,,ii  #aac? ,,congress  #a/ ,session    
,s4 #ahgi  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #ai1 #bjac,mr4
 ,frank5 7= himself & ,mr4 ,kirk7       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,employee         
,retirem5t ,income ,security ,act (     
#aigd1 ! ,public ,heal? ,s]vice ,act1 & 
! ,int]nal ,rev5ue ,code ( #aihf to     
require gr\p & individual heal?         
insurance cov]age & gr\p heal? plans to 
provide = cov]age ( oral anticanc] drugs
 on t]ms no less favorable ?an ! cov]age
 provid$ = anticanc] m$ications adm9i/]$
 by a heal? c>e provid]4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,canc]  
,treatm5t ,p>ity ,act ( #bjac4  #b4     
,p>ity 9 cov]age = oral anticanc] drugs 
7a7 ,employee ,retirem5t ,income        
,security ,act ( #aigd am5dm5ts  7#a7   
,subp>t ,b ( "p #g ( subtitle ,b ( title
 ,i ( ! ,employee ,retirem5t ,income    
,security ,act ( #aigd is am5d$ by add+ 

at ! end ! foll[+ new section3  #gaf4   
,p>ity 9 cov]age = oral anticanc] drugs 
7a7 ,9 g5]al ,subject to subsection 7b71
 a gr\p heal? plan1 & a heal? insurance 
issu] provid+ heal? insurance cov]age 9 
connection ) a gr\p heal? plan1 t       
provides b5efits ) respect to anticanc] 
m$ications adm9i/]$ by a heal? c>e      
provid] %all provide = no less favorable
 cov]age = prescrib$1 pati5t-adm9i/]$   
anticanc] m$ications t are us$ to kill1 
sl[1 or prev5t ! gr[? ( canc]\s cells & 
t h be5 approv$ by ! ,food & ,drug      
,adm9i/ration4  7b7 ,limitation         
,subsection 7a7 %all only apply to an   
anticanc] m$ication t is prescrib$ bas$ 
on a f9d+ by ! treat+ physician t !     
m$ication-- 7#a7 is m$ically necess>y = 
! purpose ( kill+1 sl[+1 or prev5t+ !   
gr[? ( canc]\s cells2 or  7#b7 is       
cl9ically appropriate 9 t]ms ( type1    
frequ5cy1 ext5t site1 & duration4  7c7  
,application ( co/-,%>+ & re/rictions   
7#a7 ,9 g5]al ,! cov]age ( anticanc]    
m$ication "u subsection 7a7 may be      

subject to annual d$uctibles &          
co9surance or copaym5ts s long z su*    
d$uctibles1 co9surance1 & copaym5ts d n 
exce$ ! d$uctibles1 co9surance1 &       
copaym5ts t are applicable to anticanc] 
m$ications adm9i/]$ by a heal? c>e      
provid] "u ! plan or cov]age = ! same   
purpose4  7#b7 ,re/riction ,a gr\p heal?
 plan or heal? insurance issu] may n1 9 
ord] to comply ) ! requirem5t (         
subsection 7a7-- 7,a7 impose an increase
 9 out-(-pocket co/s ) respect to       
anticanc] m$ications2  7,b7 reclassify  
b5efits ) respect to anticanc]          
m$ications2 or  7,c7 apply m re/rictive 
limitations on prescrib$ orally-adm9i/]$
 anticanc] m$ications or intrav5\sly    
adm9i/]$ or inject$ anticanc]           
m$ications4  7d7 ,application ( notice1 
prohibitions1 etc ,! provisions (       
subsections 7b71 7c71 7d71 & 7e77#b7 (  
section #gac %all apply ) respect to !  
cov]age requir$ by subsection 7a7 9 !   
same mann] z !y apply ) respect to !    
cov]age requir$ "u su* section1 except t

 ,janu>y #a1 #bjae1 %all be sub/itut$ = 
! date ref]r$ to 9 subsection 7b77#c7 ( 
su* section4  7e7 ,con/ruction ,no?+ 9  
?is section %all be con/ru$-- 7#a7 to   
require ! use ( orally-adm9i/]$         
anticanc] m$ications z a replacem5t =   
o!r anticanc] m$ications2 or  7#b7 to   
prohibit a gr\p heal? plan or heal?     
insurance issu] f requir+ prior         
au?orization or impos+ o!r appropriate  
utilization controls 9 approv+ cov]age =
 any *emo!rapy4  4  7#b7 ,section       
#gca7;c7 ( su* ,act 7#bi ,u4,s4,c4      
#aaia7;c77 is am5d$ by /rik+ section    
#gaa & ins]t+ sections #gaa & #gaf4     
7#c7 ,section #gcb7;a7 ( su* ,act 7#bi  
,u4,s4,c4 #aaia;a7a77 is am5d$ by /rik+ 
section #gaa & ins]t+ sections #gaa &   
#gaf4  7#d7 ,! table ( cont5ts 9 section
 #a ( su* ,act is am5d$ by ins]t+ aft] !
 item relat+ to section #gad ! foll[+   
new items3  ,sec4 #gae4 ,additional     
m>ket re=ms4,sec4 #gaf4 ,p>ity 9 cov]age
 = oral anticanc] drugs4  4  7b7 ,public
 heal? s]vice act am5dm5ts  7#a7 ,title 

