(e) LIMITATIONS ON EXEMPTION.—Nothing in this 
section shall exempt from the application of the antitrust 
laws any agreement or otherwise unlawful conspiracy 
that— 
(1) would have the effect of boycotting any 
independent pharmacy or group of independent 
pharmacies, or would exclude, limit the participation 
or reimbursement of, or otherwise limit the scope of 
services to be provided by, any independent phar-
macy or group of independent pharmacies with re-
spect to the performance of services that are within 
the scope of practice as defined or permitted by rel-
evant law or regulation; 
(2) allocates a market among competitors; 
(3) unlawfully ties the sale or purchase of one 
product or service to the sale or purchase of another 
product or service; or 
(4) monopolizes or attempts to monopolize a 
market. 
(f) LIMITATION BASED
ON MARKET SHARE
OF 
GROUP.—This section shall not apply with respect to the 
negotiations of any group of independent pharmacies with 
a health plan regarding the terms of any contract under 
which such pharmacies provide health care items or serv-
ices for which benefits are provided under such plan in 
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a PDP region (as defined in subsection (j)(4)) if the num-
ber of pharmacy licenses of such pharmacies within such 
group in such region exceeds 25 percent of the total num-
ber of pharmacy licenses issued to all retail pharmacies 
(including both independent and other pharmacies) in 
such region. 
(g) NO EFFECT ON TITLE VI OF CIVIL RIGHTS ACT 
OF 1964.—Nothing in this section shall be construed to 
affect the application of title VI of the Civil Rights Act 
of 1964. 
(h) NO APPLICATION TO SPECIFIED FEDERAL PRO-
GRAMS.—Nothing in this section shall apply to negotia-
tions between independent pharmacies and health plans 
pertaining to benefits provided under any of the following: 
(1) The Medicaid Program under title XIX of 
the Social Security Act (42 U.S.C. 1396 et seq.). 
(2) The State Children’s Health Insurance Pro-
gram (SHIP) under title XXI of the Social Security 
Act (42 U.S.C. 1397aa et seq.). 
(3) Chapter 55 of title 10, United States Code 
(relating to medical and dental care for members of 
the uniformed services). 
(4) Chapter 17 of title 38, United States Code 
(relating to Veterans’ medical care). 
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(5) Chapter 89 of title 5, United States Code 
(relating to the Federal employees’ health benefits 
program). 
(6) The Indian Health Care Improvement Act 
(25 U.S.C. 1601 et seq.). 
(7) Part C or D of title XVIII of the Social Se-
curity Act. 
(i) DEFINITIONS.—For purposes of this section: 
(1) ANTITRUST
LAWS.—The term ‘‘antitrust 
laws’’— 
(A) has the meaning given it in subsection 
(a) of the first section of the Clayton Act (15 
U.S.C. 12(a)), except that such term includes 
section 5 of the Federal Trade Commission Act 
(15 U.S.C. 45) to the extent such section 5 ap-
plies to unfair methods of competition; and 
(B) includes any State law similar to the 
laws referred to in subparagraph (A). 
(2) HEALTH PLAN AND RELATED TERMS.— 
(A) IN
GENERAL.—The term ‘‘health 
plan’’— 
(i) means a group health plan or a 
health insurance issuer that is offering 
health insurance coverage; 
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(ii) includes any entity
that con-
tracts with such a plan or issuer for the 
administering of services under the plan or 
coverage; and 
(iii) does not include a Medicare Ad-
vantage plan offered under part C of title 
XVIII of the Social Security Act or a pre-
scription drug plan offered under part D of 
such title. 
(B) 
HEALTH
INSURANCE
COVERAGE; 
HEALTH
INSURANCE
ISSUER.—The 
terms 
‘‘health insurance coverage’’ and ‘‘health insur-
ance issuer’’ have the meanings given such 
terms under paragraphs (1) and (2), respec-
tively, of section 733(b) of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 
1191b(b)). 
(C) GROUP
HEALTH
PLAN.—The term 
‘‘group health plan’’ has the meaning given that 
term in section 733(a)(1) of the Employee Re-
tirement Income Security Act of 1974 (29 
U.S.C. 1191b(a)(1)). 
(3) 
INDEPENDENT
PHARMACY.—The 
term 
‘‘independent pharmacy’’ means a pharmacy that 
has a market share of— 
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(A) less than 10 percent in any PDP re-
gion; and 
(B) less than 1 percent in the United 
States. 
For purposes of the preceding sentence, all phar-
macies that are members of the same controlled 
group of corporations (within the meaning of section 
267(f) of the Internal Revenue Code of 1986) and 
all pharmacies under common control (within the 
meaning of section 52(b) of such Code but deter-
mined by treating an interest of more than 50 per-
cent as a controlling interest) shall be treated as 1 
pharmacy. 
(4) PDP REGION.—The term ‘‘PDP region’’ 
has the meaning given such term in section 1860D– 
11(a)(2) of the Social Security Act (42 U.S.C. 
1395w–111(a)(2)). 
(j) 5-YEAR SUNSET.—The exemption provided in 
subsection (a) shall only apply to conduct occurring during 
the 5-year period beginning on the date of the enactment 
of this Act and shall continue to apply for 1 year after 
the end of such period to contracts entered into before 
the end of such period. 
(k) GENERAL ACCOUNTABILITY OFFICE STUDY AND 
REPORT.—The Comptroller General of the United States 
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shall conduct a study on the impact of enactment of this 
section during the 6-month period beginning with the 5th 
year of the 5-year period described in subsection (j). Not 
later than the end of such 6-month period, the Comptroller 
General shall submit to Congress a report on such study 
and shall include in the report such recommendations on 
the extension of this section (and changes that should be 
made in making such extension) as the Comptroller Gen-
eral deems appropriate. 
(l) OVERSIGHT.—Nothing in this section shall pre-
clude the Federal Trade Commission or the Department 
of Justice from overseeing the conduct of independent 
pharmacies covered under this section. 
Æ 
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