I 

115TH 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 20, 2017 

Mr. GUTHRIE (for himself, Mr. KIND, Mr. REED, Mr. BUTTERFIELD, Mrs. 

BLACKBURN, Mr. KING of Iowa, Ms. KUSTER of New Hampshire, Mr. 

BOST, Mr. FOSTER, Mr. RYAN of Ohio, Mr. SWALWELL of California, Mr. 

SHUSTER, Mr. THOMAS J. ROONEY of Florida, Mr. TIPTON, Mr. BROOKS

of Alabama, Mr. FARENTHOLD, Mr. YOUNG of Alaska, Mrs. MCMORRIS

RODGERS, Ms. NORTON, Mr. LANGEVIN, Mr. STEWART, Mr. CUMMINGS, 

Mr. BILIRAKIS, Mr. CONNOLLY, Mr. LIPINSKI, Ms. DELAURO, Mr. MEEHAN, Mr. COLLINS of Georgia, Mr. LONG, Mr. MASSIE, Mr. DUNCAN of 

Tennessee, Mr. WALBERG, Mr. HILL, Ms. SPEIER, Ms. DELBENE, Mrs. 

WALORSKI, Ms. PINGREE, Mr. CARTER of Texas, Mr. BLUM, Ms. 

SLAUGHTER, Mr. ROGERS of Kentucky, Mr. PETERSON, Mr. LOBIONDO, 

Mr. SMITH of Texas, Mr. TIBERI, Mr. WEBSTER of Florida, Ms. TSONGAS, Mr. DELANEY, Mr. STIVERS, Mr. HUNTER, Mr. MESSER, Mr. 

YOHO, Mr. JONES, Mr. KNIGHT, Mrs. COMSTOCK, Mr. CARTER of Georgia, Mr. LARSON of Connecticut, Mr. COLLINS of New York, Mr. ROYCE

of California, Mr. PITTENGER, Mr. HASTINGS, Mr. THOMPSON of Pennsylvania, Mr. AUSTIN SCOTT of Georgia, Mr. COHEN, Mr. RODNEY DAVIS

of Illinois, Mr. MULLIN, Mr. HENSARLING, Mr. GIBBS, Mr. JOYCE of 

Ohio, Ms. STEFANIK, Mr. PRICE of North Carolina, Mr. BARLETTA, Mr. 

TURNER, Mr. OLSON, Mr. CRAMER, Mr. BYRNE, Mr. JOHNSON of Ohio, 

Mr. WALZ, Mr. VEASEY, Mr. KATKO, Mr. HURD, Mr. HUDSON, Mr. 

POCAN, Ms. MCSALLY, Mr. MARINO, Mr. DEFAZIO, Mr. HARPER, Mr. 

DESJARLAIS, Mrs. BUSTOS, Mr. HECK, Mr. SHIMKUS, Mr. PAULSEN, 

Ms. MICHELLE LUJAN GRISHAM of New Mexico, Mr. WELCH, Mr. 

LOEBSACK, Mr. GRAVES of Missouri, Mr. ABRAHAM, Mr. BISHOP of 

Michigan, Ms. MOORE, Mr. LANCE, Mr. LUCAS, Mr. KINZINGER, Mr. 

LUETKEMEYER, Ms. GABBARD, Ms. KELLY of Illinois, Mr. DENT, Mr. 

POLIQUIN, and Mr. EMMER) 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 


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•HR 592 IH

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— 

9 (1) by striking ‘‘and’’ at the end of subpara10 graph (FF); 

11 (2) by adding ‘‘and’’ at the end of subpara12 graph (GG); and 

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

14 following new subparagraph: 

15 ‘‘(HH) pharmacist services furnished by a 

16 pharmacist, as licensed by State law, individ17 ually or on behalf of a pharmacy provider— 

18 ‘‘(i) which the pharmacist is legally 

19 authorized to perform in the State in 

20 which the individual performs such serv21 ices; 


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•HR 592 IH

1 ‘‘(ii) as would otherwise be covered 

2 under this part if furnished by a physician, 

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

4 and 

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

6 professional shortage area (as defined in 

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

8 Service Act), medically underserved area, 

9 or medically underserved population (as 

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

11 (b) PAYMENT.—Section 1833(a)(1) of the Social Se12 curity Act (42 U.S.C. 1395l(a)(1)) is amended— 

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

14 ‘‘(BB)’’; and 

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

16 the following: ‘‘, and (CC) with respect to phar17 macist services (as defined in section 

18 1861(s)(2)(HH)), the amounts paid shall be equal to 

19 80 percent of the lesser of the actual charge or 85 

20 percent of the fee schedule amount provided under 

21 section 1848 if such services had been furnished by 

22 a physician’’. 

23 (c) EFFECTIVE DATE; PHARMACIST SPECIFIC

24 CODES.— 


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1 (1) EFFECTIVE DATE.—The amendments made 

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

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

4 (2) PHARMACIST SPECIFIC CODES.—The Sec5 retary of Health and Human Services shall develop 

6 pharmacist specific codes, as necessary, under the 

7 physician fee schedule under section 1848 of the So8 cial Security Act (42 U.S.C. 1395w–4). 

Æ 


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