119-s2617

[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) .''.
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