152 
tioner, or an individual represented by the per-
son as a practitioner, and the practitioner or 
such individual issued a prescription for the 
drug that was purchased; 
‘‘(D) the person knew, or had reason to 
know, that the practitioner or the individual re-
ferred to in subparagraph (C) did not, when 
issuing the prescription, have a qualifying med-
ical relationship with the patient; and 
‘‘(E) the person received payment for the 
dispensing or sale of the drug. 
For purposes of subparagraph (E), payment is re-
ceived if money or other valuable consideration is re-
ceived. 
‘‘(2) EXCEPTIONS.—Paragraph (1) does not 
apply to— 
‘‘(A) the dispensing or selling of a pre-
scription drug pursuant to telemedicine prac-
tices sponsored by— 
‘‘(i) a hospital that has in effect a 
provider agreement under title XVIII of 
the Social Security Act (relating to the 
Medicare program); or 
‘‘(ii) a group practice that has not 
fewer than 100 physicians who have in ef-
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153 
fect provider agreements under such title; 
or 
‘‘(B) the dispensing or selling of a pre-
scription drug pursuant to practices that pro-
mote the public health, as determined by the 
Secretary by regulation. 
‘‘(3) QUALIFYING MEDICAL RELATIONSHIP.— 
‘‘(A) 
IN
GENERAL.—With 
respect 
to 
issuing a prescription for a drug for a patient, 
a practitioner has a qualifying medical relation-
ship with the patient for purposes of this sec-
tion if— 
‘‘(i) at least one in-person medical 
evaluation of the patient has been con-
ducted by the practitioner; or 
‘‘(ii) the practitioner conducts a med-
ical evaluation of the patient as a covering 
practitioner. 
‘‘(B) IN-PERSON MEDICAL EVALUATION.— 
A medical evaluation by a practitioner is an in- 
person medical evaluation for purposes of this 
section if the practitioner is in the physical 
presence of the patient as part of conducting 
the evaluation, without regard to whether por-
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tions of the evaluation are conducted by other 
health professionals. 
‘‘(C) COVERING PRACTITIONER.—With re-
spect to a patient, a practitioner is a covering 
practitioner for purposes of this section if the 
practitioner conducts a medical evaluation of 
the patient at the request of a practitioner who 
has conducted at least one in-person medical 
evaluation of the patient and is temporarily un-
available to conduct the evaluation of the pa-
tient. A practitioner is a covering practitioner 
without regard to whether the practitioner has 
conducted any in-person medical evaluation of 
the patient involved. 
‘‘(4) RULES OF CONSTRUCTION.— 
‘‘(A) 
INDIVIDUALS
REPRESENTED
AS 
PRACTITIONERS.—A person who is not a practi-
tioner (as defined in subsection (e)(1)) lacks 
legal capacity under this section to have a 
qualifying medical relationship with any patient. 
‘‘(B) STANDARD
PRACTICE
OF
PHAR-
MACY.—Paragraph (1) may not be construed as 
prohibiting any conduct that is a standard prac-
tice in the practice of pharmacy. 
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155 
‘‘(C) 
APPLICABILITY
OF
REQUIRE-
MENTS.—Paragraph (3) may not be construed 
as having any applicability beyond this section, 
and does not affect any State law, or interpre-
tation of State law, concerning the practice of 
medicine. 
‘‘(c) ACTIONS BY STATES.— 
‘‘(1) IN GENERAL.—Whenever an attorney gen-
eral of any State has reason to believe that the in-
terests of the residents of that State have been or 
are being threatened or adversely affected because 
any person has engaged or is engaging in a pattern 
or practice that violates section 301(l), the State 
may bring a civil action on behalf of its residents in 
an appropriate district court of the United States to 
enjoin such practice, to enforce compliance with such 
section (including a nationwide injunction), to obtain 
damages, restitution, or other compensation on be-
half of residents of such State, to obtain reasonable 
attorneys fees and costs if the State prevails in the 
civil action, or to obtain such further and other relief 
as the court may deem appropriate. 
