Source: http://law2.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395w-104&num=0&edition=prelim
Timestamp: 2018-12-15 12:02:13
Document Index: 690873100

Matched Legal Cases: ['§1860', '§101', '§103', '§3307', '§10328', '§507', '§704', '§50354', '§2']

[USC07] 42 USC 1395w-104: Beneficiary protections for qualified prescription drug coverage
42 USC 1395w-104: Beneficiary protections for qualified prescription drug coverage Text contains those laws in effect on October 23, 2018 Pending Updates: Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018), Pub L. 115-271 (10/24/2018) [View Details]
Targeted beneficiaries described in this clause are part D eligible individuals who-
Such program may include elements that promote-
A PDP sponsor may establish a drug management program for at-risk beneficiaries under which, subject to subparagraph (B), the PDP sponsor may, in the case of an at-risk beneficiary for prescription drug abuse who is an enrollee in a prescription drug plan of such PDP sponsor, limit such beneficiary's access to coverage for frequently abused drugs under such plan to frequently abused drugs that are prescribed for such beneficiary by one or more prescribers selected under subparagraph (D), and dispensed for such beneficiary by one or more pharmacies selected under such subparagraph.
For purposes of this paragraph, the term "at-risk beneficiary for prescription drug abuse" means a part D eligible individual who is not an exempted individual described in clause (ii) and-
(m) Prohibition on limiting certain information on drug prices
(Aug. 14, 1935, ch. 531, title XVIII, §1860D–4, as added Pub. L. 108–173, title I, §101(a)(2), Dec. 8, 2003, 117 Stat. 2082 ; amended Pub. L. 110–275, title I, §§103(a)(2), (b)(2), (c)(2), (d)(2), 176, July 15, 2008, 122 Stat. 2499–2501 , 2581; Pub. L. 111–148, title III, §§3307(a), 3310(a), 3312(a), title X, §10328(a), Mar. 23, 2010, 124 Stat. 471 , 475, 476, 964; Pub. L. 114–10, title V, §507, Apr. 16, 2015, 129 Stat. 168 ; Pub. L. 114–198, title VII, §704(a)(1), (2), (b), July 22, 2016, 130 Stat. 742–748 ; Pub. L. 115–123, div. E, title III, §50354, Feb. 9, 2018, 132 Stat. 213 ; Pub. L. 115–262, §2(a), Oct. 10, 2018, 132 Stat. 3670 .)
Amendment of section by section 2(a) of Pub. L. 115–262 applicable to to plan years beginning on or after January 1, 2020. See 2018 Amendment note below.
2018-Subsec. (c)(6). Pub. L. 115–123 added par. (6) relating to providing prescription drug plans with parts A and B claims data to promote the appropriate use of medications and improve health outcomes.
Subsec. (m). Pub. L. 115–262 added subsec. (m).
1 So in original. Probably means first par. (6) relating to utilization management tool to prevent drug abuse.