,,ii  #aadth ,,congress  #ast ,session  
,s4 #acfd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,may #ah1      
#bjae,mr4 ,sanders 7for himself1 ,mr4   
,brown1 ,ms4 ,hirono1 ,mr4 ,blumenthal1 
and ,mr4 ,franken7 introduced the       
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend title ,,xix of the 
,social ,security ,act to require the   
payment of an additional rebate to the  
,state ,medicaid plan in the case of    
increase in the price of a generic drug 
at a rate that is greater than the rate 
of inflation4  #a4 ,short title ,this   
,act may be cited as the ,medicaid      
,generic ,drug ,price ,fairness ,act of 
#bjae4  #b4 ,applying the medicaid      
additional rebate requirement to generic
 drugs  7a7 ,in general ,section        
#aibg7;c77#c7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #acifr-#h7;c77#c77  
is amended--  7#a7 in subparagraph 7,a71
 by striking ,the amount and inserting  
,except as provided in subparagraph     

7,c71 the amount2 and  7#b7 by adding at
 the end the following new subparagraph3
  7,c7 ,additional rebate  7i7 ,in      
general ,the amount of the rebate       
specified in this paragraph for a rebate
 period1 with respect to each dosage    
form and strength of a covered          
outpatient drug other than a single     
source drug or an innovator multiple    
source drug1 shall be increased in the  
manner that the rebate for a dosage form
 and strength of a single source drug or
 an innovator multiple source drug is   
increased under subparagraphs 7,a7 and  
7,d7 of paragraph 7#b71 except as       
provided in clause 7ii74  7ii7 ,special 
rules for application of provision ,in  
applying subparagraphs 7,a7 and 7,d7 of 
paragraph 7#b7 under clause 7i7-- 7,i7  
the reference in subparagraph 7,a77i7 of
 such paragraph to #aiij shall be deemed
 a reference to #bjad2  7,,ii7 subject  
to clause 7iii71 the reference in       
subparagraph 7,a77ii7 of such paragraph 
to calendar quarter beginning ,july #a1 

#aiij shall be deemed a reference to the
 calendar quarter in which the average  
manufacturer price for the drug is the  
lowest during the #ab-;calendar quarter 
period ending on ,september #cj1 #bjad2 
and  7,,iii7 subject to clause 7iii71   
the reference in subparagraph 7,a77ii7  
of such paragraph to ,september #aiij   
shall be deemed a reference to the last 
month of such calendar quarter2  7,,iv7 
the references in subparagraph 7,d7 of  
such paragraph to paragraph             
7#a77;,a77ii71 this paragraph1 and      
,december #ca1 #bjji shall be deemed    
references to subparagraph 7,a71 this   
subparagraph1 and ,december #ca1 #bjad1 
respectively2 and  7,v7 any reference in
 such paragraph to a single source drug 
or an innovator multiple source drug    
shall be deemed to be a reference to a  
drug to which clause 7i7 applies4  7iii7
 ,special rule for certain noninnovator 
multiple source drugs ,in applying      
paragraph 7#b77;,a77ii77,,ii7 under     
clause 7i7 with respect to a covered    

outpatient drug that is first sold as a 
drug other than a single source drug or 
an innovator multiple source drug after 
the date that is #c years before the    
date of the enactment of this           
subparagraph1 such paragraph shall be   
applied--  7,i7 by substituting the     
applicable quarter for the calendar     
quarter beginning ,july #a1 #aiij2 and  
7,,ii7 by substituting the last month in
 such applicable quarter for ,september 
#aiij4  7iv7 ,applicable quarter defined
 ,in this subsection1 the term          
applicable quarter means1 with respect  
to a drug described in clause 7iii71 the
 fifth full calendar quarter in which   
the drug is sold as a drug other than a 
single source drug or an innovator      
multiple source drug4  4  7b7 ,effective
 date ,the amendments made by subsection
 7a7 shall apply to rebate periods      
beginning after ,december #ca1 #bjad4