A bill to amend title XVIII of the Social Security Act to improve access to pharmacies under part D.
Pharmacy Access Improvement (PhAIm) Act of 2007 - Amends part D (Voluntary Prescription Drug Benefit Program ) of title XVIII (Medicare) of the Social Security Act (SSA) with respect to participating pharmacies and standards for access to them. Requires that such standards ensure that enrollees residing in long-term care facilities have access to a long-term care network pharmacy.
Requires prompt payment of clean claims to pharmacies by prescription drug plans (PDPs) and Medicare Advantage prescription drug plans (MA-PD Plans). Defines prompt payment as payment occurring within 14 days from submission for claims submitted electronically, and within 30 days for claims submitted otherwise. Requires payment of interest if a payment is not issued, mailed, or otherwise transmitted within the applicable number of calendar days.
Directs the Secretary of Health and Human Services to establish a 24-hour toll-free telephone number dedicated to providing Medicare prescription drug benefit information to pharmacists and pharmacy staff.
Requires PDP sponsors to establish toll-free pharmacy and physician and provider hotlines.
Prohibits a Medicare prescription drug card issued by a PDP sponsor from displaying the name, brand, logo, or trademark (co-branding) of any pharmacy.
Provides for submission of claims by pharmacies located in or contracting with long-term care facilities.
Requires the Inspector General of the Department of Health and Human Services to analyze and report to the Secretary on the cost of dispensing covered part D drugs under a PDP or an MA-PD plan.
Provides that, if the PDP sponsor uses a standard for reimbursement of pharmacies based on the cost of a drug, each contract entered into with such sponsor with respect to the plan shall require the sponsor to update the standard at least once every seven days.
Introduced in Senate
Sponsor introductory remarks on measure. (CR S10802)
Read twice and referred to the Committee on Finance.
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