‘‘(2) NOTICE.—The State shall serve prior writ-
ten notice of any civil action under paragraph (1) or 
(5)(B) upon the Secretary and provide the Secretary 
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with a copy of its complaint, except that if it is not 
feasible for the State to provide such prior notice, 
the State shall serve such notice immediately upon 
instituting such action. Upon receiving a notice re-
specting a civil action, the Secretary shall have the 
right— 
‘‘(A) to intervene in such action; 
‘‘(B) upon so intervening, to be heard on 
all matters arising therein; and 
‘‘(C) to file petitions for appeal. 
‘‘(3) CONSTRUCTION.—For purposes of bring-
ing any civil action under paragraph (1), nothing in 
this chapter shall prevent an attorney general of a 
State from exercising the powers conferred on the 
attorney general by the laws of such State to con-
duct investigations or to administer oaths or affir-
mations or to compel the attendance of witnesses or 
the production of documentary and other evidence. 
‘‘(4) VENUE; SERVICE OF PROCESS.—Any civil 
action brought under paragraph (1) in a district 
court of the United States may be brought in the 
district in which the defendant is found, is an inhab-
itant, or transacts business or wherever venue is 
proper under section 1391 of title 28, United States 
Code. Process in such an action may be served in 
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any district in which the defendant is an inhabitant 
or in which the defendant may be found. 
‘‘(5) ACTIONS BY OTHER STATE OFFICIALS.— 
‘‘(A) Nothing contained in this section 
shall prohibit an authorized State official from 
proceeding in State court on the basis of an al-
leged violation of any civil or criminal statute of 
such State. 
‘‘(B) In addition to actions brought by an 
attorney general of a State under paragraph 
(1), such an action may be brought by officers 
of such State who are authorized by the State 
to bring actions in such State on behalf of its 
residents. 
‘‘(d) EFFECT OF SECTION.—This section shall not 
apply to a person that is a registered exporter under sec-
tion 804. 
‘‘(e) GENERAL DEFINITIONS.—For purposes of this 
section: 
‘‘(1) The term ‘practitioner’ means a practi-
tioner referred to in section 503(b)(1) with respect 
to issuing a written or oral prescription. 
‘‘(2) The term ‘prescription drug’ means a drug 
that is described in section 503(b)(1). 
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158 
‘‘(3) The term ‘qualifying medical relationship’, 
with respect to a practitioner and a patient, has the 
meaning indicated for such term in subsection (b). 
‘‘(f) INTERNET-RELATED DEFINITIONS.— 
‘‘(1) IN GENERAL.—For purposes of this sec-
tion: 
‘‘(A) The term ‘Internet’ means collectively 
the myriad of computer and telecommunications 
facilities, including equipment and operating 
software, which comprise the interconnected 
world-wide network of networks that employ the 
transmission control protocol/internet protocol, 
or any predecessor or successor protocols to 
such protocol, to communicate information of 
all kinds by wire or radio. 
‘‘(B) The term ‘link’, with respect to the 
Internet, means one or more letters, words, 
numbers, symbols, or graphic items that appear 
on a page of an Internet site for the purpose 
of serving, when activated, as a method for exe-
cuting an electronic command— 
‘‘(i) to move from viewing one portion 
of a page on such site to another portion 
of the page; 
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159 
‘‘(ii) to move from viewing one page 
on such site to another page on such site; 
or 
‘‘(iii) to move from viewing a page on 
one Internet site to a page on another 
Internet site. 
‘‘(C) The term ‘page’, with respect to the 
Internet, means a document or other file 
accessed at an Internet site. 
‘‘(D)(i) The terms ‘site’ and ‘address’, with 
respect to the Internet, mean a specific location 
on the Internet that is determined by Internet 
Protocol numbers. Such term includes the do-
main name, if any. 
‘‘(ii) The term ‘domain name’ means a 
method of representing an Internet address 
without direct reference to the Internet Protocol 
numbers for the address, including methods 
that use designations such as ‘.com’, ‘.edu’, 
‘.gov’, ‘.net’, or ‘.org’. 
‘‘(iii) The term ‘Internet Protocol num-
bers’ includes any successor protocol for deter-
mining a specific location on the Internet. 
‘‘(2) AUTHORITY
OF
SECRETARY.—The Sec-
retary may by regulation modify any definition 
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160 
under paragraph (1) to take into account changes in 
technology. 
