Summary: Addressing Cost Containment Measures To Ensure the Sustainability and Success of ADAP Act or the ACCESS ADAP Act - Transfers funds from discretionary amounts appropriated under the American Recovery and Reinvestment Act that remain unobligated to the Secretary of Health and Human Services (HHS) to be used in FY2010 to provide assistance in reducing AIDS Drug Assistance Program waiting lists and to address other cost containment measures that state AIDS Drug Assistance Programs implement after January 1, 2009. Requires amounts transferred under this Act to be used by states in a manner consistent with their state programs. Requires the Secretary, in allocating such funds, to: (1) give special consideration to the total scope and the basis of a state's needs, including the total number of patients on a waiting list, eligibility requirements, and other cost containment measures; and (2) ensure that funds be used only to provide treatments to individuals who were eligible to participate in the state program on the date of enactment of this Act.

addressing cost containment measures ensure sustainability success act access act transfers funds discretionary amounts appropriated american_recovery_and_reinvestment_act remain unobligated secretary health_and_human_services hhs fy2010 provide assistance reducing aids drug assistance program waiting lists address cost containment measures state aids drug assistance programs implement january requires amounts transferred act states manner consistent state programs requires secretary allocating funds special consideration total scope basis state needs including total number patients waiting list eligibility requirements cost containment measures ensure funds provide treatments individuals eligible participate state program date enactment act


Summary: Medicare Prescription Drug Price Negotiation Act of 2010 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to negotiate with pharmaceutical manufacturers the prices that may be charged to Medicare part D prescription drug plan (PDP) sponsors and MedicareAdvantage (MA) organizations for covered part D drugs for part D eligible individuals who are enrolled under a PDP or under an MA-Prescription Drug (MA-PD) plan.

medicare prescription drug price negotiation act amends voluntary prescription drug benefit program title xviii medicare social security act direct secretary health_and_human_services hhs negotiate pharmaceutical manufacturers prices charged medicare prescription drug plan pdp sponsors medicareadvantage organizations covered drugs eligible individuals enrolled pdp ma-prescription_drug ma-pd plan


Summary: Addressing Cost Containment Measures To Ensure the Sustainability and Success of ADAP Act or the ACCESS ADAP Act - Requires specified funds to be transferred to the Secretary of Health and Human Services (HHS) from discretionary amounts appropriated under the American Recovery and Reinvestment Act that remain unobligated, to be obligated during the FY2010 grant period under the AIDS Drug Assistance Program to provide assistance in reducing waiting lists and to address other cost containment measures that state AIDS Drug Assistance Programs implement after January 1, 2009. Requires amounts transferred under this Act to be used by states in a manner consistent with their state programs. Requires the Secretary, in allocating such funds, to: (1) give special consideration to the total scope and the basis of a state's needs, including the total number of patients on a waiting list, eligibility requirements, and other cost containment measures; and (2) ensure that funds be used only to provide treatments to individuals who were eligible to participate in the state program on the date of enactment of this Act or who would have been eligible to participate in the state program  but were not so eligible because of the implementation of cost-containment measures after January 1, 2009.

addressing cost containment measures ensure sustainability success act access act requires specified funds transferred secretary health_and_human_services hhs discretionary amounts appropriated american_recovery_and_reinvestment_act remain unobligated obligated fy2010 grant period aids drug assistance program provide assistance reducing waiting lists address cost containment measures state aids drug assistance programs implement january requires amounts transferred act states manner consistent state programs requires secretary allocating funds special consideration total scope basis state needs including total number patients waiting list eligibility requirements cost containment measures ensure funds provide treatments individuals eligible participate state program date enactment act eligible participate state program eligible implementation cost containment measures january


Summary: Medicare Enhancements for Needed Drugs Act of 2010 - Directs the Comptroller General to review and report to Congress on the retail cost of prescription drugs in the United States during 2004 through 2010, with an emphasis on the prescription drugs most utilized for individuals age 65 or older. Requires the Comptroller General to conduct an ongoing study that compares the average retail cost in the United States for each of the 20 most utilized prescription drugs for individuals age 65 or older with: (1) the average prices at which private health plans, the Department of Defense (DOD) under the Defense Health Program, and the Department of Veterans Affairs (VA) acquire each such drug; and (2) the average negotiated price for each such drug that eligible beneficiaries have access to under a Medicare prescription drug plan providing only basic prescription drug coverage. Amends title XVIII (Medicare) of the Social Security Act (SSA) to include in the comparative plan information for beneficiaries under Medicare part D (Voluntary Prescription Drug Benefit Program) a comparison of average aggregate prescription drug plan beneficiary costs and savings with such costs for a beneficiary with no prescription drug plan. Repeals the prohibition against interference by the Secretary of Health and Human Services (HHS) with the negotiations between drug manufacturers and pharmacies and prescription drug plan sponsors. Authorizes the Secretary instead, like other federal entities that purchase prescription drugs in bulk, to negotiate contracts with manufacturers of covered part D drugs. Requires the use of the resulting savings to the Medicare Prescription Drug Account to strengthen the part D program and to reduce the federal deficit. Requires the Secretary to ensure that each part D eligible individual has: (1) a choice of enrollment in a comprehensive prescription drug plan in the area in which the individual resides; or (2) in any case in which such a plan is not available, the opportunity to enroll in a comprehensive fallback prescription drug plan.

needed drugs act directs comptroller general review report congress retail cost prescription drugs united_states emphasis prescription drugs utilized individuals age older requires comptroller general conduct ongoing study compares average retail cost united_states utilized prescription drugs individuals age older average prices private health plans department_of_defense dod defense_health_program department_of_veterans_affairs acquire drug average negotiated price drug eligible beneficiaries access medicare prescription drug plan providing basic prescription drug coverage amends title xviii medicare social security act ssa include comparative plan information beneficiaries medicare voluntary prescription drug benefit program comparison average aggregate prescription drug plan beneficiary costs savings costs beneficiary prescription drug plan repeals prohibition interference secretary health_and_human_services hhs negotiations drug manufacturers pharmacies prescription drug plan sponsors authorizes secretary instead like federal entities purchase prescription drugs bulk negotiate contracts manufacturers covered drugs requires use resulting savings strengthen program reduce federal deficit requires secretary ensure eligible individual choice enrollment comprehensive prescription drug plan area individual resides case plan available opportunity enroll comprehensive fallback prescription drug plan


Summary: Health Care Tax Deduction Act of 2011 - Amends the Internal Revenue Code to allow individuals a tax deduction from gross income for health insurance premiums and unreimbursed prescription drug expenses paid for the benefit of the taxpayer and the taxpayer's spouse and dependents.

amends internal revenue code allow individuals tax deduction gross income health insurance premiums unreimbursed prescription drug expenses paid benefit taxpayer taxpayer spouse dependents


Summary: Restoring Consumer-driven Health Care Act of 2011 - Repeals provisions of the Internal Revenue Code, as added by the Patient Protection and Affordable Care Act, that: (1) limit payments from health and medical savings accounts and health flexible spending arrangements solely to medications that are prescribed drugs or insulin, and (2) increase taxes on distributions from health and medical savings accounts that are not used for qualified medical expenses.

health care act repeals provisions internal_revenue_code added patient_protection affordable care act limit payments health medical savings accounts health flexible spending arrangements solely medications prescribed drugs insulin increase taxes distributions health medical savings accounts qualified medical expenses


Summary: Stop Asian Carp Act - Directs the Secretary of the Army, acting through the Chief of Engineers, to study the watersheds of the Illinois, Chicago, and Calumet Rivers, including their tributaries, that drain directly into Lake Michigan to determine the feasibility and best means of implementing the hydrologic separation of the Great Lakes and the Mississippi River Basins to prevent the introduction or establishment of populations of aquatic nuisance species between the Great Lakes and Mississippi River Basins through the Chicago Area Water System (CAWS) and other aquatic pathways.Requires the study to: (1) include options to address flooding, Chicago wastewater and stormwater infrastructure, waterway safety operations, and barge and recreational vessel traffic alternatives; and (2) contain a detailed analysis of the environmental benefits and costs of each option.Directs: (1) the Secretary to carry out this Act at full federal cost; and (2) the President, or the Council on Environmental Quality as a designee to the President, to oversee the study to ensure its thoroughness and timely completion.Requires the Director of the United States Geological Survey (USGS), in cooperation with the Director of the United States Fish and Wildlife Service, to: (1) monitor and survey all waters that connect to the Great Lakes Basin or could connect to it due to flooding, underground hydrological connection, or human-made diversion to identify additional threats that could allow Asian Carp to enter the Basin; and (2) prioritize each threat and help identify means to impede the passage of Asian Carp to the Basin.

