(1) The first sentence of section 1866(a)(2)(A)
(42 U.S.C. 1395cc(a)(2)(A)) is amended—
(A) 
by 
inserting 
‘‘1834(d),’’ 
after
‘‘1833(b),’’; and
(B) by inserting ‘‘and in the case of cov-
ered outpatient drugs, applicable coinsurance
percent (specified in section 1834(d)(2)(C)) of
the lesser of the actual charges for the drugs or
the payment limit (established under section
1834(d)(3))’’ after ‘‘established by the Sec-
retary’’.
(2) Section 1903(i)(5) (42 U.S.C. 1396b(i)(5))
is amended by striking ‘‘section 1862(c)’’ and insert-
ing ‘‘section 1862(c)(1)’’.
(h) PRESCRIPTION DRUG PAYMENT REVIEW COM-
MISSION.—Part B is amended by inserting after section
1846 the following new section:
‘‘PRESCRIPTION DRUG PAYMENT REVIEW COMMISSION
‘‘SEC. 1847. (a)(1) The Director of the Congressional
Office of Technology Assessment (in this section referred
to as the ‘Director’ and the ‘Office’, respectively) shall
provide for the appointment of a Prescription Drug Pay-
ment Review Commission (in this section referred to as
the ‘Commission’), to be composed of individuals with ex-
pertise in the provision and financing of covered out-
patient drugs appointed by the Director (without regard
to the provisions of title 5, United States Code, governing
appointments in the competitive service).
‘‘(2) The Commission shall consist of 11 individuals.
Members of the Commission shall first be appointed by
no later than January 1, 1998, for a term of 3 years, ex-
cept that the Director may provide initially for such short-
er terms as will ensure that (on a continuing basis) the
terms of no more than 4 members expire in any one year.
‘‘(3) The membership of the Commission shall in-
clude recognized experts in the fields of health care eco-
nomics, medicine, pharmacology, pharmacy, and prescrip-
tion drug reimbursement, as well as at least one individual
who is a medicare beneficiary.
‘‘(b)(1) The Commission shall submit to Congress an
annual report no later than May 1 of each year, beginning
with 1999, concerning methods of determining payment
for covered outpatient drugs under this part.
‘‘(2) Such report, in 2000 and thereafter, shall in-
clude, with respect to the previous year, information on—
‘‘(A) increases in manufacturers’ prices for cov-
ered outpatient drugs and in charges of pharmacists
for covered outpatient drugs,
‘‘(B) the level of utilization of covered out-
patient drugs by medicare beneficiaries, and
‘‘(C) administrative costs relating to covered
outpatient drugs.
‘‘(c) Section 1845(c)(1) shall apply to the Commis-
sion in the same manner as it applies to the Physician
Payment Review Commission.
‘‘(d) There are authorized to be appropriated such
sums as may be necessary to carry out the provisions of
this section. Such sums shall be payable from the Federal
Supplementary Medical Insurance Trust Fund.’’.
(i) DEVELOPMENT OF STANDARD MEDICARE CLAIMS
FORM.—
(1) The Secretary shall develop, in consultation
with representatives of pharmacies and other inter-
ested individuals, a standard claims form (and a
standard electronic claims format) to be used in re-
quests for payment for covered outpatient drugs
under the medicare program and other third-party
payors.
(2) Not later than October 1, 1998, the Sec-
retary shall distribute official sample copies of the
format developed under paragraph (1) to pharmacies
and other interested parties and by not later than
October 1, 1998, shall distribute official sample cop-
ies of the form developed under paragraph (1) to
pharmacies and other interested parties.
(j) EFFECTIVE DATES.—
(1) IN
GENERAL.—Except as otherwise pro-
vided in this subsection, the amendments made by
this section shall apply to items dispensed on or
after January 1, 1999.
(2) CARRIERS.—The amendments made by sub-
section (e) shall take effect on the date of the enact-
ment of this Act; except that the amendments made
by subsection (e)(5) shall take effect on January 1,
2000, but shall not be construed as requiring pay-
ment before February 1, 2000.
(3) HMO/CMP ENROLLMENTS.—The amend-
ment made by subsection (f) shall apply to enroll-
ments effected on or after January 1, 1999.
Æ