Pharmacy and Medically Underserved Areas Enhancement Act

Pharmacy and Medically Underserved Areas Enhancement Act

This bill provides for Medicare coverage and payment with respect to certain 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.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2759 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 2759

To amend title XVIII of the Social Security Act to provide for coverage 
           under the Medicare program of pharmacist services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 22, 2021

 Mr. Butterfield (for himself, Mr. McKinley, Mr. Bilirakis, Mr. Carter 
   of Georgia, Mr. Cicilline, Ms. Clarke of New York, Mr. Cohen, Mr. 
 Crawford, Ms. DeGette, Mrs. Demings, Mr. Fitzpatrick, Mr. Foster, Mr. 
    Gohmert, Mr. Lynch, Ms. Moore of Wisconsin, Mr. O'Halleran, Ms. 
Pingree, Mr. Price of North Carolina, Ms. Ross, Mr. Smith of Missouri, 
Mr. Tonko, Mr. Westerman, and Mr. Guest) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
    addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to provide for coverage 
           under the Medicare program of pharmacist services.

    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 ``Pharmacy and Medically Underserved 
Areas Enhancement Act''.

SEC. 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) by striking ``and'' at the end of subparagraph (GG);
            (2) by striking the period at the end and inserting ``; 
        and'' at the end of subparagraph (HH); and
            (3) by inserting after subparagraph (HH) the following new 
        subparagraph at the end:
                    ``(II) 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 (DD)'' and inserting ``(DD)''; and
            (2) by inserting before the semicolon at the end the 
        following: ``and (EE) with respect to pharmacist services (as 
        defined in section 1861(s)(2)(II)), 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, 2022.
            (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).
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