Title: Medicaid Drug Decisions Transparency Act
Policy area: Health

Summary:
Medicaid Drug Decisions Transparency Act
This bill expands Medicaid and Medicare reporting requirements related to the transparency of physician ownership or investment interests to include pharmacists and individuals with authority over Medicaid formularies, and also increases civil penalties for violations.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 3770 Introduced in Senate (IS)]

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115th CONGRESS
  2d Session
                                S. 3770

  To amend title XI of the Social Security Act to expand the scope of 
    transparency reporting requirements related to the ownership or 
   investment interests of health care providers and others, and to 
  increase the penalties associated with violating such requirements.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           December 18, 2018

  Mr. Booker introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XI of the Social Security Act to expand the scope of 
    transparency reporting requirements related to the ownership or 
   investment interests of health care providers and others, and to 
  increase the penalties associated with violating such requirements.

    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 ``Medicaid Drug Decisions Transparency 
Act''.

SEC. 2. OWNERSHIP OR INVESTMENT INTEREST TRANSPARENCY FOR HEALTH CARE 
              PROVIDERS AND OTHERS.

    (a) In General.--Section 1128G of the Social Security Act (42 
U.S.C. 1320a-7h) is amended--
            (1) in subsection (b)--
                    (A) in paragraph (1)(A), by striking ``$10,000'' 
                and inserting ``$20,000'';
                    (B) in paragraph (1)(B), by striking ``$150,000'' 
                and inserting ``$300,000'';
                    (C) in paragraph (2)(A), by striking ``$100,000'' 
                and inserting ``$200,000''; and
                    (D) in paragraph (2)(B), by striking ``$1,000,000'' 
                and inserting ``$2,000,000'';
            (2) in subsection (d)(2), by adding at the end the 
        following sentence: ``Beginning with calendar year 2021, such 
        report shall include a separate summary of the information 
        submitted under subsection (a) during the preceding year with 
        respect to the covered recipients described in clause (vii) of 
        subsection (e)(6)(A).''; and
            (3) in subsection (e)(6)(A), by adding at the end the 
        following:
                            ``(vi) A pharmacist (as defined in section 
                        804(a)(2) of the Federal Food, Drug, and 
                        Cosmetic Act (21 U.S.C. 384(a)(2)).
                            ``(vii) An individual or entity with 
                        decision-making authority over the formulary or 
                        preferred drug list of a State plan (or a 
                        waiver of a plan) under title XIX, including an 
                        individual or entity that participates in the 
                        establishment of such a drug formulary or 
                        preferred drug list or in the drug utilization 
                        review process for such a plan or waiver, such 
                        as a member of a State drug use review board 
                        described in section 1927.''.
    (b) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2020, and shall apply to information required to 
be submitted under section 1128G of the Social Security Act (42 U.S.C. 
1320a-7h) on or after such date.

SEC. 3. STATE DRUG USE REVIEW BOARD MEMBERSHIP TRANSPARENCY.

    Section 1927(g)(3)(B) of the Social Security Act (42 U.S.C. 1396r-
8(g)(3)(B)) is amended--
            (1) by redesignating clauses (i) through (iv) as subclauses 
        (I) through (IV) and moving such subclauses (as so 
        redesignated) 2 ems to the right;
            (2) in the matter preceding subclause (I) (as so 
        redesignated), by striking ``The membership'' and inserting the 
        following:
                            ``(i) In general.--The membership'';
            (3) in the last sentence, by striking ``The membership'' 
        and inserting the following:
                            ``(ii) Requirement.--The membership''; and
            (4) by adding at the end the following:
                            ``(iii) Publication of membership.--Each 
                        State shall publish a list of the DUR Board 
                        members on an Internet web site in a format 
                        that is clear and understandable and regularly 
                        shall update the list with any changes to such 
                        membership.''.
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