stop asian carp act directs secretary army acting chief engineers study watersheds illinois chicago including tributaries drain directly lake michigan determine feasibility best means implementing hydrologic separation great lakes mississippi_river_basins prevent introduction establishment populations aquatic nuisance species great_lakes mississippi_river_basins caws aquatic pathways requires study include options address flooding chicago wastewater stormwater infrastructure waterway safety operations barge recreational vessel traffic alternatives contain detailed analysis environmental benefits costs option directs secretary carry act federal cost president council_on_environmental_quality designee president oversee study ensure timely completion requires director united_states_geological_survey usgs cooperation director united_states fish_and_wildlife_service monitor survey waters connect great_lakes_basin connect flooding underground hydrological connection human diversion identify additional threats allow enter basin prioritize threat help identify means impede passage asian carp basin


Summary: Positive Reduction of Incarceration by Maximizing Education Act or PRIME Act - Directs the Attorney General, through the Director of the Office of Juvenile Justice and Delinquency Prevention, to establish national, regional, and local public awareness campaigns focused on promoting the advantages of continued education among youth.

positive reduction incarceration maximizing education act prime act directs attorney general director office_of_juvenile_justice delinquency_prevention establish national regional local public awareness campaigns focused promoting advantages continued education youth


Summary: FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act - Prohibits the Office of Personnel Management (OPM) from entering a contract or approving a health benefits plan with a carrier that is a party to a pharmacy benefit manager (PBM) carrier arrangement to provide or administer prescription drug coverage under the Federal Employees Health Benefits Program (FEHBP) unless the PBM and the carrier comply with the requirements for PBM carrier arrangements set forth by this Act. Directs OPM to terminate a contract or discontinue a plan that fails to comply with such requirements. Prohibits: (1) a PBM under a carrier arrangement from being under common corporate control with a prescription drug manufacturer or a retail pharmacy, and (2) OPM from permitting a carrier under common corporate control with a PBM to earn a profit from such control. Sets forth terms and requirements for PBM carrier arrangements under the FEHBP, including: (1) drug substitution restrictions, (2) PBM reimbursement of carriers, (3) sale by a PBM of utilization and claims data, (4) drug pricing and the basis for reimbursement, (5) PBM provision to plan enrollees of an explanation of benefits statement regarding prescription drugs, (6) nondiscriminatory contracts regarding required participation, (7) OPM access to PBM contract information, and (8) civil monetary penalties for making false statements or claims to the government.

fehbp prescription drug integrity transparency cost savings act prohibits entering contract approving health benefits plan carrier party pharmacy benefit manager pbm carrier arrangement provide administer prescription drug coverage federal_employees_health_benefits_program fehbp pbm carrier comply requirements pbm carrier arrangements set forth act directs opm terminate contract discontinue plan fails comply requirements prohibits pbm carrier arrangement common corporate control prescription drug manufacturer retail pharmacy opm permitting carrier common corporate control pbm earn profit control sets forth terms requirements pbm carrier arrangements fehbp including drug substitution restrictions pbm reimbursement carriers sale pbm utilization claims data drug pricing basis reimbursement pbm provision plan enrollees explanation benefits statement prescription drugs nondiscriminatory contracts required participation opm access pbm contract information civil monetary penalties making false statements claims government


Summary: Voluntary State Discount Prescription Drug Plan Act of 2011 - Amends title XIX (Medicaid) of the Social Security Act to require drug manufacturers to pay rebates to state prescription drug discount programs as a condition of participating in a Medicaid rebate agreement for outpatient prescription drugs, but only if the state has elected to establish an optional state prescription drug discount program.

plan act amends title xix medicaid social security act require drug manufacturers pay rebates state prescription drug discount programs condition participating medicaid rebate agreement outpatient prescription drugs state elected establish optional state prescription drug discount program


Summary: Medicare Prescription Drug Savings and Choice Act of 2011 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to provide for: (1) establishment of one or more Medicare operated prescription drug plan options; and (2) an appeals process for denials of benefits under a Medicare operated prescription drug plan.

medicare_prescription_drug_savings choice act amends voluntary prescription drug benefit program title xviii medicare social security act provide establishment medicare operated prescription drug plan options appeals process denials benefits medicare operated prescription drug plan


Summary: Part D Off-Label Prescription Parity Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to permit a prescription drug plan (PDP) sponsor offering a PDP or a MedicareAdvantage (MA) organization offering an MA-PD plan to offer coverage of covered part D drugs for uses that are determined to be for medically accepted indications based upon: (1) guidance provided by the Secretary of Health and Human Services (HHS) for determining accepted uses of covered part D drugs; and (2) supportive clinical evidence in peer reviewed medical literature.

label prescription parity act amends voluntary prescription drug benefit program title xviii medicare social security act permit prescription drug plan pdp sponsor offering pdp medicareadvantage organization offering ma-pd plan offer coverage covered drugs uses determined medically accepted indications based guidance provided secretary health_and_human_services hhs determining accepted uses covered drugs supportive clinical evidence peer reviewed medical literature


Summary: Fairness to Pet Owners Act of 2011 - Requires the Federal Trade Commission (FTC) to promulgate rules relating to veterinary prescriptions, including rules requiring the prescriber of an animal drug to: (1)  provide the pet owner a copy of the veterinary prescription and a written disclosure that the pet owner may fill the prescription through the prescriber (if available) or through another pharmacy determined by the pet owner; and (2) provide or verify the prescription by electronic or other means consistent with applicable state law, if requested by any person designated to act on behalf of the pet owner. Prohibits the prescriber of an animal drug from setting conditions on providing a copy of the prescription or verifying such prescription by: (1) requiring the purchase of the drug from the prescriber or from another person; (2) requiring payment in addition to, or as part of, the fee for an examination and evaluation; or (3) requiring the pet owner to sign a waiver or disclaim liability of the prescriber for the accuracy of the veterinary prescription, or delivering to the pet owner a notice waiving or disclaiming such liability.   Permits the prescriber to require payment of fees for an examination and evaluation before providing a veterinary prescription, but only if the prescriber requires immediate payment in the case of an examination that reveals no requirement for an animal drug.

fairness pet owners act requires federal_trade_commission ftc promulgate rules relating veterinary prescriptions including rules requiring prescriber animal drug provide pet owner copy veterinary prescription written disclosure pet owner fill prescription prescriber available pharmacy determined pet owner provide verify prescription electronic means consistent applicable state law requested person designated act behalf pet owner prohibits prescriber animal drug setting conditions providing copy prescription verifying prescription requiring purchase drug prescriber person requiring payment addition fee examination evaluation requiring pet owner sign waiver liability prescriber accuracy veterinary prescription delivering pet owner notice waiving liability permits prescriber require payment fees examination evaluation providing veterinary prescription prescriber requires immediate payment case examination reveals requirement animal drug


Summary: Medicare Drug Savings Act of 2011 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to require drug manufacturers to pay the Secretary of Health and Human Services (HHS) drug rebates for rebate eligible (low-income) individuals. Excludes from Medicare coverage as a part D drug any drug or biological manufactured by a manufacturer that has not entered into and have in effect a rebate agreement with the Secretary. Requires a rebate agreement to require a drug or biological manufacturer to provide to the Secretary a rebate, determined according to a specified formula, for each rebate period ending after December 31, 2011, for any covered Medicare part D drug dispensed after that date to any rebate eligible individual for which payment was made by a prescription drug plan (PDP) sponsor or MedicareAdvantage (MA) organization for such period. Specifies a formula for determination of Medicaid rebate amounts for such drugs or biologicals. Amends SSA title XIX (Medicaid) to exclude any amounts paid under a rebate agreement from the determination of best price and average manufacturer price under the Medicaid program.

medicare_drug_savings_act amends voluntary prescription drug benefit program title xviii medicare social security act ssa require drug manufacturers pay secretary health_and_human_services hhs drug rebates rebate eligible low income individuals excludes medicare coverage drug drug biological manufactured manufacturer entered effect rebate agreement secretary requires rebate agreement require drug biological manufacturer provide secretary rebate determined according specified formula rebate period ending december covered medicare drug dispensed date rebate eligible individual payment prescription drug plan pdp sponsor medicareadvantage organization period specifies formula determination medicaid rebate amounts drugs biologicals amends ssa title xix medicaid exclude amounts paid rebate agreement determination best price average manufacturer price medicaid program


Summary: Medicare Prescription Drug Price Negotiation Act of 2011 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to negotiate with pharmaceutical manufacturers the prices that may be charged to Medicare part D prescription drug plan (PDP) sponsors and MedicareAdvantage (MA) organizations for covered part D drugs for part D eligible individuals who are enrolled under a PDP or under an MA-Prescription Drug (MA-PD) plan.


Summary: America Rx Act of 2011 - Requires the Secretary of Health and Human Services (HHS) to establish the America Rx program to provide qualified residents with access to discounted prices for outpatient prescription drugs through rebate agreements that the Secretary negotiates with prescription drug manufacturers. Makes eligible only those residents that are not covered under any public or private program that provides substantial benefits towards the purchase of outpatient prescription drugs. Requires rebates to be payable to the Secretary at least quarterly and to be paid, directly or through states, to participating pharmacies that provide discounts to qualified residents. Denies manufacturers who do not participate in the rebate program a tax deduction for advertising and marketing expenses of drugs. Authorizes the Secretary to suspend or terminate the America Rx program if the Secretary determines that American Health Benefit Exchanges (health insurance exchanges) are operational, and the America Rx program is no longer needed to ensure that qualified residents have access to outpatient prescription drugs at affordable prices.

america act requires secretary health_and_human_services hhs establish america program provide qualified residents access discounted prices outpatient prescription drugs rebate agreements secretary prescription drug manufacturers makes eligible residents covered public private program provides substantial benefits purchase outpatient prescription drugs requires rebates payable secretary quarterly paid directly states participating pharmacies provide discounts qualified residents denies manufacturers participate rebate program tax deduction advertising marketing expenses drugs authorizes secretary suspend terminate america program secretary determines health insurance exchanges operational america program longer needed ensure qualified residents access outpatient prescription drugs affordable prices


Summary: 340B Program Improvement Act - Amends the Public Health Service Act to make revisions to the 340B drug discount program (a program limiting the cost of covered outpatient drugs to certain federal grantees). Includes drugs used in connection with an inpatient or outpatient service by enrolled hospitals as covered drugs under the program (currently, only outpatient drugs are covered under the program). Requires hospitals enrolled in the 340B program to provide to each state a credit on the estimated annual purchases by such hospitals of covered drugs provided to Medicaid recipients for inpatient use. Sets forth a formula for calculating the credit. Allows a hospital to avoid paying such credits under certain circumstances. Eliminates the requirement that hospitals enrolled in the 340B program report the National Drug Code numbers for drugs administered by a physician if the state is precluded from seeking a rebate on such drugs because they were purchased at a discount under the 340B program. Removes the exclusion that prohibited covered entities added to the 340B program under the Patient Protection and Affordable Care Act from purchasing drugs for a rare disease or condition as covered outpatient drugs. Treats a facility or organization that is eligible for the 340B program as satisfying any geographic location requirements in relation to a hospital or a critical access hospital for purposes of determining provider-based status under Medicare.

revisions 340b drug discount program program limiting cost covered outpatient drugs certain federal grantees includes drugs connection inpatient outpatient service enrolled hospitals covered drugs program currently outpatient drugs covered program requires hospitals enrolled 340b program provide state credit estimated annual purchases hospitals covered drugs provided medicaid recipients inpatient use sets forth formula calculating credit allows hospital avoid paying credits certain circumstances eliminates requirement hospitals enrolled 340b program report national drug code numbers drugs administered physician state precluded seeking rebate drugs purchased discount 340b program removes exclusion prohibited covered entities added 340b program patient_protection affordable care act purchasing drugs rare disease condition covered outpatient drugs treats facility organization eligible 340b program satisfying geographic location requirements relation hospital critical access hospital purposes determining provider based status medicare


Summary: Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2011 - Amends title II (Old Age, Survivors and Disability Benefits) (OASDI) of the Social Security Act (SSA) to extend the months of coverage of immunosuppressive drugs for kidney transplant patients. Amends SSA title XVIII (Medicare) to make eligible for enrollment in Medicare part B (Supplementary Medical Insurance), solely for the purpose of such drug coverage, every individual whose insurance benefits under Medicare part A (Hospital Insurance) have ended by reason of a kidney transplant or the end of any requirement for a regular course of dialysis. Directs the Secretary of Health and Human Services (HHS) to determine a monthly premium rate for such individuals equal to 35% of the monthly actuarial rate for enrollees age 65 and over. Prescribes a formula for detemination of a government contribution to such a premium.

comprehensive immunosuppressive drug coverage kidney transplant patients act amends title old age survivors disability benefits oasdi social security act ssa extend months coverage immunosuppressive drugs kidney transplant patients amends ssa title xviii medicare eligible enrollment medicare supplementary_medical_insurance solely purpose drug coverage individual insurance benefits medicare ended reason kidney transplant end requirement regular course dialysis directs secretary health_and_human_services hhs determine monthly premium rate individuals equal monthly actuarial rate enrollees age prescribes formula government contribution premium


Summary: Part D Beneficiary Appeals Fairness Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to a prescription drug plan (PDP) that provides for any tiered cost-sharing within a formulary (including a structure that provides for different co-payment or coinsurance amounts for drugs in different tiers included within the formulary), to authorize a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure. States that in no case may the Secretary of Health and Human Services (HHS) allow a PDP sponsor to make any element of the tiered cost-sharing structure (including a tier used for very high cost or unique items) ineligible for lower-cost sharing through an exception.

beneficiary appeals fairness act amends voluntary prescription drug benefit program title xviii medicare social security act respect prescription drug plan pdp provides tiered cost sharing formulary including structure provides different payment coinsurance amounts drugs different tiers included formulary authorize medicare eligible individual enrolled plan request exception tiered cost sharing structure states case secretary health_and_human_services hhs allow pdp sponsor element tiered cost sharing structure including tier high cost unique items ineligible lower cost sharing exception


Summary: Patients' Access to Treatments Act of 2012 - Amends the Public Health Service Act to prohibit a health plan offering group or individual health insurance that provides coverage for prescription drugs and uses a formulary or other tiered cost-sharing structure from imposing co-payment, coinsurance, or other cost-sharing requirements applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of such requirements applicable to prescription drugs in a non-preferred brand drug tier. Provides that if a formulary used by such a health plan contains more than one non-preferred brand drug tier, such prohibition shall be applied with respect to the non-preferred brand drug tier for which beneficiary cost-sharing is lowest. Defines: (1) "non-preferred brand drug tier" as a category of drugs within a tier in such formulary for which beneficiary cost-sharing is greater than tiers for generic drugs or preferred brand drugs in the plan's formulary, that are prescription drugs, and that are not included within a specialty drug tier; and (2) "specialty drug tier" as a category of drugs within a tier in such formulary for which beneficiary cost-sharing is greater than tiers for generic drugs, preferred brand drugs, or non-preferred drugs in the plan's formulary and that are prescription drugs.

patients access treatments act amends public_health_service_act prohibit health plan offering group individual health insurance provides coverage prescription drugs uses formulary tiered cost sharing structure imposing payment coinsurance cost sharing requirements applicable prescription drugs specialty drug tier exceed dollar requirements applicable prescription drugs non preferred brand drug tier provides formulary health plan contains non preferred brand drug tier prohibition shall applied respect non preferred brand drug tier beneficiary cost sharing lowest defines non preferred brand drug tier category drugs tier formulary beneficiary cost sharing greater tiers generic drugs preferred brand drugs plan formulary prescription drugs included specialty drug tier specialty drug tier category drugs tier formulary beneficiary cost sharing greater tiers generic drugs preferred brand drugs non preferred drugs plan formulary prescription drugs


Summary: Medicare Pharmacy Transparency and Fair Auditing Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to require each contract entered into with a prescription drug plan (PDP) sponsor for the offering of a prescription drug plan to prohibit the PDP sponsor from contracting with any pharmacy benefits manager (PBM) to manage the prescription drug coverage under such plan, or to control the costs of such coverage, unless the manager satisfies specified PBM audit and disclosure requirements.

fair auditing act amends voluntary prescription drug benefit program title xviii medicare social security act require contract entered prescription drug plan pdp sponsor offering prescription drug plan prohibit pdp sponsor contracting pharmacy benefits manager pbm manage prescription drug coverage plan control costs coverage manager satisfies specified pbm audit disclosure requirements


Summary: Negotiating for Seniors Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to repeal the prohibition against: (1) interference by the Secretary of Health and Human Services (HHS) with the negotiations between drug manufacturers and pharmacies and prescription drug plan sponsors, and (2) the Secretary's requiring a particular formulary or instituting a price structure for the reimbursement of covered Medicare part D drugs.

negotiating seniors act amends voluntary prescription drug benefit program title xviii medicare social security act repeal prohibition interference secretary health_and_human_services hhs negotiations drug manufacturers pharmacies prescription drug plan sponsors secretary requiring particular formulary instituting price structure reimbursement covered medicare drugs


Summary: FDA User Fee Corrections Act of 2012 - Amends the Federal Food, Drug, and Cosmetic Act (FFDCA), as amended by the Food and Drug Administration Safety and Innovation Act (P.L. 112-144), to: (1) make clerical corrections to provisions of such Act; and (2) eliminate the restriction that appropriated funds shall be available only for payment of increases in the cost of reviewing medical device applications, including related personnel costs. Specifies due dates in FY2013 under FFDCA for the drug master file fee, the abbreviated new drug application and prior approval supplement filing fees, and the generic drug facility and active pharmaceutical ingredient facility fees.

fda user fee corrections act amends cosmetic act ffdca amended innovation_act clerical corrections provisions act eliminate restriction appropriated funds shall available payment increases cost reviewing medical device applications including related personnel costs specifies dates fy2013 ffdca drug master file fee abbreviated new drug application prior approval supplement filing fees generic drug facility active pharmaceutical ingredient facility fees


Summary: Prescription Drug and Health Improvement Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act (SSA) with respect to prescription drug plans to repeal the prohibition against: (1) interference by the Secretary of Health and Human Services (HHS) with negotiations between drug manufacturers and pharmacies and prescription drug plan sponsors, and (2) requiring a particular formulary or instituting a price structure for the reimbursement of covered part D (Voluntary Prescription Drug Benefit Program) drugs. Grants the Secretary authority similar to that of other federal entities that purchase prescription drugs in bulk to negotiate contracts with manufacturers of covered part D drugs.

prescription drug health improvement act amends title xviii medicare social security act ssa respect prescription drug plans repeal prohibition interference secretary health_and_human_services hhs negotiations drug manufacturers pharmacies prescription drug plan sponsors requiring particular formulary instituting price structure reimbursement covered voluntary prescription drug benefit program drugs grants secretary authority similar federal entities purchase prescription drugs bulk negotiate contracts manufacturers covered drugs


medicare prescription drug price negotiation act amends voluntary prescription drug benefit program title xviii medicare social security act direct secretary health_and_human_services hhs negotiate pharmaceutical manufacturers prices charged medicare prescription drug plan pdp sponsors medicareadvantage organizations covered drugs eligible individuals enrolled pdp ma-prescription_drug ma-pd plan


Summary: Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to exclude from the average sales price in calculating Medicare payments for drugs and biologicals any customary prompt pay discounts from manufacturers to wholesalers.

amends supplementary_medical_insurance title xviii medicare social security act exclude average sales price calculating medicare payments drugs biologicals customary prompt pay discounts manufacturers wholesalers


Summary: Stop Trafficking of Pills Act or STOP Act - Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plans to: (1) identify prescription drugs that present a high-risk of misuse or overutilization, (2) establish a dosage level for each such drug that would be deemed excessive in the absence of evidence of medical necessity, (3) identify Medicaid-eligible individuals who are either receiving a prescription drug at excessive dosage levels or who have been convicted of a drug-related offense, and (4) ensure that they are assigned to a state-established restricted recipient program. Requires a state to establish a Medicaid Lock-in Program to ensure that a high-risk prescription drug user is assigned to: (1) a single and exclusive physician for purposes of receiving any medical assistance related to a prescription drug, and (2) a single and exclusive pharmacy to receive any physician-prescribed drug. Requires a state to establish a Medicaid prescription drug restriction program to ensure that the state claims processing system does not permit a prescription drug to be dispensed to a high-risk prescription drug user more than once every 20 days. Amends part D (Miscellaneous) of SSA title XXVIII (Medicare) to direct the Secretary of Health and Human Services (HHS) to establish a similar restricted recipient program for high-risk prescription drug users under the Medicare program.

stop trafficking act stop act amends title xix medicaid social security act ssa require state medicaid plans identify prescription drugs present high risk misuse establish dosage level drug deemed excessive absence evidence medical necessity identify medicaid eligible individuals receiving prescription drug excessive dosage levels convicted drug related offense ensure assigned state established restricted recipient program requires state establish program ensure high risk prescription drug user assigned single exclusive physician purposes receiving medical assistance related prescription drug single exclusive pharmacy receive physician prescribed drug requires state establish medicaid prescription drug restriction program ensure state claims processing system permit prescription drug dispensed high risk prescription drug user days amends miscellaneous ssa title medicare direct secretary health_and_human_services hhs establish similar restricted recipient program high risk prescription drug users medicare program


Summary: Prize Fund for HIV/AIDS Act - Prohibits any person from having the right to exclusively manufacture, distribute, sell, or use in interstate commerce a qualifying treatment for HIV/AIDS or a manufacturing process for such a treatment, including the exclusive right to rely on health registration data or the 30-month stay-of-effectiveness period for Orange Book patents, notwithstanding provisions of U.S. patent law and other relevant statutes. Establishes remuneration in lieu of such market exclusivity. Makes the elimination of exclusive rights for a product that is a qualifying treatment for HIV/AIDS and that has a significant use for other diseases (dual use products) applicable only with respect to the marketing, distribution, sale, or use of a qualifying treatment for HIV/AIDS or a manufacturing process for such treatment that occurs on or after October 1, 2012. Establishes the Prize Fund for HIV/AIDS. Requires the Secretary of Health and Human Services (HHS) to designate a Prize Fund Director to administer the Fund. Directs the Prize Fund Director to award prize payments for medical innovation relating to a qualifying treatment for HIV/AIDS or a new manufacturing process for such a treatment to: (1) the first person to receive market clearance with respect to the drug or biological product; (2) the holder of the patent with respect to a manufacturing process; or (3) in the case of open source contributions, the persons or communities that openly shared knowledge, data, materials, and technology on a royalty-free and nondiscriminatory basis. Allows the Prize Fund Director to authorize multiple nonprofit intermediaries to manage Fund payments to reward projects for: (1) interim research and development of new qualifying treatments for HIV/AIDS, or (2) open source dividend prizes Sets forth transitional rules. Establishes an annual fee for health insurers to fund this Act. Establishes the Donor Innovation Prize Fund to enable the Secretary to reward owners and developers of products that permit open competition for products in developing countries.

prize fund hiv aids act prohibits person having right exclusively manufacture distribute sell use interstate commerce qualifying treatment hiv aids manufacturing process treatment including exclusive right rely health registration data month stay effectiveness period patents notwithstanding provisions patent law relevant statutes establishes remuneration lieu market exclusivity makes elimination exclusive rights product qualifying treatment hiv aids significant use diseases dual use products applicable respect marketing distribution sale use qualifying treatment hiv aids manufacturing process treatment occurs october establishes prize fund hiv aids requires secretary health_and_human_services hhs designate director administer fund directs prize fund director award prize payments medical innovation relating qualifying treatment hiv aids new manufacturing process treatment person receive market clearance respect drug biological product holder patent respect manufacturing process case open source contributions persons communities openly shared knowledge data materials technology royalty free nondiscriminatory basis allows prize fund director authorize multiple nonprofit intermediaries manage fund payments reward projects interim research development new qualifying treatments hiv aids open source dividend prizes sets forth transitional rules establishes annual fee health insurers fund act establishes donor innovation prize fund enable secretary reward owners developers products permit open competition products developing countries


Summary: Affordable Medicines Utilization Act of 2011 - Amends title XIX (Medicaid) of the Social Security Act, with respect to FY2012-FY2014, to require an increase in the quarterly Medicaid payment to a state by 50% of the generic drug utilization savings amount if the state's generic substitution rate for the most recent preceding fiscal year for which data is available is greater than its rate for the most recent second preceding fiscal year for which data is available. Directs the Secretary of Health and Human Services (HHS) to determine the state's generic substitution rate for such fiscal years. Defines "generic substitution rate" as the share of all drug units for which Medicaid payment is made to a state for the 20 most widely prescribed multiple source drugs under the state program that have a specific National Drug Code.

affordable medicines utilization act amends title xix medicaid social security act respect fy2012-fy2014 require increase quarterly medicaid payment state generic drug utilization savings state generic substitution rate recent preceding fiscal year data available greater rate recent second preceding fiscal year data available directs secretary health_and_human_services hhs determine state generic substitution rate fiscal years defines generic substitution rate share drug units medicaid payment state widely prescribed multiple source drugs state program specific


Summary: Restoring Access to Medication Act - Repeals provisions of the Patient Protection and Affordable Care Act that limited payments for medications from health savings accounts, medical savings accounts, and health flexible spending arrangements to only prescription drugs or insulin. Rescinds appropriated but unobligated discretionary funds determined by the Director of the Office of Management and Budget (OMB) to be equal to the reduction in tax revenues resulting from the repeal in this Act. Requires the Director to report to the Secretary of the Treasury and Congress the accounts and amounts identified for rescission. Exempts unobligated funds of the Department of Veterans Affairs (VA) or the Social Security Administration (SSA).

restoring access medication act repeals provisions patient_protection affordable care act limited payments medications health savings accounts medical savings accounts health flexible spending arrangements prescription drugs insulin rescinds appropriated unobligated discretionary funds determined director office_of_management_and_budget omb equal reduction tax revenues resulting repeal act requires director report secretary treasury congress accounts amounts identified rescission exempts unobligated funds department_of_veterans_affairs social_security_administration ssa


Summary: Prescription Drug Cost Reduction Act - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to establish a program requiring a manufacturer to provide a rebate to the Secretary for drugs or biologicals furnished under Medicare part B (Supplementary Medical Insurance). Requires the Secretary to negotiate a contract with a manufacturer to establish the amount of payment under Medicare part B for any drug or biological for which the Medicare part B program is the majority purchaser. Requires that payment for both a drug or biological functionally equivalent to another drug or biological and that other drug or biological to be the same as for the least costly of them. Directs the Secretary of HHS to study physician reimbursement for drugs and biologicals furnished under Medicare part B. Imposes on a pharmacy benefit manager (PBM) specified fiduciary duties to the head of each federal agency with which the PBM contracts. Requires the Secretary to develop a form for use by physicians and practitioners to certify that any off-label use (not approved by the Food and Drug Administration [FDA]) for which an applicable drug is prescribed under Medicare is for a medically accepted indication. Amends the Public Health Service Act to: (1) include among "340B" program-covered entities (permitted to buy outpatient drugs at significant discounts) the Program of All-Inclusive Care for the Elderly (PACE); and (2) direct the Secretary to establish a mechanism to ensure that a manufacturer does not pay a duplicate discount with respect to a drug subject to a 340B program agreement if the PACE program receives any rebate (including any negotiated price concessions) for the drug under Medicare part D (Voluntary Prescription Drug Benefit Program). Makes an organization offering prescription drug coverage eligible to receive from the Secretary 10% of the estimated annual savings to the federal government as a result of the organization's participation in the drug discount program under the Public Health Service Act.

prescription drug cost reduction act amends title xviii medicare social security act direct secretary health_and_human_services hhs establish program requiring manufacturer provide rebate secretary drugs biologicals furnished medicare supplementary_medical_insurance requires secretary negotiate contract manufacturer establish payment medicare drug biological medicare program majority purchaser requires payment drug biological functionally equivalent drug biological drug biological costly directs secretary hhs study physician reimbursement drugs biologicals furnished medicare pharmacy benefit manager pbm specified fiduciary duties head federal agency pbm contracts requires secretary develop form use physicians practitioners certify label use approved food_and_drug_administration fda applicable drug prescribed medicare medically accepted indication amends public_health_service_act include 340b program covered entities permitted buy outpatient drugs significant discounts pace direct secretary establish mechanism ensure manufacturer pay duplicate discount respect drug subject 340b program agreement pace program receives rebate including negotiated price concessions drug medicare voluntary prescription drug benefit program makes organization offering prescription drug coverage eligible receive secretary estimated annual savings federal government result organization participation drug discount program public_health_service_act


Summary: Coordination of Pro Bono Medically Recommended Dental Care Act - Amends the Public Health Service Act to direct the Secretary of Health and Human Services (HHS) to award competitive grants to, or enter into contracts with, eligible entities to fund the employment costs of professionals who will use grant or contract funds to: (1) coordinate the provision of medically recommended dental care to eligible low-income individuals by volunteer dentists in a manner consistent with state licensing laws; and (2) verify the medical, dental, and financial needs of individuals who may be eligible for free dental services. Requires an eligible: (1) entity to be tax exempt and provide for the participation of eligible individuals in a free dental services program on a national basis; and (2) individual to be entitled to benefits or be enrolled under Medicare, Medicaid, or a state plan or waiver under the State Children's Health Insurance Program (CHIP, formerly known as SCHIP).

coordination pro bono medically recommended dental care act amends public_health_service_act direct secretary health_and_human_services hhs award competitive grants enter contracts eligible entities fund employment costs professionals use grant contract funds coordinate provision medically recommended dental care eligible low income individuals volunteer dentists manner consistent state licensing laws verify medical dental financial needs individuals eligible free dental services requires eligible entity tax exempt provide participation eligible individuals free dental services program national basis individual entitled benefits enrolled medicare medicaid state plan waiver known schip


Summary: Protecting Patients and Hospitals From Price Gouging Act - Authorizes the President to issue an executive order declaring a market shortage for six months with regard to one or more vital drugs if the total supply of all clinically interchangeable versions of a drug regulated by the Food and Drug Administration (FDA) is inadequate to meet the current or projected demand at the user level. Defines a "vital drug" as any drug or biologic used to prevent or treat a serious or life-threatening disease or medical condition, for which there is no other available source with sufficient supply available. Makes it unlawful, when the President issues such an executive order, for any person to sell vital drugs at a price that: (1) is unreasonably excessive, and (2) indicates that the seller is taking unfair advantage of the circumstances related to a market shortage to increase prices unreasonably during that period. Gives the Attorney General authority to enforce penalties under this Act. Makes any person who sells, or offers to sell, any vital drug during a declared market shortage with the knowledge and intent to charge a price unreasonably excessive under the circumstances guilty of an offense and subject to injunction and penalties. Applies such sanctions, except to a hospital or a physician, in the geographical area where the vital drug market shortage has been declared and to all wholesalers and distributors in the chain of distribution. Sets forth factors for the Attorney General to consider in determining whether an alleged violator's price was unreasonably excessive. Makes a declaration under this Act terminate if: (1) there is enacted a law terminating the market shortage after a national market shortage is declared, or (2) the President issues a proclamation terminating the declaration. Authorizes the President to renew such a market shortage declaration if the severe shortage continues to affect the health and well-being of citizens beyond the initial six-month period.

price gouging act authorizes president issue executive order declaring market shortage months regard vital drugs total supply clinically interchangeable versions drug regulated food_and_drug_administration fda inadequate meet current projected demand user level defines vital drug drug biologic prevent treat life threatening disease medical condition available source sufficient supply available makes unlawful president issues executive order person sell vital drugs price unreasonably excessive indicates seller taking unfair advantage circumstances related market shortage increase prices unreasonably period gives attorney general authority enforce penalties act makes person sells offers sell vital drug declared market shortage knowledge intent charge price unreasonably excessive circumstances guilty offense subject injunction penalties applies sanctions hospital physician geographical area vital drug market shortage declared wholesalers distributors chain distribution sets forth factors attorney general consider determining alleged violator price unreasonably excessive makes declaration act terminate enacted law terminating market shortage national market shortage declared president issues proclamation terminating declaration authorizes president renew market shortage declaration severe shortage continues affect health citizens initial month period


Summary:
Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier.

Defines: (1) "non-preferred brand drug tier" as a category of prescription drugs within a tier in a formulary for which beneficiary cost-sharing is greater than tiers for generic drugs or preferred brand drugs, and that are not included within a specialty drug tier; and (2) "specialty drug tier" as a category of prescription drugs within a tier in a formulary for which beneficiary cost-sharing is greater than tiers for generic drugs, preferred brand drugs, or non-preferred drugs in the plan's formulary.

patients access treatments act amends public_health_service_act establish cost sharing limits health plans cover prescription drugs use formulary tiered cost sharing structure prohibits health plan imposing cost sharing requirements including payment insurance applicable prescription drugs specialty drug tier exceed dollar cost sharing requirements applicable prescription drugs non preferred brand drug tier applies non preferred brand drug tier beneficiary cost sharing lowest formulary health plan contains non preferred brand drug tier defines non preferred brand drug tier category prescription drugs tier formulary beneficiary cost sharing greater tiers generic drugs preferred brand drugs included specialty drug tier specialty drug tier category prescription drugs tier formulary beneficiary cost sharing greater tiers generic drugs preferred brand drugs non preferred drugs plan formulary


Summary: Medicare Prescription Drug Savings and Choice Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to provide for: (1) establishment of one or more Medicare operated prescription drug plan options; and (2) an appeals process for denials of benefits under a Medicare operated prescription drug plan.

medicare_prescription_drug_savings choice act amends voluntary prescription drug benefit program title xviii medicare social security act provide establishment medicare operated prescription drug plan options appeals process denials benefits medicare operated prescription drug plan


Summary:
Medication Therapy Management Empowerment Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to provide access to services under medication therapy management programs for Medicare part D (Voluntary Prescription Drug Program) eligible individuals with a single chronic disease.

Allows the application of this Act only if the Chief Actuary for the Centers for Medicare & Medicaid Services determines that such application with regard to a particular single chronic disease is not projected to increase overall costs to the Medicare program over the following five year period.

medication therapy management empowerment act amends voluntary prescription drug benefit program title xviii medicare social security act provide access services medication therapy management programs medicare voluntary prescription drug program eligible individuals single chronic disease allows application act chief actuary centers determines application regard particular single chronic disease projected increase overall costs medicare program following year period


Summary: Medicare Prescription Drug Price Negotiation Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to negotiate with pharmaceutical manufacturers the prices that may be charged to Medicare part D prescription drug plan (PDP) sponsors and MedicareAdvantage (MA) organizations for covered part D drugs for part D eligible individuals who are enrolled under a PDP or under an MA-Prescription Drug (MA-PD) plan.


Summary: Accessing Medicare Therapies Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to cost-sharing under a prescription drug plan, to require incurred costs to include the negotiated price of a covered part D drug if the drug is: (1) classified in the highest copayment tier; (2) furnished to the individual free or at nominal charge under a compassionate treatment program; and (3) covered under the formulary of the plan, if the drug is furnished other than through such a program, or is available through exception or appeal.

accessing medicare therapies act amends voluntary prescription drug benefit program title xviii medicare social security act respect cost sharing prescription drug plan require incurred costs include negotiated price covered drug drug classified highest copayment tier furnished individual free nominal charge compassionate treatment program covered formulary plan drug furnished program available exception appeal


Summary:
Improving Cancer Treatment Education Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to extend Medicare coverage to comprehensive cancer patient treatment education services, including a one-hour patient treatment education session delivered, in advance of treatment, by a registered nurse to an individual diagnosed with cancer (or whose course of treatment has been materially modified).

Amends the Public Health Service Act to require the Director of the National Institutes of Health (NIH) to expand, intensify, and coordinate research programs to: (1) improve the treatment and management of symptoms and side effects associated with cancer and cancer treatment, and (2) evaluate the role of nursing interventions in the amelioration of such symptoms and side effects.

amends title xviii medicare social security act extend medicare coverage comprehensive cancer patient treatment education services including hour patient treatment education session delivered advance treatment registered nurse individual diagnosed cancer course treatment materially modified amends public_health_service_act require director national_institutes_of_health nih expand intensify coordinate research programs improve treatment management symptoms effects associated cancer cancer treatment evaluate role nursing interventions symptoms effects


Summary:
Securing Care for Seniors Act of 2013 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to terminate after 2013 the permission to disenroll, between January 1 and March 15 of each year, only from a MedicareAdvantage (MA) plan to elect enrollment in the original Medicare fee-for-service program.

Restores the option under previous law to elect to change from an MA plan to the original Medicare fee-for-service plan, or from the original Medicare fee-for-service to an MA plan, once a year during the first three months.

Permits an MA organization to offer individuals enrolled in one of its MA plans one or more incentive programs designed to improve their health care.

Permits an MA plan, through mechanisms such as value based insurance design (VBID) practices, to vary cost sharing for the purpose of encouraging enrollees to use providers that the MA organization has identified as performing well on quality metrics.

Directs the Secretary of Health and Human Services (HHS) to evaluate and, as appropriate, revise for 2017 and periodically thereafter the risk adjustment system so that a risk score, with respect to an individual, takes into account the number of chronic conditions with which the individual has been diagnosed, and, to the extent available, at least two years of diagnostic data including data obtained during the individual's health risk assessments.

Requires the Secretary to take steps necessary to ensure that the MA 5-star rating system: (1) does not disadvantage a plan that enrolls a disproportionately high proportion of enrollees who are full-benefit dual eligible individuals, subsidy eligible individuals, or other individuals with complex health care needs such as individuals with multiple conditions; and (2) allows adjustments to account for differences in socioeconomic and demographic characteristics of enrollees and geographic variation in health outcomes.

securing care seniors act amends title xviii medicare social security act terminate permission january march year medicareadvantage plan elect enrollment original medicare fee service program restores option previous law elect change plan original medicare fee service plan original medicare fee service plan year months permits organization offer individuals enrolled plans incentive programs designed improve health care permits plan mechanisms value based insurance design practices vary cost sharing purpose encouraging enrollees use providers organization identified performing quality metrics directs secretary health_and_human_services hhs evaluate appropriate revise periodically risk adjustment system risk score respect individual takes account number chronic conditions individual diagnosed extent available years diagnostic data including data obtained individual health risk assessments requires secretary steps necessary ensure star rating system disadvantage plan enrolls disproportionately high proportion enrollees benefit dual eligible individuals subsidy eligible individuals individuals complex health care needs individuals multiple conditions allows adjustments account differences socioeconomic demographic characteristics enrollees geographic variation health outcomes


Summary:
Part D Beneficiary Appeals Fairness Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to a prescription drug plan (PDP) that provides for any tiered cost-sharing within a formulary (including a structure that provides for different co-payment or coinsurance amounts for drugs in different tiers included within the formulary), to authorize a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure.

States that in no case may the Secretary of Health and Human Services (HHS) allow a PDP sponsor to make any formulary tier of the tiered cost-sharing structure (including a formulary tier used for very high cost or unique items) ineligible for lower-cost sharing through an exception.

beneficiary appeals fairness act amends voluntary prescription drug benefit program title xviii medicare social security act respect prescription drug plan pdp provides tiered cost sharing formulary including structure provides different payment coinsurance amounts drugs different tiers included formulary authorize medicare eligible individual enrolled plan request exception tiered cost sharing structure states case secretary health_and_human_services hhs allow pdp sponsor formulary tier tiered cost sharing structure including formulary tier high cost unique items ineligible lower cost sharing exception


Summary:
Access to Hearing Healthcare Act of 2014 - Amends title XVIII (Medicare) of the Social Security Act to revise the definition of Medicare-covered audiology (hearing and balance assessment) services provided by a qualified and legally authorized audiologist to state that such services are covered without regard to any requirement that: (1) the individual receiving them be under the care of (or referred by) a physician or other health care practitioner, or (2) such services are provided under the supervision of a physician or other health practitioner.

Includes audiology services as medical services, as so redefined, under Medicare part B (Supplementary Medical Insurance).

access hearing healthcare act amends title xviii medicare social security act revise definition medicare covered audiology hearing balance assessment services provided qualified legally authorized audiologist state services covered regard requirement individual receiving care referred physician health care practitioner services provided supervision physician health practitioner includes audiology services medical services medicare supplementary_medical_insurance


Summary: Keep the Promise to Seniors Act of 2014 - Prohibits the Secretary of Health and Human Services (HHS) from taking any action (through promulgation of a final or interim final regulation, issuance of regulatory or program guidance, use of federal payment audit procedures, or other enforcement or administrative action, policy, or practice) to implement any provision of the proposed regulation (relating to policy and technical changes to the MedicareAdvantage and part D programs under Medicare) published in the Federal Register on January 10, 2014, insofar as that regulation relates to part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA), including its application to MedicareAdvantage- Prescription Drug (MA-PD) plans under part C (Medicare+Choice Program).

promise seniors act prohibits secretary health_and_human_services hhs taking action promulgation final interim final regulation issuance regulatory program guidance use federal payment audit procedures enforcement administrative action policy practice implement provision proposed regulation relating policy technical changes medicareadvantage programs medicare published federal_register january insofar regulation relates voluntary prescription drug benefit program title xviii medicare social security act ssa including application prescription drug ma-pd plans program


Summary:
Caring for Military Children with Developmental Disabilities Act of 2014 - Includes in the treatment of military dependents' developmental disabilities under the Department of Defense (DOD) TRICARE program behavioral health treatment, including applied behavior analysis, that is prescribed by a physician or psychologist.

Makes such behavioral health treatment available to retired members of the Coast Guard, the Commissioned Corps of the National Oceanic and Atmospheric Administration (NOAA), the Commissioned Corps of Public Health Service, or their dependents only to the extent that amounts are specifically appropriated to the Defense Health Program Account for their coverage.

Expresses the sense of Congress that amounts should be appropriated for the behavioral health treatment of TRICARE beneficiaries in a manner that ensures that all beneficiaries receive appropriate and equitable access to such treatment.

includes treatment military dependents developmental disabilities department_of_defense dod tricare program behavioral health treatment including applied behavior analysis prescribed physician psychologist makes behavioral health treatment available retired members coast_guard noaa dependents extent amounts specifically appropriated coverage expresses sense congress amounts appropriated behavioral health treatment tricare beneficiaries manner ensures beneficiaries receive appropriate equitable access treatment


Summary:
Caring for America's Heroes Act - Eliminates the limit on the number of days each year inpatient mental health services may be provided to military dependents under the Department of Defense (DOD) TRICARE program (a DOD managed care program).

Eliminates the need for TRICARE Standard beneficiaries to obtain: (1) a nonavailability statement or preauthorization to receive mental health services from a civilian provider, or (2) a nonavailability statement to receive mental health services in specialized treatment facilities outside the 200-mile radius of a military medical treatment facility.

caring america heroes act eliminates limit number days year inpatient mental health services provided military dependents department_of_defense dod tricare program dod managed care program eliminates need tricare standard beneficiaries obtain statement receive mental health services civilian provider statement receive mental health services specialized treatment facilities outside mile radius military medical treatment facility


Summary:
Clay Hunt Suicide Prevention for American Veterans Act or the Clay Hunt SAV Act - (Sec. 2) Requires the Secretary of Veterans Affairs (VA) to: (1) arrange for an independent third party evaluation, at least annually, of the VA's mental health care and suicide prevention programs; and (2) submit a report to Congress, by December 1 of each year, containing the most recent evaluations not yet submitted to Congress and any recommendations the Secretary considers appropriate.

(Sec. 3) Directs the Secretary to survey the VA's existing Internet websites and information resources to publish an Internet website that serves as a centralized source to provide veterans with information, updated at least once every 90 days, regarding all of the VA's mental health care services.

(Sec. 4) Requires the Secretary to carry out a three-year pilot program to repay the education loans relating to psychiatric medicine that are incurred by individuals who:

 are eligible to practice psychiatric medicine in the Veterans Health Administration (VHA) or are enrolled in the final year of a residency program leading to a specialty qualification in psychiatric medicine; demonstrate a commitment to a long-term career as a psychiatrist in the VHA; and agree to a period of two or more years of obligated service with the VHA in the field of psychiatric medicine, as determined by the Secretary. Limits the loan repayment to no more than $30,000 for each year an individual performs such obligated service.

Directs the Secretary to submit interim and final reports to Congress on such pilot program.

 (Sec. 5) Directs the Secretary to establish a three-year pilot program at not less than five Veterans Integrated Service Networks (VISNs) to assist veterans transitioning from active duty and to improve the access of veterans to mental health services. Requires the pilot program at each VISN to include: (1) a community oriented veteran peer support network, carried out in partnership with an entity that has experience in peer support programs; and (2) a community outreach team for each medical center in such VISN.

Directs the Secretary to submit interim and final reports to Congress on such pilot program.

(Sec. 6) Authorizes the Secretary to collaborate with nonprofit mental health organizations to prevent suicide among veterans. Requires the Secretary and any such organization with which the Secretary is collaborating to exchange training sessions and best practices.

Directs the Secretary to select a VA Director of Suicide Prevention Coordination to undertake any collaboration with nonprofit mental health organizations.

(Sec. 7) Extends, for the one-year period beginning on January 1, 2015, combat veterans' eligibility for VA hospital care, medical services, and nursing home care for illnesses which have not been medically proven to be attributable to their service, provided: (1) they were discharged or released from active duty between January 1, 2009, and January 1, 2011, and (2) did not enroll to receive such care during the five-year period of eligibility following their discharge.

(Sec. 8) Prohibits the authorization of any additional appropriations to carry out this Act's provisions.

prevention american veterans act clay hunt act sec requires secretary veterans_affairs arrange independent party evaluation annually mental health care suicide prevention programs submit report congress december year containing recent evaluations submitted congress recommendations secretary considers appropriate sec directs secretary survey existing internet websites information resources publish internet website serves centralized source provide veterans information updated days mental health care services sec requires secretary carry year pilot program repay education loans relating psychiatric medicine incurred individuals eligible practice psychiatric medicine veterans_health_administration vha enrolled final year residency program leading specialty qualification psychiatric medicine demonstrate commitment long term career psychiatrist vha agree period years obligated service vha field psychiatric medicine determined secretary limits loan repayment year individual performs obligated service directs secretary submit interim final reports congress pilot program sec directs secretary establish year pilot program veterans_integrated_service_networks visns assist veterans transitioning active duty improve access veterans mental health services requires pilot program visn include community oriented veteran peer support network carried partnership entity experience peer support programs community outreach team medical center visn directs secretary submit interim final reports congress pilot program sec authorizes secretary collaborate nonprofit mental health organizations prevent suicide veterans requires secretary organization secretary collaborating exchange training sessions best practices directs secretary select director suicide prevention coordination undertake collaboration nonprofit mental health organizations sec extends year period beginning january combat veterans eligibility hospital care medical services nursing home care illnesses medically proven attributable service provided discharged released active duty january january enroll receive care year period eligibility following discharge sec prohibits authorization additional appropriations carry act provisions


Summary:
Prescription Drug and Health Improvement Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act (SSA) with respect to prescription drug plans to repeal the prohibition against: (1) interference by the Secretary of Health and Human Services (HHS) with negotiations between drug manufacturers and pharmacies and prescription drug plan sponsors, and (2) requiring a particular formulary or instituting a price structure for the reimbursement of covered part D (Voluntary Prescription Drug Benefit Program) drugs.

Grants the Secretary authority similar to that of other federal entities that purchase prescription drugs in bulk to negotiate contracts with manufacturers of covered part D drugs.

prescription drug health improvement act amends title xviii medicare social security act ssa respect prescription drug plans repeal prohibition interference secretary health_and_human_services hhs negotiations drug manufacturers pharmacies prescription drug plan sponsors requiring particular formulary instituting price structure reimbursement covered voluntary prescription drug benefit program drugs grants secretary authority similar federal entities purchase prescription drugs bulk negotiate contracts manufacturers covered drugs


medicare prescription drug price negotiation act amends voluntary prescription drug benefit program title xviii medicare social security act direct secretary health_and_human_services hhs negotiate pharmaceutical manufacturers prices charged medicare prescription drug plan pdp sponsors medicareadvantage organizations covered drugs eligible individuals enrolled pdp ma-prescription_drug ma-pd plan


Summary:
Medicare Drug Savings Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to require drug manufacturers to pay the Secretary of Health and Human Services (HHS) drug rebates for rebate eligible (low-income) individuals. Excludes from Medicare coverage as a part D drug any drug or biological manufactured by a manufacturer that has not entered into and have in effect a rebate agreement with the Secretary.

Requires a rebate agreement to require a drug or biological manufacturer to provide to the Secretary a rebate, determined according to a specified formula, for each rebate period ending after December 31, 2011, for any covered Medicare part D drug dispensed after that date to any rebate eligible individual for which payment was made by a prescription drug plan (PDP) sponsor or MedicareAdvantage (MA) organization for such period.

Specifies a formula for determination of Medicaid rebate amounts for such drugs or biologicals.

Amends SSA title XIX (Medicaid) to exclude any amounts paid under a rebate agreement from the determination of best price and average manufacturer price under the Medicaid program.

medicare_drug_savings_act amends voluntary prescription drug benefit program title xviii medicare social security act ssa require drug manufacturers pay secretary health_and_human_services hhs drug rebates rebate eligible low income individuals excludes medicare coverage drug drug biological manufactured manufacturer entered effect rebate agreement secretary requires rebate agreement require drug biological manufacturer provide secretary rebate determined according specified formula rebate period ending december covered medicare drug dispensed date rebate eligible individual payment prescription drug plan pdp sponsor medicareadvantage organization period specifies formula determination medicaid rebate amounts drugs biologicals amends ssa title xix medicaid exclude amounts paid rebate agreement determination best price average manufacturer price medicaid program


Summary:
Medicare Prescription Drug Program Integrity and Transparency Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to require each contract entered into with a prescription drug plan (PDP) sponsor with respect to a PDP the sponsor offers to prohibit the PDP from entering into a contract with any pharmacy benefits manager (PBM) to manage the prescription drug coverage provided under such plan, or to control the costs of the prescription drug coverage under it, unless the manager satisfies specified PBM audit and disclosure requirements.

Requires a PBM to provide: (1) a particular aggregate average reimbursement rate for generics or a maximum average discount off of an accepted pharmaceutical pricing benchmark for multi-source generics as a whole ("generic effective rate"), and (2) a process for the generic effective rate to be appealed. Revises requirements for contracts with PDP sponsors to require that the PDP sponsor or a subcontractor of the sponsor disclose to a pharmacy, at the time when a contract is offered and at least once every seven days, the methodology and actual per unit reimbursement amount for each covered drug for each contracted pharmacy.

transparency act amends voluntary prescription drug benefit program title xviii medicare social security act require contract entered prescription drug plan pdp sponsor respect pdp sponsor offers prohibit pdp entering contract pharmacy benefits manager pbm manage prescription drug coverage provided plan control costs prescription drug coverage manager satisfies specified pbm audit disclosure requirements requires pbm provide particular aggregate average reimbursement rate generics maximum average discount accepted pharmaceutical pricing benchmark multi source generics generic effective rate process generic effective rate appealed revises requirements contracts pdp sponsors require pdp sponsor subcontractor sponsor disclose pharmacy time contract offered seven days methodology actual unit reimbursement covered drug contracted pharmacy


Summary:
Medicare Efficient Drug Dispensing Act of 2013 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to require a prescription drug plan (PDP) sponsor to have in place a payment structure for covered part D drugs that encourages the use of dispensing techniques that foster efficiency and reduce wasteful dispensing of outpatient prescription drugs in long-term care facilities.

Requires a PDP sponsor also to take into account, in establishing fees for dispensing covered Medicare part D drugs to enrollees in a long-term care facility, the utilization of such dispensing techniques to minimize the dispensing of unused drugs, the incremental costs associated with the type of dispensing methodology, and the requirements applicable to long-term care pharmacies.

medicare efficient drug dispensing act amends voluntary prescription drug benefit program title xviii medicare social security act require prescription drug plan pdp sponsor place payment structure covered drugs encourages use dispensing techniques foster efficiency reduce wasteful dispensing outpatient prescription drugs long term care facilities requires pdp sponsor account establishing fees dispensing covered medicare drugs enrollees long term care facility utilization dispensing techniques minimize dispensing unused drugs incremental costs associated type dispensing methodology requirements applicable long term care pharmacies


Summary:
Recovery Enhancement for Addiction Treatment Act or the TREAT Act - Amends the Controlled Substances Act to increase the number of patients that a qualifying practitioner dispensing narcotic drugs for maintenance or detoxification treatment is initially allowed to treat from 30 to 100 patients per year.

Allows a qualifying physician, after one year, to request approval to treat an unlimited number of patients under specified conditions, including that he or she: (1) agrees to fully participate in the Prescription Drug Monitoring Program of the state in which the practitioner is licensed, (2) practices in a qualified practice setting, and (3) has completed at least 24 hours of training regarding treatment and management of opiate-dependent patients for substance use disorders provided by specified organizations.

Revises the definition of a "qualifying practitioner" to include: (1) a physician who holds a board certification from the American Board of Addiction Medicine; and (2) a nurse practitioner or physicians assistant who is licensed under state law to prescribe schedule III, IV, or V medications for pain, who has specified training or experience that demonstrates specialization in the ability to treat opiate-dependent patients, who practices under the supervision of, or prescribes opioid addiction therapy in collaboration with, a licensed physician who holds an active waiver to prescribe schedule III, IV, or V narcotic medications for opioid addiction therapy, and who practices in a qualified practice setting.

Directs the Comptroller General to initiate an evaluation of the effectiveness of this Act, including an evaluation of: (1) changes in the availability and use of medication-assisted treatment for opioid addiction, (2) the quality of medication-assisted treatment programs, (3) diversion of opioid addiction treatment medication, and (4) changes in state or local policies and legislation relating to opioid addiction treatment.

treat act amends controlled substances act increase number patients qualifying practitioner dispensing narcotic drugs maintenance detoxification treatment initially allowed treat patients year allows qualifying physician year request approval treat unlimited number patients specified conditions including agrees fully participate state practitioner licensed practices qualified practice setting completed hours training treatment management opiate dependent patients substance use disorders provided specified organizations revises definition qualifying practitioner include physician holds board certification nurse practitioner physicians assistant licensed state law prescribe schedule iii medications pain specified training experience demonstrates ability treat opiate dependent patients practices supervision prescribes opioid addiction therapy collaboration licensed physician holds active waiver prescribe schedule iii narcotic medications opioid addiction therapy practices qualified practice setting directs comptroller general initiate evaluation effectiveness act including evaluation changes availability use medication assisted treatment opioid addiction quality medication assisted treatment programs diversion opioid addiction treatment medication changes state local policies legislation relating opioid addiction treatment


Summary:
Clay Hunt Suicide Prevention for American Veterans Act or the Clay Hunt SAV Act - Requires the Secretary of Veterans Affairs (VA) and the Secretary of Defense (DOD) to each arrange for an independent third party evaluation of, respectively, the VA and DOD mental health care and suicide prevention programs.

Directs the VA Secretary to publish an Internet website that serves as a centralized source to provide veterans with regularly updated information regarding all of the VA's mental health care services.

Requires the VA Secretary and the DOD Secretary to enter into certain strategic relationships to facilitate:

 the mental health referrals of members of the reserve components who have a service-connected disability and are being discharged or released from the Armed Forces, timely behavioral health services for such members, communication when such members are at risk for behavioral health reasons, and the transfer of documentation for line-of-duty and fitness-for-duty determinations. Requires the VA Secretary to carry out a three-year pilot program to repay the education loans relating to psychiatric medicine that are incurred by individuals who:

 are eligible to practice psychiatric medicine in the Veterans Health Administration (VHA) or are enrolled in the final year of a residency program leading to a specialty qualification in psychiatric medicine, demonstrate a commitment to a long-term career as a psychiatrist in the VHA, and agree to a period of obligated service with the VHA in the field of psychiatric medicine in exchange for the repayment of such loans. Requires the DOD Secretary to submit to Congress a review of the staffing requirements for individual State National Guard Commands with respect to Directors of Psychological Health.

Authorizes the VA Secretary to collaborate with nonprofit mental health organizations to prevent suicide among veterans. Requires the collaborators to exchange training sessions, best practices, and other resources to enhance their suicide prevention efforts. Directs the Secretary to select a Director of Suicide Prevention Coordination within the VA to undertake any collaboration with nonprofit mental health organizations.

prevention american veterans act clay hunt act requires secretary veterans_affairs secretary defense dod arrange independent party evaluation respectively dod mental health care suicide prevention programs directs secretary publish internet website serves centralized source provide veterans regularly updated information mental health care services requires secretary dod secretary enter certain strategic relationships facilitate mental health referrals members reserve components service connected disability discharged released armed_forces timely behavioral health services members communication members risk behavioral health reasons transfer documentation line duty fitness duty determinations requires secretary carry year pilot program repay education loans relating psychiatric medicine incurred individuals eligible practice psychiatric medicine veterans_health_administration vha enrolled final year residency program leading specialty qualification psychiatric medicine demonstrate commitment long term career psychiatrist vha agree period obligated service vha field psychiatric medicine exchange repayment loans requires dod secretary submit congress review staffing requirements individual respect directors psychological health authorizes secretary collaborate nonprofit mental health organizations prevent suicide veterans requires exchange training sessions best practices resources enhance suicide prevention efforts directs secretary select director suicide prevention coordination undertake collaboration nonprofit mental health organizations


Summary:
(This measure has not been amended since it was introduced. The expanded summary of the House passed version is repeated here.)

Clay Hunt Suicide Prevention for American Veterans Act or the Clay Hunt SAV Act

 (Sec. 2) Requires the Secretary of Veterans Affairs (VA) to: (1) arrange for an independent third party evaluation, to be conducted by September 30, 2018, and each fiscal year thereafter, of the VA's mental health care and suicide prevention programs; and (2) submit a report to Congress, by December 1, 2018, and each year thereafter, containing the most recent evaluations not yet submitted to Congress and any recommendations the Secretary considers appropriate.

Directs the Secretary to submit interim reports to Congress by September 30, 2016, and September 30, 2017, on the VA's mental health care and suicide prevention programs.

 (Sec. 3) Directs the Secretary to survey the VA's websites and information resources to publish a website that serves as a centralized source to provide veterans with information, updated at least once every 90 days, regarding the VA's mental health care services.

 (Sec. 4) Requires the Secretary to carry out a three-year pilot program to repay the education loans relating to psychiatric medicine that are incurred by individuals who:

 are eligible to practice psychiatric medicine in the Veterans Health Administration (VHA) or are enrolled in the final year of a residency program leading to a specialty qualification in psychiatric medicine; demonstrate a commitment to a long-term career as a psychiatrist in the VHA; and agree to a period of two or more years of obligated service with the VHA in the field of psychiatric medicine, as determined by the Secretary. Limits the loan repayment to no more than $30,000 for each year an individual performs such obligated service, as determined by the Secretary.

Directs the Secretary to submit interim and final reports to Congress on such pilot program.

 (Sec. 5) Directs the Secretary to establish a three-year pilot program at not less than five Veterans Integrated Service Networks (VISNs) to assist veterans transitioning from active duty and to improve the access of veterans to mental health services. Requires the pilot program at each VISN to include: (1) a community oriented veteran peer support network carried out in partnership with an entity that has experience in peer support programs, and (2) a community outreach team for each medical center in such VISN.

Directs the Secretary to submit interim and final reports to Congress on such pilot program.

(Sec. 6) Authorizes the Secretary to collaborate with nonprofit mental health organizations to prevent suicide among veterans. Requires the Secretary and any such organization to exchange training sessions and best practices.

Directs the Secretary to select a VA Director of Suicide Prevention Coordination to undertake any collaboration with nonprofit mental health organizations.

(Sec. 7) Extends for one year combat veterans' eligibility for VA hospital care, medical services, and nursing home care for illnesses that have not been medically proven to be attributable to their service, provided they: (1) were discharged or released from active duty between January 1, 2009, and January 1, 2011, and (2) did not enroll to receive such care during the five-year period of eligibility following their discharge.

(Sec. 8) Prohibits the authorization of any additional appropriations to carry out this Act's provisions.

measure amended introduced expanded summary house passed version repeated prevention american veterans act sec requires secretary veterans_affairs arrange independent party evaluation conducted september fiscal year mental health care suicide prevention programs submit report congress december year containing recent evaluations submitted congress recommendations secretary considers appropriate directs secretary submit interim reports congress september september mental health care suicide prevention programs sec directs secretary survey websites information resources publish website serves centralized source provide veterans information updated days mental health care services sec requires secretary carry year pilot program repay education loans relating psychiatric medicine incurred individuals eligible practice psychiatric medicine veterans_health_administration vha enrolled final year residency program leading specialty qualification psychiatric medicine demonstrate commitment long term career psychiatrist vha agree period years obligated service vha field psychiatric medicine determined secretary limits loan repayment year individual performs obligated service determined secretary directs secretary submit interim final reports congress pilot program sec directs secretary establish year pilot program veterans_integrated_service_networks visns assist veterans transitioning active duty improve access veterans mental health services requires pilot program visn include community oriented veteran peer support network carried partnership entity experience peer support programs community outreach team medical center visn directs secretary submit interim final reports congress pilot program sec authorizes secretary collaborate nonprofit mental health organizations prevent suicide veterans requires secretary organization exchange training sessions best practices directs secretary select director suicide prevention coordination undertake collaboration nonprofit mental health organizations sec extends year combat veterans eligibility hospital care medical services nursing home care illnesses medically proven attributable service provided discharged released active duty january january enroll receive care year period eligibility following discharge sec prohibits authorization additional appropriations carry act provisions


Summary:
Classified Veterans Access to Care Act

Requires the Secretary of Veterans Affairs (VA) to:

 establish standards and procedures to ensure that a veteran who participated in a classified mission or served in a sensitive unit while in the Armed Forces may access VA mental health care in a manner that fully accommodates the veteran's obligation to not improperly disclose classified information; disseminate guidance to employees of the Veterans Health Administration, including mental health professionals, on such standards and procedures and on how to best engage such veterans during the course of mental health treatment with respect to classified information; and ensure that an individual may elect to identify as such a veteran on an appropriate form.

classified veterans access care act requires secretary veterans_affairs establish standards procedures ensure veteran participated classified mission served sensitive unit armed_forces access mental health care manner fully accommodates veteran obligation improperly disclose classified information disseminate guidance employees veterans_health_administration including mental health professionals standards procedures best engage veterans course mental health treatment respect classified information ensure individual elect identify veteran appropriate form