Sec. 714. Pilot program for operation of network of retail pharmacies under TRICARE pharmacy benefits program
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The Secretary of Defense may conduct a pilot program to evaluate whether, in carrying out the TRICARE pharmacy benefits program under section 1074g of title 10, United States Code, operating a network of preferred retail pharmacies will generate cost savings for the Department of Defense. In conducting the pilot program under subsection (a), the Secretary shall— incorporate best practices to enhance patient access from non-TRICARE health plans that are using a preferred retail network of pharmacies along with the mail-order pharmacy program of the plans and preferred pharmacy networks in Medicare Part D; allow beneficiaries to obtain prescription medication that is available through the TRICARE pharmacy benefits program, including maintenance medication, through the network of preferred retail pharmacies and the national mail-order pharmacy program under section 1074g(a)(2)(E)(iii) of title 10 United States Code; allow retail pharmacies participating in the network of preferred retail pharmacies to purchase prescription medication for beneficiaries at rates available to the Federal government pursuant to section 1074g(f) of title 10, United States Code; ensure that retail pharmacies participating in the network of preferred retail pharmacies shall be comprised of small business pharmacies at a rate no lower than the current TRICARE pharmacy program participation rate; study the potential, viability, cost efficiency, and health care effectiveness of the TRICARE pharmacy benefits program administering prescription medication through a network of preferred retail pharmacies in addition to the methods available pursuant to section 1074g(a)(2)(E) of title 10, United States Code; and determine the opportunities for and barriers to coordinating and leveraging the use of a network of preferred retail pharmacies in addition to such methods available pursuant to such section 1074g(a)(2)(E).
The Secretary shall select the retail pharmacies to participate in the preferred network of preferred retail pharmacies pursuant to subsection (a). In making such selection the Secretary may— require that retail pharmacies opt-in to the network and agree to the reimbursement rates paid by the Secretary; determine specific criteria for each retail pharmacy to meet or that a certain number of retail pharmacies must meet; use a competitive process; and require the preferred pharmacy network to comply with the existing TRICARE retail pharmacy access standards.
In carrying out the pilot program under subsection (a), the Secretary shall select at least one region in which to carry out the pilot program. The Secretary shall ensure that any region selected meets the following criteria: The region has a certain number or percentage, as determined by the Secretary, of— members of the Armed Forces serving on active duty; members of the Armed Forces serving in a reserve component; and retired members of the Armed Forces. The number of beneficiaries under paragraph
(1)is sufficient to produce statistically significant results. The region has at least one retail pharmacy that operates at least 10 pharmacy locations in the region. The region has at least one military installation that has a military medical treatment facility with a pharmacy. The Secretary shall develop the pilot program under subsection
(a)in consultation with— the Secretaries of the military departments; representatives from the military installations within the region selected under subsection (d); and the TRICARE-managed pharmacy contractor with responsibility for the national pharmacy mail-order program. If the Secretary of Defense carries out the pilot program under subsection (a), the Secretary shall commence such pilot program by not later than May 1, 2016, and shall terminate such program on September 30, 2018. If the Secretary of Defense carries out the pilot program under subsection (a), the Secretary of Defense shall submit to the congressional defense committees reports on the pilot program as follows: Not later than 90 days after the date of the enactment of this Act, a report containing an implementation plan for the pilot program. Not later than 90 days after the date on which the pilot program commences, and semiannually thereafter during the period in which the pilot program is carried out, an interim report on the pilot program. Not later than 90 days after the date on which the pilot program terminates, a final report describing the results of the pilot program, including any recommendations of the Secretary to expand such program.