I 
108TH CONGRESS 
2D SESSION 
H. R. 4681 
To require the Secretary of Health and Human Services to establish and 
maintain an Internet website that is designed to allow consumers to 
compare the usual and customary prices for covered outpatient drugs 
sold by retail pharmacies that participate in the Medicaid Program 
for each postal Zip Code, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 24, 2004 
Mr. CARDIN (for himself, Mr. PALLONE, and Mr. MCNULTY) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To require the Secretary of Health and Human Services 
to establish and maintain an Internet website that is 
designed to allow consumers to compare the usual and 
customary prices for covered outpatient drugs sold by 
retail pharmacies that participate in the Medicaid Pro-
gram for each postal Zip Code, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Prescription Drug 
Price Comparison for Savings Act of 2004’’.
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Access to prescription drugs is important to 
all Americans. 
(2) Many individuals cannot afford to purchase 
the drugs prescribed by their doctors. Others skip 
doses or split pills contrary to their doctor’s orders 
because they cannot afford to refill their prescrip-
tions. 
(3) Individuals who use their limited financial 
resources to obtain needed drugs may do so by fore-
going other expenditures important to their health 
and well-being. 
(4) Among the objectives of the medicaid pro-
gram set forth in section 1901 of the Social Security 
Act (42 U.S.C. 1396) is the objective to enable each 
State to furnish services to help low-income families 
and aged, blind, or disabled individuals ‘‘attain or 
retain capability for independence or self-care’’. 
(5) Some States, such as Maryland, have estab-
lished interactive Internet websites that use the 
usual and customary price information reported by 
pharmacies participating in the State’s medicaid 
program to allow all residents of the State to com-
parison shop for prescription drugs.
(6) Requiring all States to collect from phar-
macies that participate in the medicaid program the 
usual and customary price for prescription drugs 
sold by the pharmacies and to report that informa-
tion to the Secretary of Health and Human Services 
in order that a national, interactive Internet website 
may be established and maintained for individuals to 
use to comparison shop for prescription drugs is 
consistent with the objectives of the medicaid pro-
gram. 
SEC. 3. STATE PLAN REQUIREMENT TO COLLECT AND RE-
PORT USUAL AND CUSTOMARY PRICES FOR 
COVERED OUTPATIENT DRUGS SOLD UNDER 
THE MEDICAID PROGRAM. 
Section 1902(a) of the Social Security Act (42 U.S.C. 
1396a(a)) is amended— 
(1) in paragraph (66), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (67), by striking the period 
and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (67), the fol-
lowing: 
‘‘(68) provide that the State shall— 
‘‘(A) require each retail pharmacy which 
receives payments under the plan to report to
the State concurrent with the filling of a pre-
scription for a covered outpatient drug (as de-
fined in section 1927(k)(2)) for an individual 
receiving medical assistance under this title— 
‘‘(i) the usual and customary price (as 
defined in section 1927(k)(10)) for the 
strength, quantity, and dosage form of the 
covered outpatient drug, as of the date the 
prescription is filled; and 
‘‘(ii) the postal Zip Code in which the 
retail pharmacy is located; and 
‘‘(B) submit the information reported 
under subparagraph (A) to the Secretary on 
such frequent basis as the Secretary shall re-
quire so as to allow for monthly updates of the 
information posted on the Internet website re-
quired to be established under section 5 of the 
Prescription Drug Price Comparison for Sav-
ings Act of 2004.’’. 
SEC. 4. USUAL AND CUSTOMARY PRICES FOR COVERED 
OUTPATIENT DRUGS. 
(a) DEFINITION.—Section 1927(k) of the Social Se-
curity Act (42 U.S.C. 1396r–8(k)) is amended by adding 
at the end the following:
‘‘(10) USUAL
AND
CUSTOMARY
PRICE.—The 
term ‘usual and customary price’ means the price a 
retail pharmacy would charge an individual who does 
not have health insurance coverage for purchasing a 
specific strength, quantity, and dosage form of a 
covered outpatient drug.’’. 
(b) INCLUSION OF INFORMATION IN ANNUAL RE-
PORT TO CONGRESS.—Section 1927(i)(2)(E) of the Social 
Security Act (42 U.S.C. 1396r–8(i)(2)(E)) is amended— 
(1) by redesignating subparagraphs (E) and 
(F) as subparagraphs (F) and (G), respectively; and 
(2) by inserting after subparagraph (D), the 
following: 
‘‘(E) the range of usual and customary 
prices for specific strengths, quantities, and 
dosage forms of covered outpatient drugs, 
disaggregated by postal Zip Code;’’. 
SEC. 5. REQUIREMENT TO ESTABLISH AND MAINTAIN PRE-
SCRIPTION 
DRUG 
PRICE 
COMPARISON 
WEBSITE. 
(a) AUTHORITY.—Not later than 6 months after the 
date of enactment of this Act, the Secretary shall establish 
and arrange for the maintenance of an Internet website 
that is designed to allow an individual to compare the 
usual and customary prices for a range of strengths and
quantities of covered outpatient drugs sold by retail phar-
macies that receive payments under the medicaid program 
for each postal Zip Code that corresponds to an area of 
a State. 
(b) REQUIREMENTS.—The Internet website required 
to be established and maintained under this section shall 
consist of— 
(1) the information submitted to the Secretary 
in accordance with section 1902(a)(68)(B) of the 
Social Security Act (42 U.S.C. 1396a(a)(68)(B)) (as 
added by section 3(a)(3)); and 
(2) such other information as the Secretary de-
termines is appropriate. 
(c) DEFINITIONS.—In this section: 
(1) COVERED OUTPATIENT DRUG.—The term 
‘‘covered outpatient drug’’ has the meaning given 
that term in section 1927(k)(2) of the Social Secu-
rity Act (42 U.S.C. 1396r–8(k)(2)). 
(2) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(3) STATE.—The term ‘‘State’’ has the mean-
ing given that term for purposes of title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.). 
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