I 

114TH CONGRESS 

1ST SESSION H. R. 592 

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

under the Medicare program of pharmacist services. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 28, 2015 

Mr. GUTHRIE (for himself, Mr. BUTTERFIELD, Mr. YOUNG of Indiana, and 

Mr. KIND) 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 

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’’. 

6 SEC. 2. MEDICARE COVERAGE OF PHARMACIST SERVICES. 

7 (a) COVERAGE.—Section 1861(s)(2) of the Social Se8 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 


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1 (1) by striking ‘‘and’’ at the end of subpara2 graph (EE); 

3 (2) by adding ‘‘and’’ at the end of subpara4 graph (FF); and 

5 (3) by inserting after subparagraph (FF) the 

6 following new subparagraph: 

7 ‘‘(GG) pharmacist services furnished by a 

8 pharmacist, as licensed by State law, individ9 ually or on behalf of a pharmacy provider— 

10 ‘‘(i) which the pharmacist is legally 

11 authorized to perform in the State in 

12 which the individual performs such serv13 ices; 

14 ‘‘(ii) as would otherwise be covered 

15 under this part if furnished by a physician, 

16 or as an incident to a physician’s service; 

17 and 

18 ‘‘(iii) in a setting located in a health 

19 professional shortage area (as defined in 

20 section 332(a)(1)(A) of the Public Health 

21 Service Act), medically underserved area, 

22 or medically underserved population (as 

23 defined in section 330(b)(3) of such Act);’’. 

24 (b) PAYMENT.—Section 1833(a)(1) of the Social Se25 curity Act (42 U.S.C. 1395l(a)(1)) is amended— 


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1 (1) by striking ‘‘and (Z)’’ and inserting ‘‘(Z)’’; 

2 and 

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

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

6 1861(s)(2)(GG)), 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, 2016. 

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 


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