II 

115TH CONGRESS 

1ST SESSION S. 109 

To amend title XVIII of the Social Security Act to provide for coverage 

under the Medicare program of pharmacist services. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 12, 2017 

Mr. GRASSLEY (for himself, Mr. CASEY, Mr. BROWN, Mr. UDALL, Ms. 

HIRONO, Mr. FRANKEN, Mr. PETERS, Ms. KLOBUCHAR, Mr. COONS, Mr. 

DONNELLY, Mrs. SHAHEEN, Mrs. CAPITO, Mr. WICKER, Mr. COCHRAN, 

Mr. GARDNER, Mr. BOOZMAN, Ms. COLLINS, Mr. HOEVEN, Mr. BLUNT, 

Mr. BARRASSO, Mr. THUNE, Mr. MORAN, Mr. COTTON, Mrs. ERNST, Mr. 

DAINES, Mr. SCOTT, and Mr. YOUNG) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for coverage under the Medicare program of pharmacist 

services. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Pharmacy and Medi5 cally Underserved Areas Enhancement Act’’. 


asabaliauskas on DSK3SPTVN1PROD with BILLS
2 

•S 109 IS

1 SEC. 2. MEDICARE COVERAGE OF PHARMACIST SERVICES. 

2 (a) COVERAGE.—Section 1861(s)(2) of the Social Se3 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 

4 (1) by striking ‘‘and’’ at the end of subpara5 graph (FF); 

6 (2) by adding ‘‘and’’ at the end of subpara7 graph (GG); and 

8 (3) by inserting after subparagraph (GG) the 

9 following new subparagraph: 

10 ‘‘(HH) pharmacist services furnished by a phar11 macist, as licensed by State law, individually or on 

12 behalf of a pharmacy provider— 

13 ‘‘(i) which the pharmacist is legally author14 ized to perform in the State in which the indi15 vidual performs such services; 

16 ‘‘(ii) as would otherwise be covered under 

17 this part if furnished by a physician, or as an 

18 incident to a physician’s service; and 

19 ‘‘(iii) in a setting located in a health pro20 fessional shortage area (as defined in section 

21 332(a)(1)(A) of the Public Health Service Act), 

22 medically underserved area, or medically under23 served population (as defined in section 

24 330(b)(3) of such Act);’’. 

25 (b) PAYMENT.—Section 1833(a)(1) of the Social Se26 curity Act (42 U.S.C. 1395l(a)(1)) is amended— 


asabaliauskas on DSK3SPTVN1PROD with BILLS
3 

•S 109 IS

1 (1) by striking ‘‘and (BB)’’ and inserting 

2 ‘‘(BB)’’; and 

3 (2) by inserting before the semicolon at the end 

4 the following: ‘‘, and (CC) with respect to phar5 macist services (as defined in section 

6 1861(s)(2)(HH)), the amounts paid shall be equal to 

7 80 percent of the lesser of the actual charge or 85 

8 percent of the fee schedule amount provided under 

9 section 1848 if such services had been furnished by 

10 a physician’’. 

11 (c) EFFECTIVE DATE; PHARMACIST SPECIFIC

12 CODES.— 

13 (1) EFFECTIVE DATE.—The amendments made 

14 by subsections (a) and (b) shall apply with respect 

15 to services furnished on or after January 1, 2018. 

16 (2) PHARMACIST SPECIFIC CODES.—The Sec17 retary of Health and Human Services shall develop 

18 pharmacist specific codes, as necessary, under the 

19 physician fee schedule under section 1848 of the So20 cial Security Act (42 U.S.C. 1395w–4). 

Æ 


asabaliauskas on DSK3SPTVN1PROD with BILLS