S. 2664 · 109th Congress

PhAIm bill

Stage
In committee
Sponsor
Max Baucus
Introduced
2006-04-27
Latest action
2006-04-27 · Introduced in Senate

Summary

Pharmacy Access Improvement (PhAIm) Act of 2006 - Amends part D (Voluntary Prescription Drug Benefit Program ) of title XVIII (Medicare) of the Social Security Act (SSA) with respect to participating pharmacies and standards for access to them. Requires that such standards ensure that enrollees residing in long-term care facilities have access to a long-term care network pharmacy.

Requires prompt payment of clean claims to pharmacies by prescription drug plans (PDPs) and Medicare Advantage prescription drug plans (MA-PD Plans) Defines prompt payment as within 14 days from submission for claims submitted electronically, and within 30 days for claims submitted otherwise. Requires payment of interest, also, if a payment is not issued, mailed, or otherwise transmitted within the applicable number of calendar days.

Directs the Secretary of Health and Human Services to establish a 24-hour toll-free telephone number dedicated to providing Medicare prescription drug benefit information to pharmacists and pharmacy staff.

Amends SSA title XVIII to require PDP sponsors to establish toll-free pharmacy and physician and provider hotlines.

Requires a PDP sponsor to utilize standardized technology for any communication or transaction occurring between the PDP and a participating pharmacy.

Prohibits a Medicare prescription drug card issued by a PDP sponsor from displaying the name, brand, logo, or trademark (co-branding) of any pharmacy.

Provides for submission of claims by pharmacies located in or contracting with long-term care facilities.

Requires the Secretary to establish reasonable dispensing fees for covered Medicare part D drugs dispensed through participating pharmacies.

Requires a PDP sponsor to encourage generic utilization by paying an increased dispensing fee for generic drugs.