text: 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.
target: 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.
feat_title: Safe Medications for the Elderly Act