I 
114TH 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 28, 2015 
Mr. GUTHRIE (for himself, Mr. BUTTERFIELD, Mr. YOUNG of Indiana, and 
Mr. KIND) introduced the following bill; which was referred to the Com-
mittee 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 
for coverage under the Medicare program of pharmacist 
services. 
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 ‘‘Pharmacy and Medi-
cally Underserved Areas Enhancement Act’’. 
SEC. 2. MEDICARE COVERAGE OF PHARMACIST SERVICES. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
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(1) by striking ‘‘and’’ at the end of subpara-
graph (EE); 
(2) by adding ‘‘and’’ at the end of subpara-
graph (FF); and 
(3) by inserting after subparagraph (FF) the 
following new subparagraph: 
‘‘(GG) pharmacist services furnished by a 
pharmacist, as licensed by State law, individ-
ually or on behalf of a pharmacy provider— 
‘‘(i) which the pharmacist is legally 
authorized to perform in the State in 
which the individual performs such serv-
ices; 
‘‘(ii) as would otherwise be covered 
under this part if furnished by a physician, 
or as an incident to a physician’s service; 
and 
‘‘(iii) in a setting located in a health 
professional shortage area (as defined in 
section 332(a)(1)(A) of the Public Health 
Service Act), medically underserved area, 
or medically underserved population (as 
defined in section 330(b)(3) of such Act);’’. 
(b) PAYMENT.—Section 1833(a)(1) of the Social Se-
curity Act (42 U.S.C. 1395l(a)(1)) is amended— 
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(1) by striking ‘‘and (Z)’’ and inserting ‘‘(Z)’’; 
and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (AA) with respect to phar-
macist 
services 
(as 
defined 
in 
section 
1861(s)(2)(GG)), the amounts paid shall be equal to 
80 percent of the lesser of the actual charge or 85 
percent of the fee schedule amount provided under 
section 1848 if such services had been furnished by 
a physician’’. 
(c) 
EFFECTIVE
DATE; 
PHARMACIST
SPECIFIC 
CODES.— 
(1) EFFECTIVE DATE.—The amendments made 
by subsections (a) and (b) shall apply with respect 
to services furnished on or after January 1, 2016. 
(2) PHARMACIST SPECIFIC CODES.—The Sec-
retary of Health and Human Services shall develop 
pharmacist specific codes, as necessary, under the 
physician fee schedule under section 1848 of the So-
cial Security Act (42 U.S.C. 1395w–4). 
Æ 
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