[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1694 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 1694
To establish an America Rx program to establish fairer pricing for
prescription drugs for individuals without access to prescription drugs
at discounted prices.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 9, 2003
Mr. Michaud (for himself, Mr. Allen, Mr. Abercrombie, Mr. Alexander,
Mr. Brown of Ohio, Mr. Berry, Mr. Bell, Mr. Case, Mr. Crowley, Mr.
Stark, Mr. Cardoza, Ms. DeLauro, Mr. Frost, Mr. Hinchey, Mr. Holden,
Ms. Jackson-Lee of Texas, Mr. Hinojosa, Mr. Israel, Mr. Lynch, Mr.
Reyes, Mr. Ross, Mr. Pallone, Mr. Pomeroy, Ms. Schakowsky, Mr. Meehan,
Mr. Sandlin, Mr. Sanders, Mr. Stenholm, Mr. Turner of Texas, Mr. Wynn,
and Mr. Stupak) introduced the following bill; which was referred to
the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To establish an America Rx program to establish fairer pricing for
prescription drugs for individuals without access to prescription drugs
at discounted prices.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; FINDINGS; PURPOSE
(a) Short Title.--This Act may be cited as the ``America Rx Act of
2003''.
(b) Findings.--Congress finds the following:
(1) Affordability is critical in providing access to
prescription drugs for residents of the United States.
(2) It is not the intention of the Congress to discourage
employers and health insurers from providing coverage for
prescription drugs, including discounts for the purchase of
those drugs.
(c) Purpose.--The purpose of this Act is to establish an America Rx
program that utilizes manufacturer rebates and pharmacy discounts to
reduce prescription drug prices to those residents who are without
access to discounted prices for outpatient prescription drugs.
SEC. 2. ESTABLISHMENT OF AMERICA RX PROGRAM.
(a) Establishment.--
(1) In general.--The Secretary of Health and Human Services
shall establish a program (in this section referred to as the
``America Rx program'') consistent with the provisions of this
section to provide qualified residents with access to
discounted prices for outpatient prescription drugs.
(2) Principles.--The Secretary shall design and execute the
America Rx program in a manner consistent with the following
principles:
(A) Medicaid beneficiaries and other low-income
individuals, as well as senior citizens and the
disabled, are not hurt or disadvantaged as a result of
the program's implementation.
(B) Pharmacies participating are ensured reasonable
and timely payment of discounts they provide to
qualified residents under the program.
(C) The Federal Government will fully reimburse
States for reasonable costs they incur in carrying out
the program.
(D) Individuals who apply for benefits under the
program are screened for eligibility under the medicaid
program and other applicable Governmental health care
programs and, if found eligible, are enrolled in such
program or programs.
(E) The Secretary provides for--
(i) outreach efforts to build public
awareness of the program and maximize
enrollment of qualified residents; and
(ii) simplified eligibility procedures and
uniform eligibility standards for qualified
residents.
(3) Qualified resident defined.--For purposes of this
section, the term ``qualified resident'' means an individual
who--
(A) a citizen or national of the United States (or
an alien lawful residing permanently in the United
States); and
(B) as determined under regulations of the
Secretary, is not covered under any public or private
program that provides substantial benefits (which may
be discounted prices) towards the purchase of
outpatient prescription drugs.
(b) Rebate Agreements With Manufacturers.--
(1) In general.--Under the America Rx program the Secretary
shall negotiate with manufacturers of outpatient prescription
drugs rebate agreements with respect to drugs offered under the
program to qualified residents.
(2) Minimum amount of rebates.--In negotiating the amount
of such a rebate under paragraph (1), the Secretary shall take
into consideration the amount of the rebate calculated under
the medicaid program, the average manufacturer price of
prescription drugs, and other information on prescription drug
prices and price discounts. The Secretary shall negotiate the
amount of such rebates in a manner so that the rebates on
average are comparable to the average percentage rebate
obtained in outpatient prescription drugs provided under
section 1927(c) of the Social Security Act (42 U.S.C. 1396r-
8(c)).
