Sec. 702. MODIFICATIONS OF COST-SHARING REQUIREMENTS FOR THE TRICARE PHARMACY BENEFITS PROGRAM AND TREATMENT OF CERTAIN PHARMACEUTICAL AGENTS
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## SEC. 702 MODIFICATIONS OF COST-SHARING REQUIREMENTS FOR THE TRICARE PHARMACY BENEFITS PROGRAM AND TREATMENT OF CERTAIN PHARMACEUTICAL AGENTS ###
(a)In General Paragraph
(6)of section 1074g(a) of title 10, United States Code, is amended to read as follows: > > #### “(6) > > > #####
(A)> > In the case of any of the years 2018 through 2027, the cost-sharing amounts under this subsection for eligible covered beneficiaries shall be determined in accordance with the following table: ``For:The cost-sharing amount for a 30-day supply of a retail generic is:The cost-sharing amount for a 30-day supply of a retail formulary is:The cost-sharing amount for a 90-day supply of a mail order generic is:The cost-sharing amount for a 90-day supply of a mail order formulary is:The cost-sharing amount for a 90-day supply of a mail order non-formulary is:2018$11$28$7$24$532019$11$28$7$24$532020$13$33$10$29$602021$13$33$10$29$602022$14$38$12$34$682023$14$38$12$34$682024$16$43$13$38$762025$16$43$13$38$762026$16$48$14$44$852027$16$48$14$44$85 > > > ##### “(B) > > For any year after 2027, the cost-sharing amounts under this subsection for eligible covered beneficiaries shall be equal to the cost-sharing amounts for the previous year adjusted by an amount, if any, determined by the Secretary to reflect changes in the costs of pharmaceutical agents and prescription dispensing, rounded to the nearest dollar. > > > ##### “(C) > > Notwithstanding subparagraphs
(A)and (B), the cost-sharing amounts under this subsection for a dependent of a member of the uniformed services who dies while on active duty, a member retired under chapter 61 of this title, or a dependent of a member retired under such chapter shall be equal to the cost-sharing amounts, if any, for 2017.” > . ###
(b)Treatment of Certain Pharmaceutical Agents ####
(1)Pharmacy benefits program Such section is amended by adding at the end the following new paragraph: > > #### “(10) > > Notwithstanding paragraphs (2), (5), and (6), in order to encourage the use by covered beneficiaries of pharmaceutical agents that provide the best clinical effectiveness to covered beneficiaries and the Department of Defense (as determined by the Secretary, including considerations of better care, healthier people, and smarter spending), the Secretary may, upon the recommendation of the Pharmacy and Therapeutics Committee established under subsection
(b)and review by the Uniform Formulary Beneficiary Advisory Panel established under subsection (c)— > > > ##### “(A) > > exclude from the pharmacy benefits program any pharmaceutical agent that the Secretary determines provides very little or no clinical effectiveness to covered beneficiaries and the Department under the program; and > > > ##### “(B) > > give preferential status to any non-generic pharmaceutical agent on the uniform formulary by treating it, for purposes of cost-sharing under paragraph (6), as a generic product under the TRICARE retail pharmacy program and mail order pharmacy program.” > . ####
(2)Medical contracts Section 1079 of such title is amended by adding at the end the following new subsection: > > ### “(q) > > In the case of any pharmaceutical agent (as defined in section 1074g(g) of this title) provided under a contract entered into under this section by a physician, in an outpatient department of a hospital, or otherwise as part of any medical services provided under such a contract, the Secretary of Defense may, under regulations prescribed by the Secretary, adopt special reimbursement methods, amounts, and procedures to encourage the use of high-value products and discourage the use of low-value products, as determined by the Secretary.” > . ####
(3)Regulations **[**[10 U.S.C. 1074g note](/us/usc/t10/s1074g)**]** In order to implement expeditiously the reforms authorized by the amendments made by paragraphs
(1)and (2), the Secretary of Defense may prescribe such changes to the regulations implementing the TRICARE program (as defined in section 1072 of title 10, United States Code) as the Secretary considers appropriate— #####
(A)by prescribing an interim final rule; and #####
(B)not later than one year after prescribing such interim final rule and considering public comments with respect to such interim final rule, by prescribing a final rule.
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Sec. 702
MODIFICATIONS OF COST-SHARING REQUIREMENTS FOR THE TRICARE PHARMACY BENEFITS PROGRAM AND TREATMENT OF CERTAIN PHARMACEUTICAL AGENTS
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