Long-Term Care Pharmacy Definition Act of 2021
Bill: H.R.5632 | Sponsor: Rep. Schrader, Kurt (D-OR)
Policy area: Health

Summary:
Long-Term Care Pharmacy Definition Act of 2021
This bill establishes a statutory definition for long-term care pharmacy under the Medicare prescription drug benefit.
Currently, there is no statutory definition. Regulations from the Centers for Medicare & Medicaid Services (CMS) define a long-term care pharmacy as a pharmacy that is owned by or under contract with a long-term care facility to provide prescription drugs to the facility's residents. Additional requirements are set out in CMS guidance relating to the Medicare prescription drug benefit; pharmacies are also subject to regulations and guidance from other agencies (e.g., packaging requirements from the Food and Drug Administration).
The bill defines a long-term care pharmacy as a state-licensed pharmacy that is able to provide enhanced pharmacy and clinical services to individuals who have certain comorbid and medically complex chronic conditions and who reside in skilled nursing facilities, nursing facilities, or any other applicable setting (as determined by the CMS). The term enhanced pharmacy and clinical services includes medication dispensed in special packaging, drug utilization review, and 24-7 availability of medication delivery and on-call pharmacists.

To codify a statutory definition for long-term care pharmacies.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Long-Term Care Pharmacy Definition 
Act of 2021''.

SEC. 2. DEFINITION.

    Section 1860D-2 of the Social Security Act (42 U.S.C. 1395w-102) is 
amended by adding at the end the following new subsection:
    ``(f) Long-Term Care Pharmacy Defined.--
            ``(1) In general.--The term `long-term care pharmacy' means 
        a pharmacy licensed under applicable State law that is able to 
        provide enhanced pharmacy and clinical services to individuals 
        who require enhanced medication services and reside in a 
        facility (as defined in paragraph (4)).
            ``(2) Enhanced pharmacy and clinical services.--As used in 
        this subsection, the term `enhanced pharmacy and clinical 
        services' includes--
                    ``(A) medications dispensed pursuant to a 
                prescription or chart order in specialized packaging 
                which shall include unit of use packaging, unit dose 
                packaging, single use containers, packaging from remote 
                automated dispensing technology, or other packaging 
                required;
                    ``(B) drug utilization review to identify potential 
                adverse drug reactions and inappropriate drug usage;
                    ``(C) medication reconciliation services at the 
                transition of care and other necessary clinical 
                management and medication services;
                    ``(D) timely medication delivery 24 hours a day, 7 
                days a week;
                    ``(E) pharmacist on-call availability to provider 
                dispensing and clinical services 24 hours a day, 7 days 
                a week;
                    ``(F) emergency supplies of medication as permitted 
                by law and as required, including emergency kits or 
                remote automated dispensing technology at a facility; 
                and
                    ``(G) such other services as the Secretary 
                determines appropriate.
            ``(3) Individuals requiring enhanced medication services.--
        As used in this subsection, the term `individual who requires 
        enhanced medication services' means an individual who has one 
        or more comorbid and medically complex chronic conditions that 
        are life-threatening or significantly limit overall health or 
        function, pose a high risk of hospitalization or other adverse 
        health outcomes, and require enhanced pharmacy and clinical 
        services.
            ``(4) Facility.--As used in this subsection, the term 
        `facility' includes a facility described in section 1819(a), 
        1919(a), or 1905(d), or any other setting in which individuals 
        who require enhanced medication services reside as determined 
        by the Secretary.''.
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