Section 1 Short title
This Act may be cited as the “Medicaid Drug Decisions Transparency Act”.
Medicaid Drug Decisions Transparency Act
A BILL
To amend title XI of the Social Security Act to expand the scope of transparency reporting requirements related to the ownership or investment interests of health care providers and others, and to increase the penalties associated with violating such requirements.
Sec. 2 Ownership or investment interest transparency for health care providers and others
in subsection (b)—
in paragraph (1)(A), by striking “$10,000” and inserting “$20,000”;
in paragraph (1)(B), by striking “$150,000” and inserting “$300,000”;
in paragraph (2)(A), by striking “$100,000” and inserting “$200,000”; and
in paragraph (2)(B), by striking “$1,000,000” and inserting “$2,000,000”;
in subsection (d)(2), by adding at the end the following sentence: “Beginning with calendar year 2021, such report shall include a separate summary of the information submitted under subsection (a) during the preceding year with respect to the covered recipients described in clause (vii) of subsection (e)(6)(A).”; and
in subsection (e)(6)(A), by adding at the end the following:
“(vi) A pharmacist (as defined in section 804(a)(2) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 384(a)(2)).
“(vii) An individual or entity with decision-making authority over the formulary or preferred drug list of a State plan (or a waiver of a plan) under title XIX, including an individual or entity that participates in the establishment of such a drug formulary or preferred drug list or in the drug utilization review process for such a plan or waiver, such as a member of a State drug use review board described in section 1927.”
Effective date— The amendments made by this section shall take effect on January 1, 2020, and shall apply to information required to be submitted under section 1128G of the Social Security Act (42 U.S.C. 1320a–7h) on or after such date.
Sec. 3 State drug use review board membership transparency
Section 1927(g)(3)(B) of the Social Security Act (42 U.S.C. 1396r–8(g)(3)(B)) is amended—
by redesignating clauses (i) through (iv) as subclauses (I) through (IV) and moving such subclauses (as so redesignated) 2 ems to the right;
in the matter preceding subclause (I) (as so redesignated), by striking “The membership” and inserting the following:
“(i) In general—The membership”
in the last sentence, by striking “The membership” and inserting the following:
“(ii) Requirement—The membership”
by adding at the end the following:
“(iii) Publication of membership—Each State shall publish a list of the DUR Board members on an Internet web site in a format that is clear and understandable and regularly shall update the list with any changes to such membership.”