1. Short title
This Act may be cited as the “Streamlining Part D Appeals Process Act”.
Streamlining Part D Appeals Process Act
A BILL
To provide for the treatment of a pharmacy counter refusal as a coverage determination under Medicare part D.
2. Providing for the treatment of a pharmacy counter refusal as a coverage determination under Medicare part D
Section 1860D–4(g) of the Social Security Act (42 U.S.C. 1395w–104(g)) is amended by adding at the end the following new paragraph:
“(3) Treatment of pharmacy counter refusal as coverage determination—For plan years beginning on or after January 1, 2020, the refusal by a pharmacy to fill a prescription for a covered part D drug under a prescription drug plan shall be treated as a coverage determination subject to reconsideration and appeal pursuant to this subsection and subsection (h).”