(3) Payment.--Such rebates shall be payable to the
Secretary according to a schedule (not less often than
quarterly) negotiated with manufacturers and shall be paid,
directly or through States, to participating pharmacies that
provide discounts to qualified residents.
(4) Incentive.--In order to induce manufacturers of
outpatient prescription drugs to enter into such rebate
agreements, the Secretary shall, in a manner consistent with
the design principle specified in subsection (a)(2), provide,
in the case of a manufacturer that has not entered into such an
agreement, for a denial of a deduction under chapter 1 of the
Internal Revenue Code of 1986 for the amount of expenses of the
manufacturer for advertising and marketing of drugs of the
manufacturer, other than expenses for free samples of drugs
subject to section 503(b)(1) of the Federal Food Drug, and
Cosmetic Act intended to be distributed to patients.
(5) Application of rebates.--Amounts received by the
Secretary as rebates under this subsection shall be placed into
an appropriate account in the Treasury and shall be available
in advance of appropriations to the Secretary for the payment
of discounts and other costs of participating pharmacies in
carrying out the America Rx program and for the payment of
administrative costs in carrying out the program.
(c) Arrangements With Participating Pharmacies.--
(1) In general.--Under the America Rx program arrangements
are made with pharmacies for the provision of prescription
drugs at discounted prices to qualified residents in a
reasonably accessible manner. Such arrangements shall provide
that--
(A) each participating pharmacy shall--
(i) provide discounts on prices for
outpatient prescription drugs for qualified
residents in return for prompt reimbursement of
the amount of such discounts and a reasonable
dispensing fee;
(ii) not charge qualified residents more
(before such discounts) for outpatient
prescription drugs than the amount that
individuals who are not qualified residents are
charged for such drugs; and
(iii) report to the Secretary (or the
Secretary's designee) information regarding the
discounts provided and fees incurred; and
(B) the program shall--
(i) reimburse a participating retail
pharmacy on a prompt basis (no less promptly
than as provided under the medicare program)
for discounted prices provided to qualified
residents under the program and for reasonable
dispensing fees; and
(ii) not impose any additional fees on such
pharmacies in connection with participation in
the program.
(2) Discounted prices.--The amount of the discount provided
to enrolled qualifying residents shall reflect the amount of
rebates obtained, reduced by expenses relating to
administrative costs of the Federal and State governments and
of participating pharmacies. The Secretary shall specify the
method for computing and applying discounts, including a method
for computing and applying discounts on a uniform, average
percentage basis.
(d) Administration.--
(1) In general.--Under the America Rx program the Secretary
may enter into appropriate arrangements with States under which
States provide for the administration of the program in return
for payment of the reasonable administrative expenses
associated with such administration.
(2) Administrative functions.--Such administration
functions may include--
(A) determinations of eligibility of qualified
residents;
(B) arrangements with participating pharmacies; and
(C) such other functions as the Secretary
determines appropriate.
(3) Contractual authority.--In carrying out
responsibilities under this section, the Secretary and States
may enter into agreements with pharmacy benefit managers and
other third parties.
(e) Definitions.--For purposes of this section:
(1) The term ``manufacturer'' has the meaning given such
term in section 1927(k)(5) of the Social Security Act (42
U.S.C. 1396r-8(k)(5)).
(2) The term ``medicaid program'' means a State program
under title XIX of the Social Security Act, including such a
program operating under a Statewide waiver under section 1115
of such Act.
(3) The term ``outpatient prescription drug'' has the
meaning given the term ``covered outpatient drug'' in section
1927(k)(2) of the Social Security Act (42 U.S.C. 1396r-
8(k)(2)).
(4) The term ``Secretary'' means the Secretary of Health
and Human Services.
(5) The term ``State'' has the meaning given such term for
purposes of title XIX of the Social Security Act.
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