[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6757 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 6757
To amend title XVIII of the Social Security Act to establish under the
Medicare prescription drug program a minimum amount of price
concessions for insulin to be passed through to beneficiaries at the
point-of-sale, and for other purposes.
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IN THE HOUSE OF REPRESENTATIVES
February 18, 2022
Mr. Burgess (for himself and Mrs. Miller-Meeks) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
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A BILL
To amend title XVIII of the Social Security Act to establish under the
Medicare prescription drug program a minimum amount of price
concessions for insulin to be passed through to beneficiaries at the
point-of-sale, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Insulin Savings for Patients Act''.
SEC. 2. NEGOTIATED PRICE CONCESSIONS FOR INSULIN AT POINT-OF-SALE UNDER
PART D OF MEDICARE PROGRAM.
(a) In General.--Section 1860D-2(d)(1) of the Social Security Act
(42 U.S.C. 1395w-102(d)(1)) is amended--
(1) in subparagraph (A), by striking ``Under'' and
inserting ``Subject to subparagraph (D), under''; and
(2) by adding at the end the following new subparagraph:
``(D) Negotiated price concessions for insulin at
point-of-sale.--
``(i) In general.--For drugs dispensed in
plan year 2022 or a subsequent plan year, the
minimum percentage described in clause (ii) for
such plan year of price concessions negotiated
between manufacturers and a prescription drug
plan or MA-PD plan (or any entity that provides
pharmacy benefits management services under a
contract with any such prescription drug plan
or MA-PD plan) and taken into account under
subparagraph (B) in determining negotiated
prices for the plan year for covered part D
drugs that are insulin provided under such a
plan shall be provided to enrollees of such a
plan at pharmacies or by mail order service at
the point-of-sale of such drugs.
``(ii) Amount of price concession.--For
purposes of clause (i), and subject to clause
(iii), the minimum percentage described in this
clause is--
``(I) for drugs dispensed in plan
year 2022, 50 percent;
``(II) for drugs dispensed in plan
year 2023, 75 percent; and
``(III) for drugs dispensed in plan
year 2024 or a subsequent plan year,
100 percent.
``(iii) Modification of minimum
percentage.--For plan years beginning on or
after January 1, 2024, the Secretary may,
through notice and comment rulemaking, specify
a percentage other than the percentage
described in clause (ii) for a plan year,
except that in specifying such percentage the
Secretary shall not specify a percentage that
is less than 50 percent of the negotiated price
concession for such plan year. Any percentage
specified pursuant to the authority of the
previous sentence for a plan year that would be
less than the percentage otherwise described in
clause (ii) for the plan year may only be
applied if such reduction in percentage is
justified as a benefit to individuals enrolled
under this title.''.
(b) Inclusion of Information in Bid Submission.--Section 1860D-
11(b)(2) of the Social Security Act (42 U.S.C. 1395w-11(b)(2)) is
amended--
(1) by redesignating subparagraph (F) as subparagraph (G);
and
(2) by inserting after subparagraph (E) the following new
subparagraph:
``(F) Point-of-sale price concessions for
insulin.--For plan years beginning on or after January
1, 2022, an estimate of the aggregate price concessions
for all insulin negotiated by the plan for such plan
year.''.
(c) GAO Study and Report on Insulin Pricing.--Not later than 2
years after the date of the enactment of this Act, and annually
thereafter, the Comptroller General of the United States shall--
(1) conduct a study on the effects of the implementation of
the requirement described in subparagraph (D) of section 1860D-
2(d)(1) of the Social Security Act (42 U.S.C. 1395w-102(d)(1)),
as added by subsection (a), including an analysis of--
(A) trends in the list and net prices of insulin
for qualified prescription drug coverage offered by a
prescription drug plan under part D of the Social
Security Act or an MA-PD plan under part C of such
title;
(B) savings on insulin for individuals enrolled in
a prescription drug plan under part D of the Social
Security Act or an MA-PD plan under part C of such
title;
(C) trends in out-of-pocket costs for individuals
enrolled in such plans, as compared to individuals
enrolled in a group health plan (as defined in section
2791(a) of the Public Health Service Act (42 U.S.C.
300gg-91(a)), a State plan under title XIX of the
Social Security Act, or a qualified health plan offered
through an Exchange established under title I of the
Patient Protection and Affordable Care Act (42 U.S.C.
18001 et seq.); and
(D) approval and market entry of biosimilar insulin
under section 351(k) of the Public Health Service Act
(42 U.S.C. 262); and
(2) submit to the Committee on Energy and Commerce and the
Committee on Ways and Means in the House of Representatives,
and the Committee on Finance in the Senate, a report on the
study conducted under paragraph (1), with recommendations on
how to enhance the access of individuals enrolled in a
prescription drug plan under part D of the Social Security Act
or an MA-PD plan under part C of such title to lower out-of-
pocket costs for insulin.
(d) Transparency.--Section 1860D-1(c)(3) of the Social Security Act
(42 U.S.C. 1395w-101(c)(3)) is amended by adding at the end the
following new subparagraph:
``(C) Additional information.--For plan year 2022
and each subsequent plan year, such information
referred to in paragraph (2)(A) shall also include, for
a plan year, information regarding the requirement
described in subparagraph (D) of section 1860D-2(d)(1)
with respect to insulin negotiated by the plan for such
plan year.''.
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