IB 
Union Calendar No. 581 
115TH CONGRESS 
2D SESSION 
H. R. 4841 
[Report No. 115–747, Part I] 
To amend title XVIII of the Social Security Act to provide for electronic 
prior authorization under Medicare part D for covered part D drugs, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 18, 2018 
Mr. SCHWEIKERT (for himself, Mr. BEN RAY LUJA´N of New Mexico, Mr. 
JOHNSON of Ohio, and Mr. THOMPSON of California) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
JUNE 12, 2018 
Additional sponsors: Mrs. WALORSKI, Mr. MARSHALL, Mr. ROKITA, Mr. 
YOUNG of Iowa, Mr. BLUMENAUER, Mr. NORCROSS, Mr. DUNN, Mr. 
STIVERS, Mr. KELLY of Pennsylvania, Mr. RENACCI, Mr. BISHOP of 
Michigan, Ms. MATSUI, Mr. JONES, Ms. SINEMA, Mr. SESSIONS, Mr. 
RASKIN, Mrs. BLACKBURN, Mr. WALDEN, Mr. BACON, Mr. WEBSTER of 
Florida, Mr. CRAMER, Mr. SCHIFF, and Mr. KENNEDY 
JUNE 12, 2018 
Reported from the Committee on Energy and Commerce with an amendment 
[Strike out all after the enacting clause and insert the part printed in italic] 
JUNE 12, 2018 
The Committee on Ways and Means discharged; committed to the Committee 
of the Whole House on the State of the Union and ordered to be printed 
[For text of introduced bill, see copy of bill as introduced on January 18, 2018] 
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A BILL 
To amend title XVIII of the Social Security Act to provide 
for electronic prior authorization under Medicare part 
D for covered part D drugs, and for other purposes. 
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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 the ‘‘Standardizing Elec-
tronic Prior Authorization for Safe Prescribing Act of 
2018’’. 
SEC. 2. ELECTRONIC PRIOR AUTHORIZATION FOR COVERED 
PART D DRUGS. 
(a) INCLUSION IN ELECTRONIC PRESCRIPTION PRO-
GRAM.—Section 1860D–4(e)(2) of the Social Security Act 
(42 U.S.C. 1395w–104(e)(2)) is amended by adding at the 
end the following new subparagraph: 
‘‘(E) 
ELECTRONIC
PRIOR
AUTHORIZA-
TION.— 
‘‘(i) IN GENERAL.—Not later than Jan-
uary 1, 2021, the program shall provide for 
the secure electronic transmittal of— 
‘‘(I) a prior authorization request 
from the prescribing health care profes-
sional for coverage of a covered part D 
drug for a part D eligible individual 
enrolled in a part D plan (as defined 
in section 1860D–23(a)(5)) to the PDP 
sponsor or Medicare Advantage organi-
zation offering such plan; and 
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‘‘(II) a response, in accordance 
with this subparagraph, from such 
PDP sponsor or Medicare Advantage 
organization, respectively, to such pro-
fessional. 
‘‘(ii) ELECTRONIC TRANSMISSION.— 
‘‘(I) EXCLUSIONS.—For purposes 
of this subparagraph, a facsimile, pro-
prietary payer portal that meets such 
standards as specified by the Secretary, 
or electronic form shall not be treated 
as an electronic transmission described 
in clause (i). 
‘‘(II) STANDARDS.—In order to be 
treated, for purposes of this subpara-
graph, as an electronic transmission 
described in clause (i), such trans-
mission shall comply with technical 
standards adopted by the Secretary in 
consultation with the National Council 
for Prescription Drug Programs, other 
standard setting organizations deter-
mined appropriate by the Secretary, 
and stakeholders including PDP spon-
sors, Medicare Advantage organiza-
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tions, health care professionals, and 
health information technology software 
vendors.’’. 
(b) SENSE OF CONGRESS REGARDING ELECTRONIC 
PRIOR AUTHORIZATION.—It is the sense of the Congress 
that— 
(1) there should be increased use of electronic 
prior authorizations for coverage of covered part D 
drugs for part D eligible individuals enrolled in pre-
scription drug plans under part D of title XVIII of 
the Social Security Act and MA–PD plans under 
part C of such title to reduce access delays by resolv-
ing coverage issues before prescriptions for such drugs 
are transmitted; and 
(2) greater priority should be placed on increas-
ing the adoption of use of such electronic prior au-
thorizations among prescribers of such drugs, phar-
macies, PDP sponsors, and Medicare Advantage orga-
nizations. 
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Union Calendar No. 581 
115TH CONGRESS 
2D SESSION 
H. R. 4841 
[Report No. 115–747, Part I] 
A BILL 
To amend title XVIII of the Social Security Act to 
provide for electronic prior authorization under 
Medicare part D for covered part D drugs, and 
for other purposes. 
JUNE 12, 2018 
Reported from the Committee on Energy and Commerce 
with an amendment 
JUNE 12, 2018 
The Committee on Ways and Means discharged; com-
mitted to the Committee of the Whole House on the 
State of the Union and ordered to be printed 
VerDate Sep 11 2014 
23:52 Jun 12, 2018
Jkt 079200
PO 00000
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