Sec. 706. Pilot program on receipt of non-generic prescription maintenance medications under TRICARE pharmacy benefits program
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Subject to paragraph (2), the Secretary of Defense may carry out a pilot program under which eligible covered beneficiaries may elect to receive non-generic prescription maintenance medications selected by the Secretary under subsection
(c)through military medical treatment facility pharmacies, retail pharmacies, or the national mail-order pharmacy program, notwithstanding section 1074g(a)(9) of title 10, United States Code. The Secretary may carry out the pilot program under paragraph
(1)only if the Secretary determines that the total costs to the Department of Defense for eligible covered beneficiaries to receive non-generic prescription maintenance medications under the pilot program will not exceed the total costs to the Department for such beneficiaries to receive such medications under the national mail-order pharmacy program pursuant to section 1074g(a)(9) of title 10, United States Code. In making such determination, the Secretary shall consider all manufacturer discounts, refunds and rebates, pharmacy transaction fees, and all other costs. If the Secretary carries out the pilot program under subsection (a)(1), the Secretary shall carry out the pilot program for a three-year period beginning not later than March 1, 2021. If the Secretary carries out the pilot program under subsection (a)(1), the Secretary shall select non-generic prescription maintenance medications described in section 1074g(a)(9)(C)(ii) of title 10, United States Code, to be covered by the pilot program. If the Secretary carries out the pilot program under subsection (a)(1), in providing each eligible covered beneficiary with an explanation of benefits, the Secretary shall notify the beneficiary of whether the medication that the beneficiary is prescribed is covered by the pilot program. If the Secretary determines to carry out the pilot program under subsection (a)(1), not later than 90 days after the date of the enactment of this Act, the Secretary shall provide to the Committees on Armed Services of the House of Representatives and the Senate a briefing on the implementation of the pilot program. If the Secretary carries out the pilot program under subsection (a)(1), not later than 18 months after the commencement of the pilot program, the Secretary shall submit to the Committees on Armed Services of the House of Representatives and the Senate a report on the pilot program. If the Secretary carries out the pilot program under subsection (a)(1), not later than March 1, 2024, the Comptroller General of the United States shall submit to the Committees on Armed Services of the House of Representatives and the Senate a report on the pilot program. The report under subparagraph
(A)shall include the following: The number of eligible covered beneficiaries who participated in the pilot program and an assessment of the satisfaction of such beneficiaries with the pilot program. The rate by which eligible covered beneficiaries elected to receive non-generic prescription maintenance medications at a retail pharmacy pursuant to the pilot program, and how such rate affected military medical treatment facility pharmacies and the national mail-order pharmacy program. The amount of cost savings realized by the pilot program, including with respect to— dispensing fees incurred at retail pharmacies compared to the national mail-order pharmacy program for brand name prescription drugs; administrative fees; any costs paid by the United States for the drugs in addition to the procurement costs; the use of military medical treatment facilities; and copayments paid by eligible covered beneficiaries. A comparison of supplemental rebates between retail pharmacies and other points of sale. Nothing in this section may be construed to affect— the ability of the Secretary to carry out section 1074g(a)(9)(C) of title 10, United States Code, after the date on which the pilot program is completed; or the prices established for medications under section 8126 of title 38, United States Code. In this section: The term eligible covered beneficiary has the meaning given that term in section 1074g(i) of title 10, United States Code. The terms military medical treatment facility pharmacies , retail pharmacies , and the national mail-order pharmacy program mean the methods for receiving prescription drugs as described in clauses (i), (ii), and (iii), respectively, of section 1074g(a)(2)(E) of title 10, United States Code.