,,xxvii ( ! ,public ,heal? ,s]vice ,act 
is am5d$ by ins]t+ aft] section #bgbh   
7#db ,u4,s4,c4 #cjj;gg-#bh71 z          
r$esignat$ by section #ajja7b7 ( !      
,pati5t ,protection & ,af=dable ,c>e    
,act 7,public ,law #aaa-adh71 ! foll[+  
new section3  #bgbi4 ,p>ity 9 cov]age = 
oral anticanc] drugs  7a7 ,9 g5]al      
,subject to subsection 7b71 a gr\p heal?
 plan1 & a heal? insurance issu] (f]+   
gr\p or individual heal? insurance      
cov]age1 t provides b5efits ) respect to
 anticanc] m$ications adm9i/]$ by a     
heal? c>e provid] %all provide = no less
 favorable cov]age = prescrib$1         
pati5t-adm9i/]$ anticanc] m$ications t  
are us$ to kill1 sl[1 or prev5t ! gr[? (
 canc]\s cells & t h be5 approv$ by !   
,food & ,drug ,adm9i/ration4  7b7       
,limitation ,subsection 7a7 %all only   
apply to an anticanc] m$ication t is    
prescrib$ bas$ on a f9d+ by ! treat+    
physician t ! m$ication-- 7#a7 is       
m$ically necess>y = ! purpose ( kill+1  
sl[+1 or prev5t+ ! gr[? ( canc]\s cells2

 or  7#b7 is cl9ically appropriate 9    
t]ms ( type1 frequ5cy1 ext5t site1 &    
duration4  7c7 ,application ( co/-,%>+ &
 re/rictions  7#a7 ,9 g5]al ,! cov]age (
 anticanc] m$ication "u subsection 7a7  
may be subject to annual d$uctibles &   
co9surance or copaym5ts s long z su*    
d$uctibles1 co9surance1 & copaym5ts d n 
exce$ ! d$uctibles1 co9surance1 &       
copaym5ts t are applicable to anticanc] 
m$ications adm9i/]$ by a heal? c>e      
provid] "u ! plan or cov]age = ! same   
purpose4  7#b7 ,re/riction ,a gr\p heal?
 plan or heal? insurance issu] may n1 9 
ord] to comply ) ! requirem5t (         
subsection 7a7-- 7,a7 impose an increase
 9 out-(-pocket co/s ) respect to       
anticanc] m$ications2  7,b7 reclassify  
b5efits ) respect to anticanc]          
m$ications2 or  7,c7 apply m re/rictive 
limitations on prescrib$ orally-adm9i/]$
 anticanc] m$ications or intrav5\sly    
adm9i/]$ or inject$ anticanc]           
m$ications4  7d7 ,application ( notice1 
prohibitions1 etc ,! provisions (       

subsections 7b71 7c71 7d71 & 7e77#b7 (  
section #gac ( ! ,employee ,retirem5t & 
,income ,security ,act ( #aigd %all     
apply ) respect to ! cov]age requir$ by 
subsection 7a7 9 ! same mann] z !y apply
 ) respect to ! cov]age requir$ "u su*  
section1 except t ,janu>y #a1 #bjae1    
%all be sub/itut$ = ! date ref]r$ to 9  
subsection 7b77#c7 ( su* section4  7e7  
,con/ruction ,no?+ 9 ?is section %all be
 con/ru$-- 7#a7 to require ! use (      
orally-adm9i/]$ anticanc] m$ications z a
 replacem5t = o!r anticanc] m$ications2 
or  7#b7 to prohibit a gr\p heal? plan  
or heal? insurance issu] f requir+ prior
 au?orization or impos+ o!r appropriate 
utilization controls 9 approv+ cov]age =
 any *emo!rapy4  4  7#b7 ,section       
#bgbd7;c7 ( su* ,act 7#db ,u4,s4,c4     
#cjj;gg-#bc7;c771 z r$esignat$ by       
section #ajja7d7 & subsection 7c77#ad7 (
 section #aefc 7relat+ to con=m+        
am5dm5ts7 ( ,public ,law #aaa-adh1 is   
am5d$ by /rik+ section #bgjd & ins]t+   
sections #bgbe & #bgbi4  7#c7 ,section  

