I 
113TH CONGRESS 
2D SESSION 
H. R. 4190 
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 
MARCH 11, 2014 
Mr. GUTHRIE (for himself, Mr. BUTTERFIELD, and Mr. YOUNG of Indiana) 
introduced the following bill; which was referred to the Committee on En-
ergy 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 jurisdic-
tion 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. MEDICARE COVERAGE OF PHARMACIST SERV-
ICES. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) by striking ‘‘and’’ at the end of subpara-
graph (EE); 
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(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— 
(1) by striking ‘‘and (Z)’’ and inserting ‘‘(Z)’’; 
and 
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(2) by inserting before the semicolon at the end 
the following: ‘‘(AA) with respect to pharmacist 
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, 2015. 
(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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