119-hr2554

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2554 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 2554

 To amend title XVIII of the Social Security Act to apply prescription 
drug inflation rebates to drugs furnished in the commercial market and 
 to change the base year for rebate calculations.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 April 1, 2025

Mr. Horsford (for himself, Mrs. Cherfilus-McCormick, and Mr. Johnson of 
 Georgia) 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

_______________________________________________________________________

 A BILL

 To amend title XVIII of the Social Security Act to apply prescription 
drug inflation rebates to drugs furnished in the commercial market and 
 to change the base year for rebate calculations.

 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 ``Lower Drug Costs for Families Act''.

SEC. 2. APPLICATION OF PRESCRIPTION DRUG INFLATION REBATES TO DRUGS 
 FURNISHED IN THE COMMERCIAL MARKET.

    (a) Part B Drugs.--

    (1) Application of prescription drug inflation rebates to 
 drugs furnished in the commercial market.--

Section 1847A
            (i) of 
 the Social Security Act (42 U.S.C. 1395w-3a
            (i) ) is amended--
        (A) in paragraph

    (1)
        (A)
            (i) , by striking ``units'' 
 and inserting ``billing units'';
        (B) in paragraph

    (2)
        (A) , by striking ``for which 
 payment is made under this part'' and inserting ``that 
 would be payable under this part if such drug were 
 furnished to an individual enrolled under this part'';
            (C) in paragraph

    (3) --
            (i) in subparagraph
        (A)
            (i) , by striking 
 ``units'' and inserting ``billing units''; and
            (ii) by striking subparagraph
        (B) and 
 inserting the following:
 ``
        (B) Total number of billing units.--For purposes 
 of subparagraph
        (A)
            (i) , the total number of billing 
 units with respect to a part B rebatable drug is 
 determined as follows:
 ``
            (i) Determine the total number of units 
 equal to--
 ``
            (I) the total number of units, as 
 reported under subsection
            (c) (1)
        (B) for 
 each National Drug Code of such drug 
 during the calendar quarter that is two 
 calendar quarters prior to the calendar 
 quarter as described in subparagraph
        (A) , minus
 ``
            (II) the total number of units 
 with respect to each National Drug Code 
 of such drug for which payment was made 
 under a State plan under title XIX (or 
 waiver of such plan), as reported by 
 States under 

section 1927

    (b)

    (2)
        (A) for 
 the rebate period that is the same 
 calendar quarter as described in 
 subclause
            (I) .
 ``
            (ii) Convert the units determined under 
 clause
            (i) to billing units for the billing and 
 payment code of such drug, using a methodology 
 similar to the methodology used under this 
 section, by dividing the units determined under 
 clause
            (i) for each National Drug Code of such 
 drug by the billing unit for the billing and 
 payment code of such drug.
 ``
            (iii) Compute the sum of the billing 
 units for each National Drug Code of such drug 
 in clause
            (ii) .''.

    (2) Change of base year for rebate calculation.--

Section 1847A
            (i) of the Social Security Act (42 U.S.C. 1395w-3a
            (i) ) is 
 amended--
        (A) in paragraph

    (3) --
            (i) in subparagraph
            (D) , by striking ``July 
 1, 2021'' and inserting ``July 1, 2016''; and
            (ii) in subparagraph
        (E) , by striking 
 ``January 2021'' and inserting ``January 
 2016''; and
        (B) in paragraph

    (4) --
            (i) in subparagraph
        (A) --
            (I) by striking ``December 1, 
 2020'' and inserting ``December 31, 
 2015''; and
            (II) by striking ``January 2021'' 
 and inserting ``January 2016'';
            (ii) in subparagraph
        (B) , by striking 
 ``December 1, 2020'' and inserting ``December 
 31, 2015''; and
            (iii) in subparagraph
            (C) , by striking 
 ``January 2021'' and inserting ``January 
 2016''.

    (3) Effective date.--The amendments made by this subsection 
 shall apply with respect to calendar quarters beginning on or 
 after January 1, 2026.

    (b) Covered Part D Drugs.--

    (1) Application of prescription drug inflation rebates to 
 drugs furnished in the commercial market.--

Section 1860D-14B of 
 the Social Security Act (42 U.S.C. 1395w-114b) is amended--
        (A) in subsection

    (b) --
            (i) in paragraph

    (1) --
            (I) in subparagraph
        (A)
            (i) , by 
 striking ``the total number of units'' 
 and all that follows through the 
 semicolon and inserting the following: 
 ``the total number of units that are 
 used to calculate the average 
 manufacturer price of such dosage form 
 and strength with respect to such part 
 D rebatable drug, as reported by the 
 manufacturer of such drug under 

section 1927 for each month, with respect to 
 such period;''; and
            (II) by striking subparagraph
        (B) and inserting the following:
 ``
        (B) Excluded units.--For purposes of subparagraph
        (A)
            (i) , the Secretary shall exclude from the total 
 number of units for a dosage form and strength with 
 respect to a part D rebatable drug, with respect to an 
 applicable period, the following:
 ``
            (i) Units of each dosage form and 
 strength of such part D rebatable drug for 
 which payment was made under a State plan under 
 title XIX (or waiver of such plan), as reported 
 by States under 

section 1927

    (b)

    (2)
        (A) .
 ``
            (ii) Units of each dosage form and 
 strength of such part D rebatable drug for 
 which a rebate is paid under 

section 1847A
            (i) .
 ``
            (iii) Beginning with plan year 2026, 
 units of each dosage form and strength of such 
 part D rebatable drug for which the 
 manufacturer provides a discount under the 
 program under 

section 340B of the Public Health 
 Service Act.''; and
            (ii) in paragraph

    (6) , by striking 
 ``information.--The Secretary'' and all that 
 follows through ``rebatable covered part D drug 
 dispensed'' and inserting the following: ``AMP 
 reports.--The Secretary shall provide for a 
 method and process under which, in the case of 
 a manufacturer of a part D rebatable drug that 
 submits revisions to information submitted 
 under 

section 1927 by the manufacturer with 
 respect to such drug''; and
        (B) by striking subsection
            (d) and inserting the 
 following:
 ``
            (d) Information.--For purposes of carrying out this section, the 
Secretary shall use information submitted by manufacturers under 

section 1927

    (b)

    (3) and information submitted by States under 

section 1927

    (b)

    (2)
        (A) .''.

    (2) Change of base year for rebate calculation.--

Section 1860D-14B of the Social Security Act (42 U.S.C. 1395w-114b) is 
 amended--
        (A) in subsection

    (b)

    (5) --
            (i) in subparagraph
        (A) --
            (I) by striking ``October 1, 2021'' 
 and inserting ``October 1, 2016''; and
            (II) by striking ``January 2021'' 
 and inserting ``January 2016''; and
            (ii) in subparagraph
            (C) , by striking 
 ``January 2021'' and inserting ``January 
 2016''; and
        (B) in subsection

    (g) --
            (i) in paragraph

    (3) --
            (I) by striking ``January 1, 2021'' 
 and inserting ``January 1, 2016''; and
            (II) by striking ``October 1, 
 2021'' and inserting ``October 1, 
 2016''; and
            (ii) in paragraph

    (4) , by striking 
 ``January 2021'' and inserting ``January 
 2016''.

    (3) Effective date.--The amendments made by this subsection 
 shall take apply with respect to applicable periods (as defined 
 in 

section 1860D-14B

    (g)

    (7) of the Social Security Act (42 
 U.S.C. 1395w-114b

    (g)

    (7) )) beginning on or after October 1, 
 2025.
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