I 

118TH CONGRESS 

1ST SESSION H. R. 1770 

To amend title XVIII of the Social Security Act to provide pharmacy payment 

of certain services. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 23, 2023 

Mr. SMITH of Nebraska (for himself, Mr. SCHNEIDER, Mr. BUCSHON, Ms. 

MATSUI, Mr. CARTER of Georgia, Mrs. HARSHBARGER, Mr. BILIRAKIS, 

Mr. BLUMENAUER, Mr. FITZPATRICK, Mr. PETERS, and Ms. SEWELL) 

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 

pharmacy payment of certain 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 ‘‘Equitable Community 

5 Access to Pharmacist Services Act’’. 


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1 SEC. 2. COVERAGE OF PHARMACIST SERVICES UNDER 

2 MEDICARE PART B. 

3 (a) COVERAGE.—Section 1861(s) of the Social Secu4 rity Act (42 U.S.C. 1395x(s)) is amended— 

5 (1) in paragraph (2)— 

6 (A) in subparagraph (II), by striking 

7 ‘‘and’’ at the end; 

8 (B) in subparagraph (JJ), by striking the 

9 period at the end and inserting ‘‘; and’’; and 

10 (C) by adding at the end the following new 

11 subparagraph: 

12 ‘‘(KK) pharmacist services and such services 

13 and supplies furnished as an incident to the phar14 macist’s service as would otherwise be covered under 

15 part B if furnished by a physician or as an incident 

16 to a physician’s service that— 

17 ‘‘(i) are furnished by a pharmacist— 

18 ‘‘(I) as licensed under State law; or 

19 ‘‘(II) pursuant to a Federal emer20 gency authority described under section 

21 319F–3 or section 361 of the Public 

22 Health Service Act, or other similar Fed23 eral law; 

24 ‘‘(ii) would otherwise be covered under part 

25 B if furnished by a physician; and 

26 ‘‘(iii) are services— 


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1 ‘‘(I) for encounters for the evaluation 

2 and management of patients for testing or 

3 treatment for COVID–19, influenza, res4 piratory syncytial virus, or streptococcal 

5 pharyngitis; or 

6 ‘‘(II) that address a public health 

7 need related to a public health emergency 

8 under section 319F–3 or section 361 of 

9 the Public Health Service Act, or other 

10 similar Federal law.’’; and 

11 (2) in paragraph (10), in each of subpara12 graphs (A) and (B), by inserting ‘‘, including when 

13 furnished by a pharmacist’’ before the semicolon in 

14 each such subparagraph. 

15 (b) PAYMENT.—Section 1833(a)(1) of the Social Se16 curity Act (42 U.S.C. 1395l(a)(1)) is amended— 

17 (1) by striking ‘‘and (HH)’’ and inserting 

18 ‘‘(HH)’’; and 

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

20 the following: ‘‘and (II) with respect to pharmacist 

21 services described in section 1861(s)(2)(KK), the 

22 amounts paid shall be equal to 80 percent of the 

23 lesser of (i) the actual charge for the services or (ii) 

24 85 percent (or 100 percent, in the case of such serv25 ices furnished pursuant to a Federal emergency auVerDate Sep 11 2014 21:22 Apr 07, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1770.IH H1770

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1 thority described in clause (i)(II) of such section) of 

2 the amount determined under the payment basis 

3 under section 1848 for such services.’’. 

4 (c) PROHIBITION ON BALANCE BILLING FOR PHAR5 MACIST SERVICES.—Section 1842(b)(18)(C) of the Social 

6 Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by 

7 adding at the end the following: 

8 ‘‘(ix) A pharmacist.’’. 

9 (d) RULE OF CONSTRUCTION.—Nothing in this sec10 tion shall be construed to restrict the ability of pharmacies 

11 and pharmacists to enroll and obtain reimbursement 

12 under existing pathways under title XVIII of the Social 

13 Security Act (42 U.S.C. 1395 et seq.) as of the date of 

14 the enactment of this Act, including payment as mass 

15 immunizers. 

16 (e) IMPLEMENTATION AUTHORITY.—Notwith17 standing any other provision of law, the Secretary of 

18 Health and Human Services shall implement the provi19 sions of, and the amendments made by, this section by 

20 interim final rule, program instruction, or otherwise not 

21 later than the date that is 60 days after the date of the 

22 enactment of this Act. 

Æ 


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