AUTOMATIC ESCALATION TO EXTERNAL REVIEW UNDER A MEDICARE PART D DRUG MANAGEMENT PROGRAM FOR AT-RISK BENEFICIARIES.

SEC. 2007. AUTOMATIC ESCALATION TO EXTERNAL REVIEW UNDER A MEDICARE PART D DRUG MANAGEMENT PROGRAM FOR AT-RISK BENEFICIARIES. (a) In General.—Section 1860D-4(c)(5) of the Social Security Act (42 U.S.C. 1395ww-10(c)(5)) is amended— (1) in subparagraph (B), in each of clauses (ii)(III) and (iii)(IV), by striking “and the option of an automatic escalation to external review” and inserting “, including notice that if on reconsideration a PDP sponsor affirms its denial, in whole or in part, the case shall be automatically forwarded to the 132 STAT. 3931 independent, outside entity contracted with the Secretary for review and resolution”; and (2) in subparagraph (E), by striking “and the option” and all that follows and inserting the following: “and if on reconsideration a PDP sponsor affirms its denial, in whole or in part, the case shall be automatically forwarded to the independent, outside entity contracted with the Secretary for review and resolution.”. (b) Effective Date.—The amendments made by subsection (a) shall apply beginning not later January 1, 2021.