#bgfb7;b77#b7 ( su* ,act 7#db ,u4,s4,c4 
#cjj;gg-#fb7;b77#b77 is am5d$ by /rik+  
section #bgea & ins]t+ sections #bgea & 
#bgbi4  7#d7 ,= purposes ( apply+       
section #bgbi ( ! ,public ,heal? ,s]vice
 ,act1 z ins]t$ by p>agraph 7#a71 to    
individual heal? insurance cov]age be=e 
#bjad1 ! provisions ( su* section %all  
be treat$ z also includ$ "u "p ,b (     
title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act4  7c7 ,int]nal rev5ue code        
am5dm5ts  7#a7 ,9 g5]al ,sub*apt] ,b (  
*apt] #ajj ( ! ,int]nal ,rev5ue ,code ( 
#aihf1 z am5d$ by subsection 7f7 (      
section #aefc 7relat+ to con=m+         
am5dm5ts7 ( ,public ,law #aaa-adh1 is   
am5d$ by add+ at ! end ! foll[+ new     
section3  #ihaf4 ,p>ity 9 cov]age = oral
 anticanc] drugs  7a7 ,9 g5]al ,subject 
to subsection 7b71 a gr\p heal? plan t  
provides b5efits ) respect to anticanc] 
m$ications adm9i/]$ by a heal? c>e      
provid] %all provide = no less favorable
 cov]age = prescrib$1 pati5t-adm9i/]$   
anticanc] m$ications t are us$ to kill1 

sl[1 or prev5t ! gr[? ( canc]\s cells & 
t h be5 approv$ by ! ,food & ,drug      
,adm9i/ration4  7b7 ,limitation         
,subsection 7a7 %all only apply to an   
anticanc] m$ication t is prescrib$ bas$ 
on a f9d+ by ! treat+ physician t !     
m$ication-- 7#a7 is m$ically necess>y = 
! purpose ( kill+1 sl[+1 or prev5t+ !   
gr[? ( canc]\s cells2 or  7#b7 is       
cl9ically appropriate 9 t]ms ( type1    
frequ5cy1 ext5t site1 & duration4  7c7  
,application ( co/-,%>+ & re/rictions   
7#a7 ,9 g5]al ,! cov]age ( anticanc]    
m$ication "u subsection 7a7 may be      
subject to annual d$uctibles &          
co9surance or copaym5ts s long z su*    
d$uctibles1 co9surance1 & copaym5ts d n 
exce$ ! d$uctibles1 co9surance1 &       
copaym5ts t are applicable to anticanc] 
m$ications adm9i/]$ by a heal? c>e      
provid] "u ! plan = ! same purpose4     
7#b7 ,re/riction ,a gr\p heal? plan may 
n1 9 ord] to comply ) ! requirem5t (    
subsection 7a7-- 7,a7 impose an increase
 9 out-(-pocket co/s ) respect to       

anticanc] m$ications2  7,b7 reclassify  
b5efits ) respect to anticanc]          
m$ications2 or  7,c7 apply m re/rictive 
limitations on prescrib$ orally-adm9i/]$
 anticanc] m$ications or intrav5\sly    
adm9i/]$ or inject$ anticanc]           
m$ications4  7d7 ,application ( notice1 
prohibitions1 etc ,! provisions (       
subsections 7b71 7c71 7d71 & 7e77#b7 (  
section #gac ( ! ,employee ,retirem5t & 
,income ,security ,act ( #aigd %all     
apply ) respect to ! cov]age requir$ by 
subsection 7a7 9 ! same mann] z !y apply
 ) respect to ! cov]age requir$ "u su*  
section1 except t ,janu>y #a1 #bjae1    
%all be sub/itut$ = ! date ref]r$ to 9  
subsection 7b77#c7 ( su* section4  7e7  
,con/ruction ,no?+ 9 ?is section %all be
 con/ru$-- 7#a7 to require ! use (      
orally-adm9i/]$ anticanc] m$ications z a
 replacem5t = o!r anticanc] m$ications2 
or  7#b7 to prohibit a gr\p heal? plan  
or heal? insurance issu] f requir+ prior
 au?orization or impos+ o!r appropriate 
utilization controls 9 approv+ cov]age =

 any *emo!rapy4  4  7#b7 ,cl]ical       
am5dm5t ,! table ( sections = su*       
sub*apt] is am5d$ by add+ at ! end !    
foll[+ new items3  ,sec4 #ihae4         
,additional m>ket re=ms4,sec4 #ihaf4    
,p>ity 9 cov]age = oral anticanc] drugs4
  4  7d7 ,effective date ,! am5dm5ts    
made by ?is section %all apply ) respect
 to gr\p & individual heal? plans = plan
 ye>s beg9n+ on or aft] ,janu>y #a1     
#bjae4  7e7 ,/udy ,n lat] ?an #b ye>s   
aft] ! date ( ! enactm5t ( ?is ,act--   
7#a7 ! ,m$ic>e ,paym5t ,advisory        
,commission %all complete a /udy t      
assesses h[ clos+ ! ,m$ic>e "p ,d donut 
hole "u ! am5dm5ts made by section #ccja
 ( ! ,pati5t ,protection & ,af=dable    
,c>e ,act 7,public ,law #aaa-adh71 z    
am5d$ by section #aaja ( ! ,heal? ,c>e &
 ,education ,reconciliation ,act ( #bjaj
 7,public ,law #aaa-aeb71 affects       
,m$ic>e cov]age = orally adm9i/]$       
anticanc] m$ications1 ) a p>ticul> focus
 on co/ & accessibility2 &  7#b7 submit 
a report to ,congress on ! results ( su*

 /udy4