I 
119TH CONGRESS 
1ST SESSION H. R. 2484 
To amend title XVIII of the Social Security Act to establish an exception 
to the physician self-referral prohibition for certain outpatient prescrip-
tion drugs furnished by a physician practice under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 31, 2025 
Mrs. HARSHBARGER (for herself, Ms. WASSERMAN SCHULTZ, Mrs. MILLER of 
West Virginia, Mr. SOTO, Mr. CRENSHAW, and Mr. DAVIS of North Caro-
lina) 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 juris-
diction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to establish 
an exception to the physician self-referral prohibition for 
certain outpatient prescription drugs furnished by a phy-
sician practice under the Medicare program. 
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 ‘‘Seniors’ Access to Crit-
ical Medications Act of 2025’’. 
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SEC. 2. ESTABLISHING AN EXCEPTION TO THE PHYSICIAN 
SELF-REFERRAL PROHIBITION FOR CERTAIN 
OUTPATIENT 
PRESCRIPTION 
DRUGS 
FUR-
NISHED BY A PHYSICIAN PRACTICE UNDER 
THE MEDICARE PROGRAM. 
(a) IN GENERAL.—Section 1877(b) of the Social Se-
curity Act (42 U.S.C. 1395nn(b)) is amended by adding 
at the end the following new paragraph: 
‘‘(6) 
CERTAIN
OUTPATIENT
PRESCRIPTION 
DRUGS.— 
‘‘(A) IN GENERAL.—In the case of des-
ignated health services described in subsection 
(h)(6)(J) that are covered part D drugs (as de-
fined in section 1860D–2(e)) and furnished to 
an individual during the period beginning on 
January 1, 2026, and ending on December 31, 
2030, if— 
‘‘(i) such drugs are prescribed by the 
referring physician (or by another physi-
cian or practitioner (as described in section 
1842(b)(18)(C)) within the same group 
practice as such physician); 
‘‘(ii) such individual has an ongoing 
relationship (as defined by the Secretary) 
with such physician or practitioner who 
prescribed such drugs (or with another 
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‘‘(II) a mail, delivery, or courier 
service; and 
‘‘(v) such drugs are billed for by the 
physician dispensing or supervising the dis-
pensing of such drugs, by a group practice 
of which such physician is a member under 
a billing number assigned to such group 
practice, or by an entity that is wholly 
owned by such physician or such group 
practice. 
‘‘(B) RULE OF CONSTRUCTION.—Nothing 
in subparagraph (A) shall be construed as 
modifying any program requirements under 
part D.’’. 
(b) GAO STUDY AND REPORT.— 
(1) STUDY.—The Comptroller General of the 
United States (in this section referred to as the 
‘‘Comptroller General’’) shall conduct a study exam-
ining— 
(A) pharmacies or pharmacy networks par-
ticipating under part D of title XVIII of the 
Social Security Act (42 U.S.C. 1395w–101 et 
seq.) that, after the date of the enactment of 
this section, dispense significantly more (as de-
termined by the Comptroller General) covered 
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part D drugs (as defined in section 1860D–2 of 
such Act (42 U.S.C. 1395e–102)) compared to 
the amount of such drugs dispensed prior to 
such date; 
(B) common characteristics of the phar-
macies and pharmacy networks identified under 
subparagraph (A), including, to the extent iden-
tifiable, the extent to which such pharmacies 
and pharmacy networks are owned by a physi-
cian or group practice (as defined in section 
1877(h) of the Social Security Act (42 U.S.C. 
1395nn(h)) or otherwise integrated into a phy-
sician’s practice or group practice; and 
(C) common characteristics of arrange-
ments entered into by physicians or group prac-
tices for purposes of dispensing drugs within 
physicians’ offices or otherwise integrating 
pharmacies or the dispensing of drugs into a 
physician’s practice or group practice, includ-
ing, to the extent feasible and identifiable, an 
analysis of— 
(i) specific physician specialties or 
subspecialties for which such arrangements 
are especially common or have shown sub-
stantial growth; 
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(ii) the extent to which physicians and 
group practices participating in such ar-
rangements have such arrangements or in-
tegration with other physicians or group 
practices or other drug supply chain par-
ticipants (including pharmacy benefit man-
agers, insurers, wholesalers, distributors, 
or management services organizations); 
(iii) common contracting features of 
such arrangements relating to the utiliza-
tion of covered part D drugs or services 
provided in connection with such drugs, in-
cluding contract terms related to adminis-
trative or dispensing fees for such drugs 
and the types of payments provided in con-
nection with such services; 
(iv) common measures, including no-
tices or disclosures, taken by physicians 
and group practices participating in such 
arrangements in order to mitigate or oth-
erwise address potential conflicts of inter-
est posed by such arrangements; and 
(v) any components or features of 
such arrangements that may influence pre-
scribing decisions or patterns among physi-
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cians and group practices participating in 
such arrangements. 
(2) REPORT.—Not later than 3 years after the 
date of the enactment of this section, the Comp-
troller General shall submit to Congress a report on 
the findings of the study required under paragraph 
(1), which shall not include identifying or propri-
etary information with respect to the pharmacies or 
pharmacy networks examined. 
SEC. 3. MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 
1395iii(b)(1)) 
is 
amended 
by 
striking 
‘‘1,804,000,000’’ and inserting ‘‘1,786,000,000’’. 
Æ 
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