article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Safe Medications for the Elderly Act''. SEC. 2. MEDICARE COVERAGE OF PHARMACEUTICAL CARE SERVICES. (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended-- (1) by striking ``and'' at the end of subparagraph (N); and (2) by inserting after subparagraph (O) the following new subparagraph: ``(P) covered pharmaceutical care services (as defined in subsection (oo));''. (b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection: ``Covered Pharmaceutical Care Services ``(oo)(1) The term `covered pharmaceutical care services' means pharmaceutical care services described in paragraph (2) which are furnished by a pharmacist who is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished. ``(2) The pharmaceutical care services described in this paragraph are as follows: ``(A) Services covered under subsection (s)(10) (relating to certain vaccines and their administration). ``(B) Consultation with a physician which results in the physician taking any of the following actions with respect to an outpatient prescription drug furnished to an individual enrolled under part B (without regard to whether or not payment is made for the drug under such part): ``(i) A change in the individual's drug regimen to avoid an adverse interaction with another drug or medical condition. ``(ii) A change in the dosage or form of an outpatient prescription drug taken by the individual. ``(iii) The elimination of a drug from the individual's drug regimen. ``(iv) The initiation of a drug therapy for a medical condition. ``(C) Consultation with an individual enrolled under part B which results in improved compliance by the individual with an outpatient prescription drug regimen with respect to any drug identified by the Secretary pursuant to paragraph (3), if the pharmacist maintains documentation (in accordance with such requirements as the Secretary may impose) that the improvement in compliance is considered necessary by the prescriber of the drug or under peer-reviewed medical literature. ``(3)(A) With respect to the consultations described in paragraph (2)(C), the Secretary shall, not later than one year after the date of the enactment of this subsection, identify and publish a list of outpatient prescription drugs (without regard to whether payment is made for such drug under part B) which are used in the treatment of the following conditions prevalent in the elderly: ``(i) Asthma and chronic obstructive pulmonary disease. ``(ii) Congestive heart failure. ``(iii) Depression. ``(iv) Hyperlipidemia. ``(v) Non-insulin-dependent diabetes. ``(vi) Prevention of stroke (including antihypertensive and anticoagulant therapy). ``(vii) Simultaneous use of 4 or more drugs. ``(B) Beginning 5 years after the date of the enactment of this subsection, the Secretary may periodically update such list of drugs to reflect changes in medical and pharmaceutical practice, the development of new drugs, and other factors the Secretary considers appropriate.''. (c) Payment.-- (1) In general.--Section 1833(a)(1) of such Act (42 U.S.C. 1395l(a)(1)) is amended-- (A) by striking ``and (P)'' and inserting ``(P)''; and (B) by striking the semicolon at the end and inserting the following: ``, and (Q) with respect to covered pharmaceutical care services (as defined in section 1861(oo)), the amounts paid shall be the amounts described in section 1834(k)(1);''. (2) Establishment of fee schedule.--Section 1834 of such Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection: ``(k) Fee Schedules for Pharmaceutical Care Services.-- ``(1) Development.--The Secretary shall develop-- ``(A) a relative value scale to serve as the basis for the payment of covered pharmaceutical care services (as defined in section 1861(oo)) under this part; and ``(B) using such scale and appropriate conversion factors, fee schedules (on a regional, statewide, locality, or carrier service area basis) for payment for covered pharmaceutical care services under this part, to be implemented for such services furnished during years beginning after the expiration of the 3- year period which begins on the date of the enactment of this subsection. ``(2) Considerations.--In developing the relative value scale and fee schedules under paragraph (1), the Secretary shall take into account-- ``(A) differences in the time required to perform types of covered pharmaceutical care services; ``(B) differences in the level of risk associated with the use of particular outpatient prescription drugs or groups of drugs; and ``(C) differences in the health status of individuals to whom covered pharmaceutical care services are provided. ``(3) Payments prior to implementation of fee schedule.--In the case of covered pharmaceutical care services described in subparagraph (B) or (C) of section 1861(oo)(2) which are furnished prior to the implementation of the fee schedule under paragraph (1)(B), the amount of payment made under this part shall be equal to 80 percent of the amount which would be paid for the service under the fee schedule applicable under section 1848 if the service were furnished by a physician.''. (3) Report to congress.--Not later than 3 years after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit a report to Congress on the relative value scale and fee schedules developed pursuant to section 1834(k)(1) of the Social Security Act (as added by paragraph (2)) for covered pharmaceutical services under part B of the Medicare program. (d) Effective Date.--The amendments made by this section shall apply to services furnished on or after January 1, 1997.
summary: Safe Medications for the Elderly Act - Amends title XVIII (Medicare) of the Social Security Act to: (1) provide for Medicare part B (Supplementary Medical Insurance) coverage of certain pharmaceutical care services; and (2) direct the Secretary of Health and Human Services to develop a relative value scale and fee schedules for the payment of such services.