‘‘(g) INTERACTIVE COMPUTER SERVICE; ADVER-
TISING.—No provider of an interactive computer service, 
as defined in section 230(f)(2) of the Communications Act 
of 1934 (47 U.S.C. 230(f)(2)), or of advertising services 
shall be liable under this section for dispensing or selling 
prescription drugs in violation of this section on account 
of another person’s selling or dispensing such drugs, pro-
vided that the provider of the interactive computer service 
or of advertising services does not own or exercise cor-
porate control over such person.’’. 
(b) INCLUSION AS PROHIBITED ACT.—Section 301 of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
331) is amended by inserting after paragraph (k) the fol-
lowing: 
‘‘(l) The dispensing or selling of a prescription drug 
in violation of section 503C.’’. 
(c) INTERNET SALES
OF PRESCRIPTION DRUGS; 
CONSIDERATION BY SECRETARY OF PRACTICES AND PRO-
CEDURES
FOR CERTIFICATION
OF LEGITIMATE BUSI-
NESSES.—In carrying out section 503C of the Federal 
Food, Drug, and Cosmetic Act (as added by subsection 
(a) of this section), the Secretary of Health and Human 
Services shall take into consideration the practices and 
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161 
procedures of public or private entities that certify that 
businesses selling prescription drugs through Internet 
sites are legitimate businesses, including practices and 
procedures regarding disclosure formats and verification 
programs. 
(d) REPORTS REGARDING INTERNET-RELATED VIO-
LATIONS OF FEDERAL AND STATE LAWS ON DISPENSING 
OF DRUGS.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this subsection as 
the ‘‘Secretary’’) shall, pursuant to the submission 
of an application meeting the criteria of the Sec-
retary, make an award of a grant or contract to the 
National Clearinghouse on Internet Prescribing (op-
erated by the Federation of State Medical Boards) 
for the purpose of— 
(A) identifying Internet sites that appear 
to be in violation of Federal or State laws con-
cerning the dispensing of drugs; 
(B) reporting such sites to State medical 
licensing boards and State pharmacy licensing 
boards, and to the Attorney General and the 
Secretary, for further investigation; and 
(C) submitting, for each fiscal year for 
which the award under this subsection is made, 
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162 
a report to the Secretary describing investiga-
tions undertaken with respect to violations de-
scribed in subparagraph (A). 
(2) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out paragraph (1), there is 
authorized to be appropriated $100,000 for each of 
the first 3 fiscal years in which this section is in ef-
fect. 
(e) EFFECTIVE DATE.—The amendments made by 
subsections (a) and (b) take effect 90 days after the date 
of enactment of this Act, without regard to whether a final 
rule to implement such amendments has been promulgated 
by the Secretary of Health and Human Services under 
section 701(a) of the Federal Food, Drug, and Cosmetic 
Act. The preceding sentence may not be construed as af-
fecting the authority of such Secretary to promulgate such 
a final rule. 
SEC. 306. PROHIBITING PAYMENTS TO UNREGISTERED 
FOREIGN PHARMACIES. 
(a) IN GENERAL.—Section 303 of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 333) is amended by 
adding at the end the following: 
‘‘(h) RESTRICTED TRANSACTIONS.— 
‘‘(1) IN
GENERAL.—The introduction of re-
stricted transactions into a payment system or the 
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completion of restricted transactions using a pay-
ment system is prohibited. 
‘‘(2) PAYMENT SYSTEM.— 
‘‘(A) IN
GENERAL.—The term ‘payment 
system’ means a system used by a person de-
scribed in subparagraph (B) to effect a credit 
transaction, electronic fund transfer, or money 
transmitting service that may be used in con-
nection with, or to facilitate, a restricted trans-
action, and includes— 
‘‘(i) a credit card system; 
‘‘(ii) an international, national, re-
gional, or local network used to effect a 
credit transaction, an electronic fund 
transfer, or a money transmitting service; 
and 
‘‘(iii) any other system that is cen-
trally managed and is primarily engaged in 
the transmission and settlement of credit 
transactions, electronic fund transfers, or 
money transmitting services. 
‘‘(B) PERSONS DESCRIBED.—A person re-
ferred to in subparagraph (A) is— 
‘‘(i) a creditor; 
‘‘(ii) a credit card issuer; 
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from or on behalf of the individual for the pur-
pose of the unlawful drug importation request; 
‘‘(C) a check, draft, or similar instrument 
which is drawn by or on behalf of the individual 
for the purpose of the unlawful drug importa-
tion request and is drawn on or payable at or 
through any financial institution; or 
‘‘(D) the proceeds of any other form of fi-
nancial transaction (identified by the Board by 
regulation) that involves a financial institution 
as a payor or financial intermediary on behalf 
of or for the benefit of the individual for the 
purpose of the unlawful drug importation re-
quest. 
