A bill to amend titles II and XVIII of the Social Security Act to include qualified drugs, requiring a physician's prescription or certification and approved by a formulary committee, among the items and services covered under the hospital insurance program.

Summary

Includes, under title II (Old-Age, Survivors' and Disability Insurance) and title XVIII (Medicare) of the Social Security Act, qualified drugs prescribed or certified by a physician and approved by a Formulary Committee within an individual's medical insurance coverage. Provides that the amount payable for qualified drugs furnished an individual pursuant to any one prescription or certification and purchased by such individual at any one time shall be reduced by an amount equal to the applicable prescription copayment. Provides that the Secretary of Health, Education, and Welfare shall each year, beginning in 1975, determine and promulgate the drug copayment which shall be applicable for the purposes of this Act during the succeeding calendar year. Provides that payment may be made under this Act for qualified drugs only when such drugs are dispensed by a licensed pharmacy which is a provider of services for purposes of the Act. Establishes in the Department of Health, Education, and Welfare a Formulary Committee. Provides that the Committee shall compile, publish, make available, and periodically revise a Formulary of the United States. Provides that the Formulary shall alphabetacally arrange a listing, by established name, of those drugs and biologicals that shall be deemed qualified drugs for purposes of the benefits provided under this Act. Provides that the Committee, prior to making a final determination to remove from the listing in the Formulary any drug which would otherwise be included therein, shall afford a reasonable opportunity for a hearing on the matter to any person engaged in manufacturing, preparing, propagating, compounding, or processing the product who shows reasonable grounds for such a hearing. Provides that any person adversely affected by the final decision of the Committee may obtain judicial review thereof in accordance with the procedures specified in the Federal Food, Drug, and Cosmetic Act. Provides standards for determining the maximum allowable cost for qualified drugs. Defines the term "qualified drug". Defines the term "licensed pharmacy" as a pharmacy, or other establishment providing community pharmaceutical services, which is licensed as such under the law of the State in which such drug is provided or otherwise dispensed in accordance with title XVIII of the Social Security Act.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

No timeline events have been ingested for this record yet.

Votes

No vote records are attached yet.

Versions

No version snapshots stored. Document URLs remain at the source.

Documents

1 official file

• Introduced in House

  summary · EN · 5 March 1973

  Open at official source

Sponsors

No sponsors or actors listed by the source.

Related records

No cross-record relationships stored yet.