,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #abci  ,,in ,,the ,,house ,,of  
,,representatives  ,march #ah1 #bjac    
,mr4 ,cassidy 7for himself and ,ms4     
,matsui7 introduced the following bill2 
which was referred to the ,committee on 
,energy and ,commerce1 and in addition  
to the ,committee on ,ways and ,means1  
for a period to be subsequently         
determined by the ,speaker1 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 count the     
negotiated price of drugs provided free 
or at nominal charge under compassionate
 treatment programs towards incurred    
out-of-pocket costs4  #a4 ,short title  
,this ,act may be cited as the          
,accessing ,medicare ,therapies ,act of 
#bjac4  #b4 ,counting the negotiated    
price of drugs provided free or at      
nominal charge under compassionate      
treatment programs towards incurred     

out-of-pocket costs  7a7 ,in general    
,section #ahfj;,d-#b7;b77#d7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#ajb7;b77#d77 is amended--  7#a7 
in subparagraph 7,c71 by striking       
subparagraph 7,e7 and inserting         
subparagraphs 7,e7 and 7,f72 and  7#b7  
by adding at the end the following new  
subparagraph3  7,f7 ,inclusion of       
negotiated price of drugs provided under
 compassionate treatment programs  7i7  
,in general ,in applying subparagraph   
7,a7 with respect to an individual      
enrolled in a prescription drug plan1   
incurred costs shall include the        
negotiated price described in clause    
7ii7 of a covered part ,d drug if--     
7,i7 the drug is classified1 for        
purposes of applying tiered copayments  
consistent with section                 
#ahfj;,d-#b7;b77#b77;,b71 in the highest
 copayment tier 7such as a tier #d for  
specialty brand-name drugs72  7,,ii7 the
 drug is furnished to the individual    
free or at nominal charge under a       

compassionate treatment program 7as     
defined in clause 7iii772 and  7,,iii7  
the drug1 if furnished other than       
through such program1 is covered under  
the formulary of the plan or is         
available through exception or appeal4  
7ii7 ,negotiated price ,the negotiated  
price described in this clause1 for a   
covered part ,d drug which is dispensed 
to an enrollee--  7,i7 by a pharmacy1 is
 the negotiated price at such pharmacy2 
or  7,,ii7 other than by a pharmacy1 is 
the average negotiated price for the    
drug in the prescription drug plan in   
the zip code of the enrollee as of the  
date the drug is dispensed4  7iii7      
,compassionate treatment program defined
 ,in this subparagraph1 the term        
compassionate treatment program means1  
with respect to covered part ,d drugs1 a
 program that--  7,i7 is administered by
 an entity described in section         
#eja7;c77#c7 of the ,internal ,revenue  
,code of #aihf that is exempt from tax  
under section #eja7;a7 of such ,code2   

7,,ii7 takes title to the drugs and     
distributes the drugs to eligible part  
,d individuals free or at nominal charge
 on the basis of the entity's assessment
 of financial need of such individuals2 
7,,iii7 does not distribute the drugs to
 an individual unless the individual's  
household income 7as determined under   
section #cf;,b of the ,internal ,revenue
 ,code of #aihf7 is less than the       
maximum income level for the taxpayer in
 the household to be eligible for a     
refundable credit under such section2   
and  7,,iv7 meets such additional       
requirements as the ,inspector ,general 
of the ,department of ,health and ,human
 ,services establishes1 consistent with 
guidance and advisory opinions issued   
under section #aabh;,d1 to prevent fraud
 or abuse in the application of this    
subparagraph4  4  7b7 ,effective date   
,the amendments made by subsection 7a7  
shall apply to drugs furnished in plan  
years beginning on or after ,january #a1
 #bjad4