I 

115TH CONGRESS 

2D SESSION H. R. 5598 

To amend the Public Health Service Act to require certain disproportionate 

share hospital covered entities under the 340B drug discount program 

to submit to the Secretary of Health and Human Services reports on 

low-income utilization rates of outpatient hospital services furnished by 

such entities. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 24, 2018 

Mr. CARTER of Georgia (for himself and Mr. COLLINS of New York) introduced the following bill; which was referred to the Committee on Energy 

and Commerce 

A BILL 

To amend the Public Health Service Act to require certain 

disproportionate share hospital covered entities under the 

340B drug discount program to submit to the Secretary 

of Health and Human Services reports on low-income 

utilization rates of outpatient hospital services furnished 

by such entities. 

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 ‘‘340B Optimization 

5 Act’’. 


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1 SEC. 2. REQUIRING 340B DRUG DISCOUNT PROGRAM RE2 PORTS BY DSH HOSPITAL COVERED ENTITIES 

3 ON LOW-INCOME UTILIZATION RATE OF OUT4 PATIENT HOSPITAL SERVICES. 

5 (a) IN GENERAL.—Section 340B(d)(2) of the Public 

6 Health Service Act (42 U.S.C. 256b(d)(2)) is amended— 

7 (1) in subparagraph (B)(i), by inserting before 

8 the period at the end the following: ‘‘, including, 

9 with respect to such updates made on or after Janu10 ary 1, 2020, by requiring covered entities described 

11 in subsection (a)(4)(L) to submit (and to so regu12 larly update) information described in subparagraph 

13 (C)’’; and 

14 (2) by adding at the end the following new sub15 paragraph: 

16 ‘‘(C) INFORMATION ON LOW-INCOME UTI17 LIZATION RATE OF OUTPATIENT HOSPITAL

18 SERVICES.— 

19 ‘‘(i) IN GENERAL.—For purposes of 

20 subparagraph (B)(i), the information de21 scribed in this subparagraph, with respect 

22 to a covered entity described in subsection 

23 (a)(4)(L) and an update under such sub24 paragraph (B)(i), is— 


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1 ‘‘(I) the low-income outpatient 

2 utilization rate of such covered entity 

3 for the most recent fiscal year; and 

4 ‘‘(II) the low-income outpatient 

5 utilization rate of off-site outpatient 

6 facilities, clinics, eligible off-site loca7 tions, and associated sites of such en8 tity identified as child sites of such 

9 entity pursuant to the identification 

10 system under subparagraph (B)(iv) 

11 for the most recent fiscal year. 

12 ‘‘(ii) LOW-INCOME OUTPATIENT UTI13 LIZATION RATE DEFINED.—In this sub14 paragraph, the term ‘low-income outpatient 

15 utilization rate’ has the meaning given the 

16 term ‘low-income utilization rate’ under 

17 paragraph (3) of section 1923(b) of the 

18 Social Security Act, except that— 

19 ‘‘(I) clauses (i) and (ii) of sub20 paragraph (A) of such paragraph 

21 shall be applied as if— 

22 ‘‘(aa) each reference to ‘pa23 tient services’ were a reference to 

24 ‘patient services furnished on an 

25 outpatient basis’; and 


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1 ‘‘(bb) for purposes of clause 

2 (i)(II) of this subparagraph, each 

3 reference to ‘hospital’ were a ref4 erence to ‘off-site outpatient fa5 cilities, clinics, eligible off-site lo6 cations, and associated sites of 

7 the hospital that are identified as 

8 child sites of the hospital pursu9 ant to the identification system 

10 under section 340B(d)(2)(B)(iv) 

11 of the Public Health Service Act’; 

12 and 

13 ‘‘(II) clauses (i) and (ii) of sub14 paragraph (B) of such paragraph 

15 shall be applied as if— 

16 ‘‘(aa) each reference to ‘in17 patient hospital services’ were a 

18 reference to ‘outpatient hospital 

19 services’; and 

20 ‘‘(bb) for purposes of clause 

21 (i)(II) each reference to ‘hos22 pital’s charges’ were a reference 

23 to ‘charges of the off-site out24 patient facilities, clinics, eligible 

25 off-site locations, and associated 


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1 sites of the hospital that are 

2 identified as child sites of the 

3 hospital pursuant to the identi4 fication system under section 

5 340B(d)(2)(B)(iv) of the Public 

6 Health Service Act’.’’. 

7 (b) ANNUAL REPORTS.—Not later than January 1, 

8 2021, and annually thereafter, the Administrator of the 

9 Health Resources and Services Administration shall sub10 mit to Congress a report on information submitted by cov11 ered entities for the previous year pursuant to the amend12 ments made by subsection (a). 

Æ 


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