Sec. 126. Improvements to provision of parts A and B claims data to prescription drug plans
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Paragraph
(6)of section 1860D–4(c) of the Social Security Act ( 42 U.S.C. 1395w–104(c) ), as added by section 50354 of division E of the Bipartisan Budget Act of 2018 ( Public Law 115–123 ), relating to providing prescription drug plans with parts A and B claims data to promote the appropriate use of medications and improve health outcomes, is amended— in subparagraph (B)— by redesignating clauses (i), (ii), and
(iii)as subclauses (I), (II), and (III), respectively, and moving such subclauses 2 ems to the right; by striking and inserting Purposes .—A PDP sponsor Purposes — A PDP sponsor. ; and by adding at the end the following new clause: The limitation on data use under subparagraph (C)(i) shall not apply to the extent that the PDP sponsor is using the data provided to carry out any of the purposes described in clause (i). ; and in subparagraph (C)(i), by striking To inform and inserting Subject to subparagraph (B)(ii), to inform . The amendments made by this subsection shall apply to plan years beginning on or after January 1, 2022. Subparagraph
(D)of such paragraph
(6)is amended— by striking and inserting “ described .—The data described in this clause described .— The data described in this subparagraph ; and by adding at the end the following new clause: Such data may be provided pursuant to this paragraph in the same manner as data under the Part D Enhanced Medication Therapy Management model tested under section 1115A, through Application Programming Interface, or in another manner as determined by the Secretary. Notwithstanding any other provision of law, the Secretary may implement this clause by program instruction or otherwise. . Such paragraph
(6)is redesignated as paragraph (7).
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- 42 USC 1395w–104(c)
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Sec. 126
Improvements to provision of parts A and B claims data to prescription drug plans
Cite42 USC 1395w–104(c)
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