‘‘(4) UNLAWFUL
DRUG
IMPORTATION
RE-
QUEST.—The term ‘unlawful drug importation re-
quest’ means the request, or transmittal of a re-
quest, made to an unregistered foreign pharmacy for 
a prescription drug by mail (including a private car-
rier), facsimile, phone, or electronic mail, or by a 
means that involves the use, in whole or in part, of 
the Internet. 
‘‘(5) UNREGISTERED
FOREIGN
PHARMACY.— 
The term ‘unregistered foreign pharmacy’ means a 
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person in a country other than the United States 
that is not a registered exporter under section 804. 
‘‘(6) OTHER DEFINITIONS.— 
‘‘(A) CREDIT; CREDITOR; CREDIT CARD.— 
The terms ‘credit’, ‘creditor’, and ‘credit card’ 
have the meanings given the terms in section 
103 of the Truth in Lending Act (15 U.S.C. 
1602). 
‘‘(B) ACCESS DEVICE; ELECTRONIC FUND 
TRANSFER.—The terms ‘access device’ and 
‘electronic fund transfer’— 
‘‘(i) have the meaning given the term 
in section 903 of the Electronic Fund 
Transfer Act (15 U.S.C. 1693a); and 
‘‘(ii) the term ‘electronic fund trans-
fer’ also includes any fund transfer covered 
under Article 4A of the Uniform Commer-
cial Code, as in effect in any State. 
‘‘(C) FINANCIAL INSTITUTION.—The term 
‘financial institution’— 
‘‘(i) has the meaning given the term 
in section 903 of the Electronic Transfer 
Fund Act (15 U.S.C. 1693a); and 
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‘‘(ii) includes a financial institution 
(as defined in section 509 of the Gramm- 
Leach-Bliley Act (15 U.S.C. 6809)). 
‘‘(D) MONEY
TRANSMITTING
BUSINESS; 
MONEY
TRANSMITTING
SERVICE.—The terms 
‘money transmitting business’ and ‘money 
transmitting service’ have the meaning given 
the terms in section 5330(d) of title 31, United 
States Code. 
‘‘(E) BOARD.—The term ‘Board’ means 
the Board of Governors of the Federal Reserve 
System. 
‘‘(7) POLICIES AND PROCEDURES REQUIRED TO 
PREVENT RESTRICTED TRANSACTIONS.— 
‘‘(A) REGULATIONS.—The Board shall 
promulgate regulations requiring— 
‘‘(i) an operator of a credit card sys-
tem; 
‘‘(ii) an operator of an international, 
national, regional, or local network used to 
effect a credit transaction, an electronic 
fund transfer, or a money transmitting 
service; 
‘‘(iii) an operator of any other pay-
ment system that is centrally managed and 
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168 
is primarily engaged in the transmission 
and settlement of credit transactions, elec-
tronic transfers or money transmitting 
services where at least one party to the 
transaction or transfer is an individual; 
and 
‘‘(iv) any other person described in 
paragraph (2)(B) and specified by the 
Board in such regulations, 
to establish policies and procedures that are 
reasonably designed to prevent the introduction 
of a restricted transaction into a payment sys-
tem or the completion of a restricted trans-
action using a payment system. 
‘‘(B) REQUIREMENTS FOR POLICIES AND 
PROCEDURES.—In 
promulgating 
regulations 
under subparagraph (A), the Board shall— 
‘‘(i) identify types of policies and pro-
cedures, including nonexclusive examples, 
that shall be considered to be reasonably 
designed to prevent the introduction of re-
stricted transactions into a payment sys-
tem or the completion of restricted trans-
actions using a payment system; and 
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169 
‘‘(ii) to the extent practicable, permit 
any payment system, or person described 
in paragraph (2)(B), as applicable, to 
choose among alternative means of pre-
venting the introduction or completion of 
restricted transactions. 
