Pharmacy and Medically Underserved Areas Enhancement Act

Bill: 118-s-1491
Sponsor: full_name: Sen. Grassley, Chuck [R-IA]
Introduced: 2023-05-09
Policy area: Health
Latest action: action_date: 2023-05-09
text: Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2023-05-09
action_desc: Introduced in Senate
text: <p><b>Pharmacy and Medically Underserved Areas Enhancement Act</b></p> <p>This bill provides for Medicare coverage and payment with respect to certain&nbsp;pharmacist services that (1) are furnished by a pharmacist in a health-professional shortage area, and (2) would otherwise be covered under Medicare if furnished by a physician. </p>

tv_txt: II 118th CONGRESS 1st Session S. 1491 IN THE SENATE OF THE UNITED STATES May 9, 2023 Mr. Grassley (for himself, Mr. Brown , Mr. Luján , Mr. Casey , and Mrs. Hyde-Smith ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of pharmacist services.

1. Short title This Act may be cited as the Pharmacy and Medically Underserved Areas Enhancement Act . 2. Medicare coverage of pharmacist services (a) Coverage Section 1861(s)(2) of the Social Security Act ( 42 U.S.C. 1395x(s)(2) ) is amended— (1) in subparagraph (II), by striking and at the end; (2) in subparagraph (JJ), by inserting and at the end; and (3) by adding at the end the following new subparagraph: (KK) pharmacist services furnished by a pharmacist, as licensed by State law, individually or on behalf of a pharmacy provider— (i) which the pharmacist is legally authorized to perform in the State in which the individual performs such services; (ii) as would otherwise be covered under this part if furnished by a physician, or as an incident to a physician’s service; and (iii) in a setting located in a health professional shortage area (as defined in section 332(a)(1)(A) of the Public Health Service Act), medically underserved area, or medically underserved population (as defined in section 330(b)(3) of such Act); . (b) Payment Section 1833(a)(1) of the Social Security Act ( 42 U.S.C. 1395l(a)(1) ) is amended— (1) by striking and (HH) and inserting (HH) ; and (2) by inserting before the semicolon at the end the following: , and (II) with respect to pharmacist services (as defined in section 1861(s)(2)(KK)), the amounts paid shall be equal to 80 percent of the lesser of the actual charge or 85 percent of the fee schedule amount provided under section 1848 if such services had been furnished by a physician . (c) Effective date; Pharmacist specific codes (1) Effective date The amendments made by subsections (a) and (b) shall apply with respect to services furnished on or after January 1, 2024. (2) Pharmacist specific codes The Secretary of Health and Human Services shall develop pharmacist specific codes, as necessary, under the physician fee schedule under section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ).