110 HR 6684 IH: To amend part D of title XVIII of the Social Security Act U.S. House of Representatives 2008-07-31 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I 110th CONGRESS 2d Session H. R. 6684 IN THE HOUSE OF REPRESENTATIVES July 31, 2008 Mr. Ellsworth 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 part D of title XVIII of the Social Security Act to apply the exceptions process for tiered formulary drugs to specialty tier drugs and to limit to 25 percent the Medicare cost-sharing for specialty tier drugs.

1.

Short title

This Act may be cited as the Medicare Prescription Drug Cost Equalization Act.

2.

Application of exceptions procedures for prescription drug plan tiered cost-sharing structure to specialty tiers

(a)

In general

Section 1860D–4(g)(2) of the Social Security Act (42 U.S.C. 1395w–104(g)(2)) is amended by adding at the end the following new sentence: The exceptions process under this paragraph shall apply to drugs included in a tier of a formulary solely for very high cost and unique items (commonly referred to as a specialty tier) in the same manner as such process applies to any other drugs.. (b)

Effective date

The provisions of this section shall apply to PDP sponsors and MA organizations for plan years beginning on or after the date of the enactment of this Act.

3.

Limiting to 25 percent the Medicare cost-sharing for specialty tier drugs

(a)

In general

Section 1860D–2(b)(2)(B) of the Social Security Act (42 U.S.C. 1395w–102(b)(2)(B)) is amended by inserting before the period the following: and so long as the tiered copayment for a tier solely for very high cost and unique items (commonly referred to as a specialty tier) does not exceed 25 percent. (b)

Effective date

The amendments made by subsection (a) shall apply with respect to plan years beginning on or after the date of the enactment of this Act.