‘‘(C) NO LIABILITY FOR BLOCKING OR RE-
FUSING
TO
HONOR
RESTRICTED
TRANS-
ACTION.— 
‘‘(i) IN
GENERAL.—A payment sys-
tem, or a person described in paragraph 
(2)(B) that is subject to a regulation 
issued under this subsection, and any par-
ticipant in such payment system that pre-
vents or otherwise refuses to honor trans-
actions in an effort to implement the poli-
cies and procedures required under this 
subsection or to otherwise comply with this 
subsection shall not be liable to any party 
for such action. 
‘‘(ii) COMPLIANCE.—A person de-
scribed in paragraph (2)(B) meets the re-
quirements of this subsection if the person 
relies on and complies with the policies and 
procedures of a payment system of which 
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170 
the person is a member or in which the 
person is a participant, and such policies 
and procedures of the payment system 
comply with the requirements of the regu-
lations promulgated under subparagraph 
(A). 
‘‘(D) ENFORCEMENT.— 
‘‘(i) IN GENERAL.—This section shall 
be enforced by the Federal functional regu-
lators and the Federal Trade Commission 
under applicable law in the manner pro-
vided in section 505(a) of the Gramm- 
Leach-Bliley Act (15 U.S.C. 6805(a)). 
‘‘(ii) FACTORS TO BE CONSIDERED.— 
In considering any enforcement action 
under this subsection against a payment 
system or person described in paragraph 
(2)(B), the Federal functional regulators 
and the Federal Trade Commission shall 
consider the following factors: 
‘‘(I) The extent to which the pay-
ment system or person knowingly per-
mits restricted transactions. 
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171 
‘‘(II) The history of the payment 
system or person in connection with 
permitting restricted transactions. 
‘‘(III) The extent to which the 
payment system or person has estab-
lished and is maintaining policies and 
procedures in compliance with regula-
tions prescribed under this subsection. 
‘‘(8) TRANSACTIONS PERMITTED.—A payment 
system, or a person described in paragraph (2)(B) 
that is subject to a regulation issued under this sub-
section, is authorized to engage in transactions with 
foreign pharmacies in connection with investigating 
violations or potential violations of any rule or re-
quirement adopted by the payment system or person 
in connection with complying with paragraph (7). A 
payment system, or such a person, and its agents 
and employees shall not be found to be in violation 
of, or liable under, any Federal, State or other law 
by virtue of engaging in any such transaction. 
‘‘(9) RELATION TO STATE LAWS.—No require-
ment, prohibition, or liability may be imposed on a 
payment system, or a person described in paragraph 
(2)(B) that is subject to a regulation issued under 
this subsection, under the laws of any State with re-
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172 
spect to any payment transaction by an individual 
because the payment transaction involves a payment 
to a foreign pharmacy. 
‘‘(10) TIMING OF REQUIREMENTS.—A payment 
system, or a person described in paragraph (2)(B) 
that is subject to a regulation issued under this sub-
section, must adopt policies and procedures reason-
ably designed to comply with any regulations re-
quired under paragraph (7) within 60 days after 
such regulations are issued in final form.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall take effect on the day that is 90 days 
after the date of enactment of this Act. 
(c) IMPLEMENTATION.—The Board of Governors of 
the Federal Reserve System shall promulgate regulations 
as required by subsection (h)(7) of section 303 of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 333), as 
added by subsection (a), not later than 90 days after the 
date of enactment of this Act. 
SEC. 307. IMPORTATION EXEMPTION UNDER CONTROLLED 
SUBSTANCES IMPORT AND EXPORT ACT. 
Section 1006(a)(2) of the Controlled Substances Im-
port and Export Act (21 U.S.C. 956(a)(2)) is amended 
by striking ‘‘not import the controlled substance into the 
United States in an amount that exceeds 50 dosage units 
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173 
of the controlled substance.’’ and inserting ‘‘import into 
the United States not more than 10 dosage units com-
bined of all such controlled substances.’’. 
SEC. 308. SEVERABILITY. 
If any provision of this Act, an amendment by this 
Act, or the application of such provision or amendment 
to any person or circumstance is held to be unconstitu-
tional, the remainder of this Act, the amendments made 
by this Act, and the application of the provisions of such 
to any person or circumstance shall not affected thereby. 
