SEC. 4. NATIONAL RESEARCH AND REPORTING STRATEGY 
FOR IMPROVED MEDICATION ADHERENCE. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Agency for 
Healthcare Research and Quality, the Centers for Medi-
care & Medicaid Services, the Health Resources and Serv-
ices Administration, the Director of the National Insti-
tutes of Health, and the Director of the Centers for Dis-
ease Control and Prevention, and in coordination with the 
Patient-Centered Outcomes Research Institute, shall con-
duct research and develop information to better inform de-
cisionmakers regarding medication adherence and medica-
tion persistence, and methods to improve medication ad-
herence and persistence in Federal health programs. 
(b) ACTIVITIES INCLUDED.—The activities described 
in subsection (a) shall include development of annual sta-
tistics on recommended medications, the rate of medica-
tion adherence, the rate of primary nonadherence, and the 
rate of medication persistence for patients with chronic 
diseases such as cardiovascular disease, hypertension, dia-
betes, autoimmune diseases, chronic obstructive pul-
monary disease (COPD), and mental health conditions 
treated under the following health care programs: 
(1) MEDICARE.—The Medicare program under 
title XVIII of the Social Security Act. 
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(2) MEDICAID.—The Medicaid program under 
title XIX of such Act. 
(3) FEHBP.—The Federal Employees Health 
Benefit Program under chapter 89 of title 5, United 
States Code. 
(c) BIENNIAL REPORT ON MEDICATION ADHERENCE 
AND MEDICATION PERSISTENCE.—Not later than 2 years 
after the date of enactment of this Act (and annually 
thereafter), the Secretary shall submit to Congress a re-
port on the statistics collected under subsection (a), to-
gether with recommendations for such legislation and ad-
ministrative action to address problems and improve medi-
cation adherence and medication persistence as the Sec-
retary determines appropriate. 
SEC. 5. TESTING MODELS FOR IMPROVING MEDICATION 
ADHERENCE. 
(a) IN GENERAL.—The Secretary shall test innova-
tive health care delivery models, as described in sub-
sections (b) and (c), to improve medication adherence and 
medication persistence, with the goal of improving health 
outcomes and decreasing health costs for chronic care con-
ditions. 
(b) MODELS TO TEST EFFICACY OF SYNCHRONI-
ZATION.— 
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(1) IN GENERAL.—The model described in this 
subsection shall test the efficacy of synchronization 
of prescription drug medications for applicable en-
rollees in improving medication adherence, deter-
mining cost avoidance, and improving outcomes for 
those enrollees. 
(2) PARTICIPATION.—An applicable enrollee 
who is eligible to participate in the model testing 
under this subsection shall participate in the model 
testing, unless the enrollee elects not to participate 
in the model. 
(3) MODELS TESTED.—The following models of 
synchronization shall be tested under this sub-
section: 
(A) MODEL 1.—Synchronization (synchro-
nization of prescription drug medications and 
medication reconciliation phone calls or elec-
tronic communication with enrollees prior to 
filling prescriptions). 
(B) MODEL
2.—Synchronization (as de-
scribed in subparagraph (A)) and compliance- 
based packaging. 
(C) MODEL
3.—Synchronization (as de-
scribed in subparagraph (A)) and ongoing phar-
macist counseling that shall occur at the pa-
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tient’s request and include review of the appro-
priateness of the medication regimen and any 
barriers to medication adherence. 
(4) EVALUATION.—The Secretary shall evaluate 
the models in paragraph (3) by collecting and ana-
lyzing relevant plan and enrollee data, including at 
least the following: 
(A) Synchronization enrollment and drop- 
out rates. 
(B) Primary medication nonadherence. 
(C) Medication adherence and persistence 
rates. 
(D) Demographic characteristics of appli-
cable enrollees. 
(E) Plan characteristics, such as plan ben-
efit design. 
(F) Impact of the models on applicable en-
rollees who are— 
(i) eligible for benefits under a State 
plan under title XIX of the Social Secu-
rity; or 
(ii) eligible for premium and cost- 
sharing subsidies under section 1860D– 
14(a) of the Social Security Act (42 U.S.C. 
1395w–114(a)). 
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(G) Prescription drug claims data in com-
parison to other medical claims data for appli-
cable enrollees in order to examine the effect of 
synchronization and adherence on overall health 
spending, including health care costs avoided, 
and patient outcomes. 
(c) TESTING 90-DAY FILLS AT RETAIL PHARMACIES 
FOR THE FIRST PRESCRIPTION.— 
(1) IN GENERAL.—The Secretary shall conduct 
a demonstration that compares the use of 90-day 
first fills of prescriptions at retail pharmacies or 
using 
mail-order 
for 
maintenance 
medications 
against 30-day first fills for applicable enrollees 
under part D of title XVIII of the Social Security 
Act, to determine whether there is an impact on 
medication persistence, cost avoidance, and improv-
ing outcomes for those enrollees in subsequent refill 
periods. 
(2) DRUGS
TESTED.—The model under this 
subsection shall only pertain to first fills for mainte-
nance drugs treating chronic diseases such as car-
diovascular disease, hypertension, diabetes, auto-
immune diseases, chronic obstructive pulmonary dis-
ease (COPD), and mental health conditions. 
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(3) EVALUATION
OF
DEMONSTRATION
BY 
GAO.— 
(A) PROVISION
OF
DATA
FOR
EVALUA-
TION.—The Secretary shall make available to 
the Comptroller General of the United States 
relevant plan and enrollee data in order to en-
able an evaluation of the demonstration under 
this subsection under subparagraph (B). 
(B) EVALUATION.—Using data made avail-
able under subparagraph (A) and other relevant 
data, the Comptroller General of the United 
States shall evaluate the demonstration con-
ducted under this subsection. Such evaluation 
shall examine the effect of long-term fills and 
adherence on overall health spending, including 
health care costs avoided, and patient outcome, 
and shall examine at least the following in rela-
tion to part D enrollees using 90-day first fills 
in comparison with those enrollees using 30-day 
first fills: 
(i) Medication adherence and persist-
ence rates. 
(ii) Cost differentials in pharmacy 
costs. 
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(iii) Prescription drug claims data in 
comparison to other medical claims. 
(iv) Medication wastage (as defined in 
section 3). 
(C) REPORT.—The Comptroller General 
shall submit a report to the Secretary and Con-
gress on the evaluation conducted under this 
paragraph. 
Æ 
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