[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 648 Introduced in Senate (IS)]

114th CONGRESS
  1st Session
                                 S. 648

 To amend title XVIII of the Social Security Act to improve formulary 
 requirements for prescription drug plans and MA-PD plans with respect 
               to certain categories or classes of drugs.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 4, 2015

Mr. Grassley (for himself and Mr. Brown) 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 improve formulary 
 requirements for prescription drug plans and MA-PD plans with respect 
               to certain categories or classes of drugs.

    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 ``Medicare Formulary Improvement Act 
of 2015''.

SEC. 2. IMPROVING FORMULARY REQUIREMENTS FOR PRESCRIPTION DRUG PLANS 
              AND MA-PD PLANS WITH RESPECT TO CERTAIN CATEGORIES OR 
              CLASSES OF DRUGS.

    (a) In General.--Section 1860D-4(b)(3)(G) of the Social Security 
Act (42 U.S.C. 1395w-104(b)(3)(G)) is amended to read as follows:
                    ``(G) Required inclusion of drugs in certain 
                categories and classes.--
                            ``(i) Formulary requirements.--
                                    ``(I) In general.--Subject to 
                                subclause (II), a PDP sponsor offering 
                                a prescription drug plan shall be 
                                required to include all covered part D 
                                drugs in the categories and classes 
                                described in clause (iii).
                                    ``(II) Exceptions.--Subject to 
                                clause (ii), the Secretary may 
                                establish exceptions that permit a PDP 
                                sponsor offering a prescription drug 
                                plan to exclude from its formulary a 
                                particular covered part D drug in a 
                                category or class that is otherwise 
                                required to be included in the 
                                formulary under subclause (I) (or to 
                                otherwise limit access to such a drug, 
                                including through prior authorization 
                                or utilization management).
                            ``(ii) Implementation.--The Secretary shall 
                        establish any exceptions under clause (i)(II) 
                        through the promulgation of a regulation which 
                        includes a public notice and comment period.
                            ``(iii) Requirement for certain categories 
                        and classes.--The following categories and 
                        classes of drugs are described in this clause:
                                    ``(I) Anticonvulsants.
                                    ``(II) Antidepressants.
                                    ``(III) Antineoplastics.
                                    ``(IV) Antipsychotics.
                                    ``(V) Antiretrovirals.
                                    ``(VI) Immunosuppressants for the 
                                treatment of transplant rejection.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to plan year 2015 and subsequent plan years.
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