IB 

Union Calendar No. 581 

115TH CONGRESS 

2D SESSION H. R. 4841 

[Report No. 115–747, Part I] 

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

prior authorization under Medicare part D for covered part D drugs, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 18, 2018 

Mr. SCHWEIKERT (for himself, Mr. BEN RAY LUJA ́N of New Mexico, Mr. 

JOHNSON of Ohio, and Mr. THOMPSON of California) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

JUNE 12, 2018 

Additional sponsors: Mrs. WALORSKI, Mr. MARSHALL, Mr. ROKITA, Mr. 

YOUNG of Iowa, Mr. BLUMENAUER, Mr. NORCROSS, Mr. DUNN, Mr. 

STIVERS, Mr. KELLY of Pennsylvania, Mr. RENACCI, Mr. BISHOP of 

Michigan, Ms. MATSUI, Mr. JONES, Ms. SINEMA, Mr. SESSIONS, Mr. 

RASKIN, Mrs. BLACKBURN, Mr. WALDEN, Mr. BACON, Mr. WEBSTER of 

Florida, Mr. CRAMER, Mr. SCHIFF, and Mr. KENNEDY

JUNE 12, 2018 

Reported from the Committee on Energy and Commerce with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

JUNE 12, 2018 

The Committee on Ways and Means discharged; committed to the Committee 

of the Whole House on the State of the Union and ordered to be printed 

[For text of introduced bill, see copy of bill as introduced on January 18, 2018] 


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•HR 4841 RH

A BILL 

To amend title XVIII of the Social Security Act to provide 

for electronic prior authorization under Medicare part 

D for covered part D drugs, and for other purposes. 


lotter on DSKBCFDHB2PROD with BILLS
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•HR 4841 RH

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 ‘‘Standardizing Elec5 tronic Prior Authorization for Safe Prescribing Act of 

6 2018’’. 

7 SEC. 2. ELECTRONIC PRIOR AUTHORIZATION FOR COVERED 

8 PART D DRUGS. 

9 (a) INCLUSION IN ELECTRONIC PRESCRIPTION PRO10 GRAM.—Section 1860D–4(e)(2) of the Social Security Act 

11 (42 U.S.C. 1395w–104(e)(2)) is amended by adding at the 

12 end the following new subparagraph: 

13 ‘‘(E) ELECTRONIC PRIOR AUTHORIZA14 TION.— 

15 ‘‘(i) IN GENERAL.—Not later than Jan16 uary 1, 2021, the program shall provide for 

17 the secure electronic transmittal of— 

18 ‘‘(I) a prior authorization request 

19 from the prescribing health care profes20 sional for coverage of a covered part D 

21 drug for a part D eligible individual 

22 enrolled in a part D plan (as defined 

23 in section 1860D–23(a)(5)) to the PDP 

24 sponsor or Medicare Advantage organi25 zation offering such plan; and 


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•HR 4841 RH

1 ‘‘(II) a response, in accordance 

2 with this subparagraph, from such 

3 PDP sponsor or Medicare Advantage 

4 organization, respectively, to such pro5 fessional. 

6 ‘‘(ii) ELECTRONIC TRANSMISSION.— 

7 ‘‘(I) EXCLUSIONS.—For purposes 

8 of this subparagraph, a facsimile, pro9 prietary payer portal that meets such 

10 standards as specified by the Secretary, 

11 or electronic form shall not be treated 

12 as an electronic transmission described 

13 in clause (i). 

14 ‘‘(II) STANDARDS.—In order to be 

15 treated, for purposes of this subpara16 graph, as an electronic transmission 

17 described in clause (i), such trans18 mission shall comply with technical 

19 standards adopted by the Secretary in 

20 consultation with the National Council 

21 for Prescription Drug Programs, other 

22 standard setting organizations deter23 mined appropriate by the Secretary, 

24 and stakeholders including PDP spon25 sors, Medicare Advantage organizaVerDate Sep 11 2014 23:52 Jun 12, 2018 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6203 E:\BILLS\H4841.RH H4841

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1 tions, health care professionals, and 

2 health information technology software 

3 vendors.’’. 

4 (b) SENSE OF CONGRESS REGARDING ELECTRONIC

5 PRIOR AUTHORIZATION.—It is the sense of the Congress 

6 that— 

7 (1) there should be increased use of electronic 

8 prior authorizations for coverage of covered part D 

9 drugs for part D eligible individuals enrolled in pre10 scription drug plans under part D of title XVIII of 

11 the Social Security Act and MA–PD plans under 

12 part C of such title to reduce access delays by resolv13 ing coverage issues before prescriptions for such drugs 

14 are transmitted; and 

15 (2) greater priority should be placed on increas16 ing the adoption of use of such electronic prior au17 thorizations among prescribers of such drugs, phar18 macies, PDP sponsors, and Medicare Advantage orga19 nizations. 


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Union Calendar No. 581 

115TH CONGRESS 

2D SESSION H. R. 4841 

[Report No. 115–747, Part I] 

A BILL 

To amend title XVIII of the Social Security Act to 

for other purposes. Medicare part D for covered part D drugs, and provide for electronic prior authorization under 

JUNE 12, 2018 

Reported from the Committee on Energy and Commerce 

with an amendment 

JUNE 12, 2018 

The Committee on Ways and Means discharged; comState of the Union and ordered to be printed mitted to the Committee of the Whole House on the 


lotter on DSKBCFDHB2PROD with BILLS