H. R. 3590—579 
SEC. 6003. DISCLOSURE REQUIREMENTS FOR IN-OFFICE ANCILLARY 
SERVICES EXCEPTION TO THE PROHIBITION ON PHYSI-
CIAN SELF-REFERRAL FOR CERTAIN IMAGING SERVICES. 
(a) IN GENERAL.—Section 1877(b)(2) of the Social Security Act 
(42 U.S.C. 1395nn(b)(2)) is amended by adding at the end the 
following new sentence: ‘‘Such requirements shall, with respect 
to magnetic resonance imaging, computed tomography, positron 
emission tomography, and any other designated health services 
specified under subsection (h)(6)(D) that the Secretary determines 
appropriate, include a requirement that the referring physician 
inform the individual in writing at the time of the referral that 
the individual may obtain the services for which the individual 
is being referred from a person other than a person described 
in subparagraph (A)(i) and provide such individual with a written 
list of suppliers (as defined in section 1861(d)) who furnish such 
services in the area in which such individual resides.’’. 
(b) EFFECTIVE DATE.—The amendment made by this section 
shall apply to services furnished on or after January 1, 2010. 
SEC. 6004. PRESCRIPTION DRUG SAMPLE TRANSPARENCY. 
Part A of title XI of the Social Security Act (42 U.S.C. 1301 
et seq.), as amended by section 6002, is amended by inserting 
after section 1128G the following new section: 
‘‘SEC. 1128H. REPORTING OF INFORMATION RELATING TO DRUG SAM-
PLES. 
‘‘(a) IN GENERAL.—Not later than April 1 of each year (begin-
ning with 2012), each manufacturer and authorized distributor 
of record of an applicable drug shall submit to the Secretary (in 
a form and manner specified by the Secretary) the following 
information with respect to the preceding year: 
‘‘(1) In the case of a manufacturer or authorized distributor 
of record which makes distributions by mail or common carrier 
under subsection (d)(2) of section 503 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 353), the identity and 
quantity of drug samples requested and the identity and 
quantity of drug samples distributed under such subsection 
during that year, aggregated by— 
‘‘(A) the name, address, professional designation, and 
signature of the practitioner making the request under 
subparagraph (A)(i) of such subsection, or of any individual 
who makes or signs for the request on behalf of the practi-
tioner; and 
‘‘(B) any other category of information determined 
appropriate by the Secretary. 
‘‘(2) In the case of a manufacturer or authorized distributor 
of record which makes distributions by means other than mail 
or common carrier under subsection (d)(3) of such section 503, 
the identity and quantity of drug samples requested and the 
identity and quantity of drug samples distributed under such 
subsection during that year, aggregated by— 
‘‘(A) the name, address, professional designation, and 
signature of the practitioner making the request under 
subparagraph (A)(i) of such subsection, or of any individual 
who makes or signs for the request on behalf of the practi-
tioner; and
H. R. 3590—580 
‘‘(B) any other category of information determined 
appropriate by the Secretary. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) APPLICABLE DRUG.—The term ‘applicable drug’ means 
a drug— 
‘‘(A) which is subject to subsection (b) of such section 
503; and 
‘‘(B) for which payment is available under title XVIII 
or a State plan under title XIX or XXI (or a waiver of 
such a plan). 
‘‘(2) AUTHORIZED
DISTRIBUTOR
OF
RECORD.—The term 
‘authorized distributor of record’ has the meaning given that 
term in subsection (e)(3)(A) of such section. 
‘‘(3) MANUFACTURER.—The term ‘manufacturer’ has the 
meaning given that term for purposes of subsection (d) of such 
section.’’. 
SEC. 6005. PHARMACY BENEFIT MANAGERS TRANSPARENCY REQUIRE-
MENTS. 
Part A of title XI of the Social Security Act (42 U.S.C. 1301 
et seq.) is amended by inserting after section 1150 the following 
new section: 
‘‘SEC. 
1150A. 
PHARMACY 
BENEFIT 
MANAGERS 
TRANSPARENCY 
REQUIREMENTS. 
‘‘(a) PROVISION OF INFORMATION.—A health benefits plan or 
any entity that provides pharmacy benefits management services 
on behalf of a health benefits plan (in this section referred to 
as a ‘PBM’) that manages prescription drug coverage under a con-
tract with— 
‘‘(1) a PDP sponsor of a prescription drug plan or an MA 
organization offering an MA–PD plan under part D of title 
XVIII; or 
‘‘(2) a qualified health benefits plan offered through an 
exchange established by a State under section 1311 of the 
Patient Protection and Affordable Care Act, 
shall provide the information described in subsection (b) to the 
Secretary and, in the case of a PBM, to the plan with which 
the PBM is under contract with, at such times, and in such form 
and manner, as the Secretary shall specify. 
‘‘(b) INFORMATION DESCRIBED.—The information described in 
this subsection is the following with respect to services provided 
by a health benefits plan or PBM for a contract year: 
‘‘(1) The percentage of all prescriptions that were provided 
through retail pharmacies compared to mail order pharmacies, 
and the percentage of prescriptions for which a generic drug 
was available and dispensed (generic dispensing rate), by phar-
macy type (which includes an independent pharmacy, chain 
pharmacy, supermarket pharmacy, or mass merchandiser phar-
macy that is licensed as a pharmacy by the State and that 
dispenses medication to the general public), that is paid by 
the health benefits plan or PBM under the contract. 
