process 

21 provided for in section 1861(t), that— 

22 ‘‘(aa) are utilized nationwide 

23 by the private health insurance 

24 industry; 

25 ‘‘(bb) are used by health 

26 care providers, such as long-term 


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•S 1003 IS

1 care facilities or academic health 

2 centers; 

3 ‘‘(cc) have a publicly avail4 able policy on the disclosure of 

5 conflicts of interest that may 

6 exist between such a health care 

7 provider and drug manufactur8 ers; and 

9 ‘‘(dd) are accepted as pro10 fessional drug compendia by at 

11 least one State board of phar12 macy (or an equivalent State li13 censing body).’’. 

14 (b) TECHNICAL AMENDMENTS.—Section 

15 1927(g)(1)(B) of the Social Security Act (42 U.S.C. 

16 1396r–8(g)(1)(B)) is amended— 

17 (1) in clause (i), by striking ‘‘compendia’’ and 

18 inserting ‘‘Compendia’’; and 

19 (2) in clause (ii), by striking ‘‘the peer-re20 viewed’’ and inserting ‘‘The peer-reviewed’’. 

21 SEC. 2. REVISING DEFINITION OF MEDICALLY ACCEPTED 

22 INDICATION FOR MEDICARE PART D DRUGS. 

23 Section 1860D–2(e)(4) of the Social Security Act (42 

24 U.S.C. 1395w–102(e)(4)) is amended— 


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•S 1003 IS

1 (1) in subparagraph (A)(i)(II), by striking ‘‘sec2 tion 1927(g)(1)(B)(i)(III)’’ and inserting ‘‘sub3 clauses (III) and (IV) of section 1927(g)(1)(B)(i)’’; 

4 and 

5 (2) in subparagraph (B), by striking ‘‘subpara6 graph (A)(i)(II)’’ and all that follows through 

7 ‘‘1927(g)(1)(B)(i)(III)’’ and inserting ‘‘a compen8 dium described in subclause (III) or (IV) of section 

9 1927(g)(1)(B)(i) shall not be included in the list of 

10 compendia described in section 1861(t)(2)(B)(ii)(I) 

11 unless such compendium’’. 

Æ 


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