I 

111TH CONGRESS 

1ST SESSION H. R. 806 

To establish a mail-order pharmacy pilot program for TRICARE beneficiaries. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 3, 2009 

Mr. BILIRAKIS introduced the following bill; which was referred to the 

Committee on Armed Services 

A BILL 

To establish a mail-order pharmacy pilot program for 

TRICARE beneficiaries. 

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 ‘‘TRICARE Mail-Order 

5 Pharmacy Pilot Program Act’’. 

6 SEC. 2. MAIL-ORDER PHARMACY PILOT PROGRAM. 

7 (a) REQUIREMENT.—The Secretary of Defense shall 

8 conduct a pilot program to— 

9 (1) educate eligible covered beneficiaries about 

10 the mail-order pharmacy available under TRICARE; 

11 and 


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1 (2) motivate such beneficiaries to voluntarily in2 crease use of the mail-order pharmacy. 

3 (b) SCOPE OF PILOT PROGRAM.—The pilot program 

4 shall include not less than 2,000 eligible covered bene5 ficiaries in each TRICARE region, of whom not less than 

6 1,000 in each TRICARE region shall be enrolled under 

7 part B of title XVIII of the Social Security Act. An eligible 

8 covered beneficiary chosen to participate in the pilot pro9 gram shall be an individual who— 

10 (1) has filled a prescription in the TRICARE 

11 retail pharmacy program for a medication intended 

12 for long-term use; and 

13 (2) has not used the mail-order pharmacy. 

14 (c) DURATION OF PILOT PROGRAM.—The pilot pro15 gram shall begin not later than October 1, 2009, and shall 

16 continue for two years. 

17 (d) ADMINISTRATION OF PILOT PROGRAM.—In ad18 ministering the pilot program, the Secretary of Defense 

19 shall— 

20 (1) offer mail-order medications within the uni21 form formulary to participants at no charge; 

22 (2) provide each participant a notification letter 

23 explaining the advantages of the mail-order phar24 macy, including convenience and cost savings; 


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1 (3) provide each participant with a personalized 

2 summary indicating the cost savings such partici3 pant would have realized had the participant used 

4 the mail-order pharmacy during the previous 12- 

5 month period; 

6 (4) provide each participant with simplified ap7 plication and instruction guidelines and such other 

8 information as the Secretary considers useful to en9 courage use of the mail-order pharmacy; and 

10 (5) survey participants to determine— 

11 (A) the understanding of and satisfaction 

12 with the mail-order pharmacy; 

13 (B) the factors that motivated the partici14 pant to use or not use the mail-order pharmacy; 

15 (C) the specific reasons for any dissatisfac16 tion with the mail-order pharmacy; 

17 (D) the extent to which the participant 

18 considers the information described in para19 graph (4) helpful; 

20 (E) the extent to which the participant 

21 would recommend to others the use of the mail22 order pharmacy; and 

23 (F) suggestions for ways to further in24 crease use of the mail-order pharmacy. 


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1 (e) CONSULTATION.—The Secretary shall consult 

2 with representatives of beneficiary associations in— 

3 (1) designing and conducting the pilot program; 

4 and 

5 (2) evaluating the results of the pilot program. 

6 (f) REPORTS.—Not later than March 1, 2010, and 

7 each 180-day period thereafter for 1 year, the Secretary 

8 shall submit to the Committee on Armed Services of the 

9 House of Representatives and the Committee on Armed 

10 Services of the Senate a report on the pilot program, in11 cluding— 

12 (1) the extent to which participants increased 

13 their use of the mail-order pharmacy; 

14 (2) the extent to which the use of the mail15 order pharmacy affected pharmacy costs for both the 

16 Department of Defense and participants; 

17 (3) summaries of the results of participant sur18 veys described in subsection (d)(5) (to the extent the 

19 results are available on the date of each report); 

20 (4) an assessment of the effect of eliminating 

21 the copayment for medications ordered through the 

22 mail-order pharmacy; 

23 (5) whether to expand the pilot program to in24 clude all eligible covered beneficiaries; and 


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1 (6) any other analyses, observations, and rec2 ommendations the Secretary considers appropriate. 

3 SEC. 3. DEFINITIONS. 

4 In this Act: 

5 (1) The term ‘‘eligible covered beneficiaries’’ 

6 has the meaning given such term in section 

7 1074g(g)(1) of title 10, United States Code. 

8 (2) The term ‘‘mail-order pharmacy’’ means the 

9 national mail-order pharmacy program required by 

10 section 1074g(a)(2)(E)(iii) of title 10, United States 

11 Code. 

12 (3) The term ‘‘participant’’ means an eligible 

13 covered beneficiary described in section 2(b) that is 

14 chosen to participate in the pilot program. 

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