TITLE 
IV—ADDITIONAL 
PRE-
SCRIPTION 
DRUGS 
PROVI-
SIONS 
SEC. 401. DISALLOWANCE OF DEDUCTION FOR ADVER-
TISING AND PROMOTIONAL EXPENSES FOR 
PRESCRIPTION PHARMACEUTICALS. 
(a) IN GENERAL.—Part IX of subchapter B of chap-
ter 1 of the Internal Revenue Code of 1986 (relating to 
items not deductible) is amended by adding at the end 
the following new section: 
‘‘SEC. 280I. DISALLOWANCE OF DEDUCTION FOR PRESCRIP-
TION PHARMACEUTICALS ADVERTISING AND 
PROMOTIONAL EXPENSES. 
‘‘(a) IN GENERAL.—No deduction shall be allowed 
under this chapter for expenses relating to advertising or 
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promoting the sale and use of prescription pharma-
ceuticals for any taxable year. 
‘‘(b) ADVERTISING OR PROMOTING.—For purposes of 
this section, the term ‘advertising or promoting’ includes 
direct to consumer advertising in any media and any activ-
ity designed to promote the use of a prescription pharma-
ceutical directed to providers or others who may make de-
cisions about the use of prescription pharmaceuticals (in-
cluding the provision of product samples, free trials, and 
starter kits).’’. 
(b) CONFORMING AMENDMENT.—The table of sec-
tions for such part IX is amended by adding after the 
item relating to section 280H the following new item: 
‘‘Sec. 280I. Disallowance of deduction for prescription pharmaceuticals adver-
tising and promotional expenses.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to amounts paid or incurred after 
the date of the enactment of this Act, in taxable years 
ending after such date. 
SEC. 402. INTEGRITY FOR PHARMACY BENEFIT MANAGERS. 
(a) STANDARDS.—A pharmacy benefit manager with 
a contract with a health benefits plan (as such term is 
defined in section 101) shall, with respect to such plan, 
comply with fiduciary standards established, by regulation, 
by the Secretary of Health and Human Services, that are 
consistent with the provisions of this section. 
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(b) DISCLOSURE.—Under such standards, a phar-
macy benefit manager shall, upon request by the health 
benefits plan— 
(1) provide all available financial information to 
such plan regarding its enrollees; and 
(2) disclose to the sponsor of such plan all the 
rebates and other discounts that the pharmacy ben-
efit manager receives from drug manufacturers, with 
respect to drugs dispensed to enrollees of such plan. 
(c) NON-DISCLOSURE.—A pharmacy benefit manager 
that is owned by, owns, or is otherwise affiliated with a 
retail pharmacy may not share with such affiliated retail 
pharmacy data on plan enrollees or other individuals that 
is obtained from claims submitted by other pharmacies. 
(d) NOTICE OF DRUG INTERCHANGES.— 
(1) IN GENERAL.—Under the standards under 
subsection (a), pharmacy benefit manager shall pro-
vide notice to a plan enrollee if the pharmacy benefit 
manager is switching the enrollee from a lower cost 
drug to a higher cost drug. 
(2) CONTENTS.—Such notice shall contain— 
(A) an explanation of the reason for the 
switch; 
(B) the difference in cost between the 2 
drugs; and 
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(C) whether a lower cost generic is avail-
able. 
(e) ADDITIONAL DISCLOSURES.—Under the stand-
ards under subsection (a), a pharmacy benefit manager 
shall disclose to the health benefits plan the actual reim-
bursement amount that is paid to the pharmacy for a pre-
scription or service by the pharmacy benefit manager that 
is covered under such plan. 
(f) EQUAL REIMBURSEMENTS FOR MAIL ORDER AND 
RETAIL.—Under the standards under subsection (a), a 
pharmacy benefit manager shall reimburse mail order and 
retail pharmacies at the same rates— 
(1) for identical prescription drugs; and 
(2) for identical services. 
(g) ELIMINATION OF SPREAD PRICING.—Under the 
standards under subsection (a), with respect to a prescrip-
tion drug that is covered by a health benefits plan and 
dispensed to a plan participant or beneficiary, a pharmacy 
benefit manager may not pay such pharmacy an amount 
that is less than the amount that is paid to the pharmacy 
benefit manager by such plan for such drug and any re-
lated dispensing fee. 
(h) EQUAL COPAYS.—Under the standards under 
subsection (a), a pharmacy benefit manager may not re-
quire that a participant or beneficiary of a health benefits 
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