; and (4) recommend the appropriate training, education, technical assistance, and patient advocacy enhancements of primary care health professionals, including registered nurses, to achieve uniform high quality and patient safety. (b) National goals Not later than 1 year after the date of enactment of this Act, the Office of Primary Health Care shall set forth national goals to increase access to high quality primary health care, particularly in underserved areas and for underserved populations. 614. Payments for prescription drugs and approved devices and equipment (a) Negotiated prices The prices to be paid for covered pharmaceuticals, medical supplies, and medically necessary assistive equipment shall be negotiated annually by the Secretary. (b) Prescription drug formulary (1) In general The Secretary shall establish a prescription drug formulary system, which shall encourage best-practices in prescribing and discourage the use of ineffective, dangerous, or excessively costly medications when better alternatives are available. (2) Promotion of use of generics The formulary under this subsection shall promote the use of generic medications to the greatest extent possible. (3) Formulary updates and petition rights The formulary under this subsection shall be updated frequently and clinicians and patients may petition the Secretary to add new pharmaceuticals or to remove ineffective or dangerous medications from the formulary. (4) Use of off-formulary medications The Secretary shall promulgate rules regarding the use of off-formulary medications which allow for patient access but do not compromise the formulary. VII Universal Medicare Trust Fund 701. Universal Medicare Trust Fund (a) In general There is hereby created on the books of the Treasury of the United States a trust fund to be known as the Universal Medicare Trust Fund (in this section referred to as the Trust Fund ). The Trust Fund shall consist of such gifts and bequests as may be made and such amounts as may be deposited in, or appropriated to, such