,,ii  #aad? ,,congress  #a/ ,session    
,s4 #acfd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #ah1 #bjae,mr4    
,s&]s 7= himself1 ,mr4 ,br[n1 ,ms4      
,hirono1 ,mr4 ,blum5?al1 & ,mr4 ,frank57
 introduc$ ! foll[+ bill2 :i* 0 read    
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to require !
 paym5t ( an additional rebate to !     
,/ate ,m$icaid plan 9 ! case ( increase 
9 ! price ( a g5]ic drug at a rate t is 
great] ?an ! rate ( inflation4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,m$icaid ,g5]ic ,drug ,price ,fairness  
,act ( #bjae4  #b4 ,apply+ ! m$icaid    
additional rebate requirem5t to g5]ic   
drugs  7a7 ,9 g5]al ,section            
#aibg7;c77#c7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifr-#h7;c77#c77 is   
am5d$--  7#a7 9 subp>agraph 7,a71 by    
/rik+ ,! am\nt & ins]t+ ,except z       
provid$ 9 subp>agraph 7,c71 ! am\nt2 &  
7#b7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,c7 ,additional rebate   

7i7 ,9 g5]al ,! am\nt ( ! rebate        
specifi$ 9 ?is p>agraph = a rebate      
p]iod1 ) respect to ea* dosage =m &     
/r5g? ( a cov]$ outpati5t drug o!r ?an a
 s+le s\rce drug or an innovator        
multiple s\rce drug1 %all be increas$ 9 
! mann] t ! rebate = a dosage =m & /r5g?
 ( a s+le s\rce drug or an innovator    
multiple s\rce drug is increas$ "u      
subp>agraphs 7,a7 & 7,d7 ( p>agraph     
7#b71 except z provid$ 9 clause 7ii74   
7ii7 ,special rules = application (     
provision ,9 apply+ subp>agraphs 7,a7 & 
7,d7 ( p>agraph 7#b7 "u clause 7i7--    
7,i7 ! ref]5ce 9 subp>agraph 7,a77i7 (  
su* p>agraph to #aiij %all be deem$ a   
ref]5ce to #bjad2  7,,ii7 subject to    
clause 7iii71 ! ref]5ce 9 subp>agraph   
7,a77ii7 ( su* p>agraph to cal5d> qu>t] 
beg9n+ ,july #a1 #aiij %all be deem$ a  
ref]5ce to ! cal5d> qu>t] 9 :i* ! av]age
 manufactur] price = ! drug is ! l[e/   
dur+ ! #ab-;cal5d> qu>t] p]iod end+ on  
,septemb] #cj1 #bjad2 &  7,,iii7 subject
 to clause 7iii71 ! ref]5ce 9           

subp>agraph 7,a77ii7 ( su* p>agraph to  
,septemb] #aiij %all be deem$ a ref]5ce 
to ! la/ mon? ( su* cal5d> qu>t]2       
7,,iv7 ! ref]5ces 9 subp>agraph 7,d7 (  
su* p>agraph to p>agraph 7#a77;,a77ii71 
?is p>agraph1 & ,decemb] #ca1 #bjji %all
 be deem$ ref]5ces to subp>agraph 7,a71 
?is subp>agraph1 & ,decemb] #ca1 #bjad1 
respectively2 &  7,v7 any ref]5ce 9 su* 
p>agraph to a s+le s\rce drug or an     
innovator multiple s\rce drug %all be   
deem$ to be a ref]5ce to a drug to :i*  
clause 7i7 applies4  7iii7 ,special rule
 = c]ta9 non9novator multiple s\rce     
drugs ,9 apply+ p>agraph                
7#b77;,a77ii77,,ii7 "u clause 7i7 )     
respect to a cov]$ outpati5t drug t is  
fir/ sold z a drug o!r ?an a s+le s\rce 
drug or an innovator multiple s\rce drug
 aft] ! date t is #c ye>s be=e ! date ( 
! enactm5t ( ?is subp>agraph1 su*       
p>agraph %all be appli$--  7,i7 by      
sub/itut+ ! applicable qu>t] = ! cal5d> 
qu>t] beg9n+ ,july #a1 #aiij2 &  7,,ii7 
by sub/itut+ ! la/ mon? 9 su* applicable

 qu>t] = ,septemb] #aiij4  7iv7         
,applicable qu>t] def9$ ,9 ?is          
subsection1 ! t]m applicable qu>t]      
means1 ) respect to a drug describ$ 9   
clause 7iii71 ! fif? full cal5d> qu>t] 9
 :i* ! drug is sold z a drug o!r ?an a  
s+le s\rce drug or an innovator multiple
 s\rce drug4  4  7b7 ,effective date ,! 
am5dm5ts made by subsection 7a7 %all    
apply to rebate p]iods beg9n+ aft]      
,decemb] #ca1 #bjad4