H.R.4209 - Patients' Access to Treatments Act of 2012112th Congress (2011-2012)
|Sponsor:||Rep. McKinley, David B. [R-WV-1] (Introduced 03/19/2012)|
|Committees:||House - Energy and Commerce|
|Latest Action:||03/19/2012 Referred to the House Committee on Energy and Commerce. (All Actions)|
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Summary: H.R.4209 — 112th Congress (2011-2012)All Information (Except Text)
Introduced in House (03/19/2012)
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.