S.Amdt. 2958

SA 2958. Mr. BENNET submitted an amendment intended to be proposed to
amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

At the end of title VII, insert the following:

Subtitle C--Rural Health Access and Improvement

SEC. 7201. GRANTS TO PROMOTE HOSPITAL HEALTH INFORMATION
TECHNOLOGY.

Section 3013 of the Public Health Service Act (42 U.S.C.
300jj-33) is amended by adding at the end the following:
``(j) Priority.--In awarding a grant under this section,
the Secretary shall give priority to qualified State-
designated entities that are critical access hospitals, as
defined in section 1861(mm) of the Social Security Act.''.

SEC. 7202. EXPANDED PARTICIPATION IN SECTION 340B PROGRAM.

Section 340B(a)(4) of the Public Health Service Act (42
U.S.C. 256b(a)(4)), as amended by section 7101(a), is further
amended by adding at the end the following:
``(P) An entity that is a rural health clinic, as defined
in section 1861(aa)(2) of the Social Security Act.''.

SEC. 7203. GAO STUDY AND REPORT ON DISPENSING FEES.

(a) Study.--The Comptroller General of the United States
shall conduct a study of the cost in each State of dispensing
prescription drugs under the Medicaid program under title XIX
of the Social Security Act (42 U.S.C. 1396a et seq.), which
shall consider--
(1) any reasonable costs associated with pharmacists--
(A) checking for information regarding Medicaid coverage of
individuals; and
(B) performing necessary clinical review and quality
assurance activities, such as--
(i) activities to identify and reduce the frequency of
patterns of fraud, abuse, gross overuse, and inappropriate or
medically unnecessary care among physicians, pharmacists, and
patients;
(ii) activities associated with specific drugs or groups of
drugs, including potential and actual severe adverse
reactions to drugs, including education on therapeutic
appropriateness, over-utilization and under-utilization of
drugs, appropriate use of generic products, therapeutic
duplication, drug-disease contraindications, drug
interactions, incorrect drug dosage or duration of drug
treatment, drug-allergy interactions, and clinical abuse or
misuse; and
(iii) any other clinical review and quality assurance
activities required under Federal or State law;
(2) the costs incurred by a pharmacy that are associated
with--
(A) the measurement or mixing of a drug covered by
Medicaid;
(B) filling the container for such a drug;
(C) physically transferring the prescription to the
patient, including any costs of delivering the medication to
the home of such patient;
(D) special packaging of drugs;
(E) overhead costs of the pharmacy, or the section of the
facility that is devoted to a pharmacy, and maintenance of
the pharmacy or section of the facility (including the
equipment necessary to operate such pharmacy or such section
and the salaries of pharmacists and other pharmacy workers);
(F) geographic factors that impact operational costs;
(G) compounding such prescription if necessary; and
(H) uncollectability of Medicaid prescription copayments;
(3) the variation in costs described in paragraph (2) based
on--
(A) whether a product dispensed is a rural or urban
pharmacy;
(B) whether the product dispensed is a specialty pharmacy
product; and
(C) whether the pharmacy is located in, or contracts with,
a long-term care facility; and
(4) the increase in dispensing fees, including the costs
described in paragraphs (1), (2), and (3), that would be
sufficient to create an incentive for a pharmacist to promote
the use of generic medications.
(b) Report.--Not later than December 1, 2010, the
Comptroller General of the United States shall submit to the
Secretary of Health and Human Services and to each State a
report describing the study conducted under subsection (a).
The report shall include--
(1) the average cost in each State of dispensing a
prescription drug under Medicaid;
(2) the findings of the study conducted under subsection
(a) with respect to--
(A) the variation in costs studied under subparagraphs (A)
and (B) of paragraph (3) of such subsection; and
(B) the increase in dispensing fees described in paragraph
(4) of such subsection.
(c) Use of Study.--Each State shall use the report
described in subsection (b) to assess the adequacy of
Medicaid pharmacy dispensing fees. The Secretary of Health
and Human Services shall use such report to approve State
plan amendments for States that submit such amendments for
the purposes of increasing Medicaid pharmacy dispensing fees.

[[Page S12627]]

SEC. 7204. STATE OFFICES OF RURAL HEALTH.

Section 338J of the Public Health Service Act (42 U.S.C.
254r) is amended by striking subsection (k).
______