I 
110TH CONGRESS 
2D SESSION 
H. R. 5780 
To amend title XVIII of the Social Security Act to provide for coverage 
of clinical pharmacist practitioner services under part B of the Medicare 
Program. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 10, 2008 
Mrs. WILSON of New Mexico (for herself, Mr. ETHERIDGE, and Mr. UDALL 
of New Mexico) 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 jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for coverage of clinical pharmacist practitioner services 
under part B of 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 ‘‘Medicare Clinical Phar-
macist Practitioner Services Coverage Act of 2008’’. 
VerDate Aug 31 2005 
04:51 Apr 12, 2008
Jkt 069200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H5780.IH
H5780
wwoods2 on PRODPC68 with BILLS
SEC. 2. MEDICARE COVERAGE OF CLINICAL PHARMACIST 
PRACTITIONER SERVICES. 
(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 (Z); 
(2) by adding ‘‘and’’ at the end of subpara-
graph (AA); and 
(3) by inserting after subparagraph (AA) the 
following new subparagraph: 
‘‘(BB) clinical pharmacist practitioner 
services (as defined in subsection (ddd)(1)); 
and’’. 
(b) SERVICES DESCRIBED.—Section 1861 of such 
Act (42 U.S.C. 1395x) is amended by adding at the end 
the following new subsection: 
‘‘(ddd) CLINICAL PHARMACIST PRACTITIONER SERV-
ICES; CLINICAL PHARMACIST PRACTITIONER.—(1) The 
term ‘clinical pharmacist practitioner services’ means such 
direct patient care services provided by a pharmacist clini-
cian or clinical pharmacist practitioner, and such services 
furnished as incident to the services of the clinician or 
practitioner, respectively, which the clinician or practi-
tioner, respectively, is legally authorized to perform under 
State law (or the State regulatory mechanism as provided 
by State law) in a collaborative practice agreement as 
VerDate Aug 31 2005 
04:51 Apr 12, 2008
Jkt 069200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H5780.IH
H5780
wwoods2 on PRODPC68 with BILLS
would otherwise be covered under this part if furnished 
by a physician, or as incident to a physician’s professional 
service. 
‘‘(2) The terms ‘pharmacist clinician’ and ‘clinical 
pharmacist practitioner’ mean a pharmacist who— 
‘‘(A) is certified by a State as a pharmacist cli-
nician or clinical pharmacist practitioner as a result 
of completing training in physical assessment and 
clinical hours of experience, as required by State law 
and the rules of State Boards of Pharmacy, in addi-
tion to any requirements of such State to be a li-
censed pharmacist; 
‘‘(B) has prescriptive authority, as established 
by State statute; and 
‘‘(C) is involved in the application of the sci-
entific principles of pharmacology, toxicology, thera-
peutics, 
clinical 
pharmacokinetics, 
pharmacoeconomics, and other life sciences for the 
direct care of patients’’. 
(c) PAYMENT.— 
(1) IN GENERAL.—Section 1833(a)(1) of such 
Act (42 U.S.C. 1395l(a)(1)) is amended— 
(A) by striking ‘‘and (V)’’ and inserting 
‘‘(V)’’; and 
VerDate Aug 31 2005 
04:51 Apr 12, 2008
Jkt 069200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5780.IH
H5780
wwoods2 on PRODPC68 with BILLS
(B) by striking the semicolon at the end 
and inserting the following: ‘‘, and (W) with re-
spect to clinical pharmacist practitioner services 
(as defined in section 1861(ddd)(1)), the 
amounts paid shall be 85 percent of the 
amounts provided for such services under sec-
tion 1834(n)(1);’’. 
(2) ESTABLISHMENT
OF
FEE
SCHEDULES.— 
Section 1834 of such Act (42 U.S.C. 1395m) is 
amended by adding at the end the following new 
subsection: 
‘‘(n) FEE SCHEDULES FOR CLINICAL PHARMACIST 
PRACTITIONER SERVICES.— 
‘‘(1) DEVELOPMENT.—The Secretary shall de-
velop and implement, for services furnished not later 
than January 1, 2010— 
‘‘(A) a relative value scale to serve as the 
basis for the payment of clinical pharmacist 
practitioner services (as defined in section 
1861(ddd)(1)) under this part; and 
‘‘(B) using such scale and appropriate con-
version factors, fee schedules (on a regional, 
statewide, locality, or carrier service area basis) 
for payment for clinical pharmacist practitioner 
services under this part. 
VerDate Aug 31 2005 
04:51 Apr 12, 2008
Jkt 069200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5780.IH
H5780
wwoods2 on PRODPC68 with BILLS
‘‘(2) PAYMENTS
PRIOR
TO
IMPLEMENTATION 
OF FEE SCHEDULES.—In the case of clinical phar-
macist practitioner services which are furnished be-
fore the implementation of fee schedules under para-
graph (1)(B) and after January 1, 2009, the 
amount of payment made under this part shall be 
based on 85 percent of the fee schedule amount ap-
plicable under section 1848 if the services were fur-
nished by a physician.’’. 
(3) REPORT
TO
CONGRESS.—Not later than 
September 30, 2009, the Secretary of Health and 
Human Services shall submit to Congress a report 
on the fee schedules (including relative value scale 
and appropriate conversion factors) developed pursu-
ant to section 1834(n)(1) of the Social Security Act 
(as added by paragraph (2)) for clinical pharmacist 
practitioner services under part B of title XVIII of 
such Act. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2009. 
Æ 
VerDate Aug 31 2005 
04:51 Apr 12, 2008
Jkt 069200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6301
E:\BILLS\H5780.IH
H5780
wwoods2 on PRODPC68 with BILLS