‘‘(2) The aggregate amount, and the type of rebates, dis-
counts, or price concessions (excluding bona fide service fees, 
which include but are not limited to distribution service fees, 
inventory management fees, product stocking allowances, and 
fees associated with administrative services agreements and 
patient care programs (such as medication compliance programs
H. R. 3590—581 
and patient education programs)) that the PBM negotiates 
that are attributable to patient utilization under the plan, 
and the aggregate amount of the rebates, discounts, or price 
concessions that are passed through to the plan sponsor, and 
the total number of prescriptions that were dispensed. 
‘‘(3) The aggregate amount of the difference between the 
amount the health benefits plan pays the PBM and the amount 
that the PBM pays retail pharmacies, and mail order phar-
macies, and the total number of prescriptions that were dis-
pensed. 
‘‘(c) CONFIDENTIALITY.—Information disclosed by a health bene-
fits plan or PBM under this section is confidential and shall not 
be disclosed by the Secretary or by a plan receiving the information, 
except that the Secretary may disclose the information in a form 
which does not disclose the identity of a specific PBM, plan, or 
prices charged for drugs, for the following purposes: 
‘‘(1) As the Secretary determines to be necessary to carry 
out this section or part D of title XVIII. 
‘‘(2) To permit the Comptroller General to review the 
information provided. 
‘‘(3) To permit the Director of the Congressional Budget 
Office to review the information provided. 
‘‘(4) To States to carry out section 1311 of the Patient 
Protection and Affordable Care Act. 
‘‘(d) PENALTIES.—The provisions of subsection (b)(3)(C) of sec-
tion 1927 shall apply to a health benefits plan or PBM that fails 
to provide information required under subsection (a) on a timely 
basis or that knowingly provides false information in the same 
manner as such provisions apply to a manufacturer with an agree-
ment under that section.’’. 
Subtitle B—Nursing Home Transparency 
and Improvement 
PART I—IMPROVING TRANSPARENCY OF 
INFORMATION 
SEC. 6101. REQUIRED DISCLOSURE OF OWNERSHIP AND ADDITIONAL 
DISCLOSABLE PARTIES INFORMATION. 
(a) IN GENERAL.—Section 1124 of the Social Security Act (42 
U.S.C. 1320a–3) is amended by adding at the end the following 
new subsection: 
‘‘(c) REQUIRED DISCLOSURE
OF OWNERSHIP
AND ADDITIONAL 
DISCLOSABLE PARTIES INFORMATION.— 
‘‘(1) DISCLOSURE.—A facility shall have the information 
described in paragraph (2) available— 
‘‘(A) during the period beginning on the date of the 
enactment of this subsection and ending on the date such 
information is made available to the public under section 
6101(b) of the Patient Protection and Affordable Care Act 
for submission to the Secretary, the Inspector General of 
the Department of Health and Human Services, the State 
in which the facility is located, and the State long-term 
care ombudsman in the case where the Secretary, the
H. R. 3590—582 
Inspector General, the State, or the State long-term care 
ombudsman requests such information; and 
‘‘(B) beginning on the effective date of the final regula-
tions promulgated under paragraph (3)(A), for reporting 
such information in accordance with such final regulations. 
Nothing in subparagraph (A) shall be construed as authorizing 
a facility to dispose of or delete information described in such 
subparagraph after the effective date of the final regulations 
promulgated under paragraph (3)(A). 
‘‘(2) INFORMATION DESCRIBED.— 
‘‘(A) IN
GENERAL.—The following information is 
described in this paragraph: 
‘‘(i) The information described in subsections (a) 
and (b), subject to subparagraph (C). 
‘‘(ii) The identity of and information on— 
‘‘(I) each member of the governing body of 
the facility, including the name, title, and period 
of service of each such member; 
‘‘(II) each person or entity who is an officer, 
director, member, partner, trustee, or managing 
employee of the facility, including the name, title, 
and period of service of each such person or entity; 
and 
‘‘(III) each person or entity who is an addi-
tional disclosable party of the facility. 
‘‘(iii) The organizational structure of each addi-
tional disclosable party of the facility and a description 
of the relationship of each such additional disclosable 
party to the facility and to one another. 
‘‘(B) SPECIAL RULE WHERE INFORMATION IS ALREADY 
REPORTED OR SUBMITTED.—To the extent that information 
reported by a facility to the Internal Revenue Service on 
Form 990, information submitted by a facility to the Securi-
ties and Exchange Commission, or information otherwise 
submitted to the Secretary or any other Federal agency 
contains the information described in clauses (i), (ii), or 
(iii) of subparagraph (A), the facility may provide such 
Form or such information submitted to meet the require-
ments of paragraph (1). 
‘‘(C) SPECIAL RULE.—In applying subparagraph (A)(i)— 
‘‘(i) with respect to subsections (a) and (b), ‘owner-
ship or control interest’ shall include direct or indirect 
interests, including such interests in intermediate enti-
ties; and 
‘‘(ii) subsection (a)(3)(A)(ii) shall include the owner 
of a whole or part interest in any mortgage, deed 
of trust, note, or other obligation secured, in whole 
or in part, by the entity or any of the property or 
assets thereof, if the interest is equal to or exceeds 
5 percent of the total property or assets of the entirety. 
‘‘(3) REPORTING.— 
‘‘(A) IN
GENERAL.—Not later than the date that is 
2 years after the date of the enactment of this subsection, 
the Secretary shall promulgate final regulations requiring, 
effective on the date that is 90 days after the date on 
which such final regulations are published in the Federal 
Register, a facility to report the information described in