[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2617 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 2617
To amend title XVIII of the Social Security Act to require that
coinsurance for drugs under Medicare part D be based on the drug's net
price and not the drug's list price.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 31, 2025
Ms. Rosen (for herself and Mr. Cornyn) introduced the following bill;
which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to require that
coinsurance for drugs under Medicare part D be based on the drug's net
price and not the drug's list price.
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 ``Reducing Drug Prices for Seniors
Act.''.
SEC. 2. REQUIRING THAT COINSURANCE FOR DRUGS UNDER MEDICARE PART D BE
BASED ON THE DRUG'S NET PRICE AND NOT THE DRUG'S LIST
PRICE.
Section 1860D-2 of the Social Security Act (42 U.S.C. 1395w-102) is
amended--
(1) in subsection (b)--
(A) in paragraph (2)(A), in the matter preceding
clause (i), by striking ``and (9)'' and inserting ``,
(9), and (10)''; and
(B) by adding at the end the following new
paragraph:
``(10) Requirement that coinsurance for covered part d
drugs be based on the net price of the drug.--
``(A) In general.--For plan years beginning on or
after January 1, 2026, for costs above the annual
deductible specified in paragraph (1) and below the
annual out-of-pocket threshold specified in paragraph
(4), any coinsurance amount for a covered part D drug
(insofar as such covered part D drug is included on the
formulary and subject to coinsurance rather than a
copayment) shall be calculated based on the net price
(and not the list price) of such covered part D drug if
such net price is lower than the list price of such
covered part D drug. The preceding sentence shall not
apply to a covered part D drug described in paragraph
(8) or (9).
``(B) Net price defined.--In this paragraph, the
term `net price' means, with respect to a covered part
D drug, the negotiated price of the covered part D drug
under the prescription drug plan or MA-PD plan, net of
any manufacturer-provided price concessions (as defined
under section 423.100 of title 42, Code of Federal
Regulations (or any successor regulation)), as reported
for such drug in the Detailed DIR Report (or any
successor report) submitted by the sponsor or
organization offering the plan for the previous plan
year.''.
(2) in subsection (c), by adding at the end the following
new paragraph:
``(7) Requirement that coinsurance for covered part d drugs
be based on the net price of the drug.--The coverage is
provided in accordance with subsection (b)(10).''.
<all>