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108th CONGRESS
2d Session
H. R. 4681
To require the Secretary of Health and Human Services to establish and
maintain an Internet website that is designed to allow consumers to
compare the usual and customary prices for covered outpatient drugs
sold by retail pharmacies that participate in the Medicaid Program for
each postal Zip Code, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 24, 2004
Mr. Cardin (for himself, Mr. Pallone, and Mr. McNulty) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
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A BILL
To require the Secretary of Health and Human Services to establish and
maintain an Internet website that is designed to allow consumers to
compare the usual and customary prices for covered outpatient drugs
sold by retail pharmacies that participate in the Medicaid Program for
each postal Zip Code, and for other purposes.
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 ``Prescription Drug Price Comparison
for Savings Act of 2004''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Access to prescription drugs is important to all
Americans.
(2) Many individuals cannot afford to purchase the drugs
prescribed by their doctors. Others skip doses or split pills
contrary to their doctor's orders because they cannot afford to
refill their prescriptions.
(3) Individuals who use their limited financial resources
to obtain needed drugs may do so by foregoing other
expenditures important to their health and well-being.
(4) Among the objectives of the medicaid program set forth
in section 1901 of the Social Security Act (42 U.S.C. 1396) is
the objective to enable each State to furnish services to help
low-income families and aged, blind, or disabled individuals
``attain or retain capability for independence or self-care''.
(5) Some States, such as Maryland, have established
interactive Internet websites that use the usual and customary
price information reported by pharmacies participating in the
State's medicaid program to allow all residents of the State to
comparison shop for prescription drugs.
(6) Requiring all States to collect from pharmacies that
participate in the medicaid program the usual and customary
price for prescription drugs sold by the pharmacies and to
report that information to the Secretary of Health and Human
Services in order that a national, interactive Internet website
may be established and maintained for individuals to use to
comparison shop for prescription drugs is consistent with the
objectives of the medicaid program.
SEC. 3. STATE PLAN REQUIREMENT TO COLLECT AND REPORT USUAL AND
CUSTOMARY PRICES FOR COVERED OUTPATIENT DRUGS SOLD UNDER
THE MEDICAID PROGRAM.
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is
amended--
(1) in paragraph (66), by striking ``and'' at the end;
(2) in paragraph (67), by striking the period and inserting
``; and''; and
(3) by inserting after paragraph (67), the following:
``(68) provide that the State shall--
``(A) require each retail pharmacy which receives
payments under the plan to report to the State
concurrent with the filling of a prescription for a
covered outpatient drug (as defined in section
1927(k)(2)) for an individual receiving medical
assistance under this title--
``(i) the usual and customary price (as
defined in section 1927(k)(10)) for the
strength, quantity, and dosage form of the
covered outpatient drug, as of the date the
prescription is filled; and
``(ii) the postal Zip Code in which the
retail pharmacy is located; and
``(B) submit the information reported under
subparagraph (A) to the Secretary on such frequent
basis as the Secretary shall require so as to allow for
monthly updates of the information posted on the
Internet website required to be established under
section 5 of the Prescription Drug Price Comparison for
Savings Act of 2004.''.
SEC. 4. USUAL AND CUSTOMARY PRICES FOR COVERED OUTPATIENT DRUGS.
(a) Definition.--Section 1927(k) of the Social Security Act (42
U.S.C. 1396r-8(k)) is amended by adding at the end the following:
``(10) Usual and customary price.--The term `usual and
customary price' means the price a retail pharmacy would charge
an individual who does not have health insurance coverage for
purchasing a specific strength, quantity, and dosage form of a
covered outpatient drug.''.
(b) Inclusion of Information in Annual Report to Congress.--Section
1927(i)(2)(E) of the Social Security Act (42 U.S.C. 1396r-8(i)(2)(E))
is amended--
(1) by redesignating subparagraphs (E) and (F) as
subparagraphs (F) and (G), respectively; and
(2) by inserting after subparagraph (D), the following:
``(E) the range of usual and customary prices for
specific strengths, quantities, and dosage forms of
covered outpatient drugs, disaggregated by postal Zip
Code;''.
SEC. 5. REQUIREMENT TO ESTABLISH AND MAINTAIN PRESCRIPTION DRUG PRICE
COMPARISON WEBSITE.
(a) Authority.--Not later than 6 months after the date of enactment
of this Act, the Secretary shall establish and arrange for the
maintenance of an Internet website that is designed to allow an
individual to compare the usual and customary prices for a range of
strengths and quantities of covered outpatient drugs sold by retail
pharmacies that receive payments under the medicaid program for each
postal Zip Code that corresponds to an area of a State.
(b) Requirements.--The Internet website required to be established
and maintained under this section shall consist of--
(1) the information submitted to the Secretary in
accordance with section 1902(a)(68)(B) of the Social Security
Act (42 U.S.C. 1396a(a)(68)(B)) (as added by section 3(a)(3));
and
(2) such other information as the Secretary determines is
appropriate.
(c) Definitions.--In this section:
(1) Covered outpatient drug.--The term ``covered outpatient
drug'' has the meaning given that term in section 1927(k)(2) of
the Social Security Act (42 U.S.C. 1396r-8(k)(2)).
(2) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(3) State.--The term ``State'' has the meaning given that
term for purposes of title XIX of the Social Security Act (42
U.S.C. 1396 et seq.).
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