,,ii  #aad? ,,congress  #b;d ,session   
,s4 #bheh  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,april #bg1 #bjaf,mr4  
,frank5 7= himself & ,ms4 ,klobu*>7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d "p ,d (    
title ,,xviii ( ! ,social ,security ,act
 to require ! ,secret>y ( ,heal? &      
,human ,s]vices to negotiate = l[]      
prices = ,m$ic>e prescription drugs4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,prescription ,drug & ,heal?          
,improvem5t ,act ( #bjaf4  #b4          
,negotiat+ fair prices = ,m$ic>e        
prescription drugs  7a7 ,negotiat+ fair 
prices  7#a7 ,9 g5]al ,section          
#ahfj;,d-#aa ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciew-#aaa7 is am5d$ by 
/rik+ subsection 7i7 7relat+ to         
non9t]f]5ce7 & by ins]t+ ! foll[+3  7i7 
,negotiat+ fair prices ) manufactur]s   
7#a7 ,9 g5]al ,not)/&+ any o!r provision
 ( law1 9 fur!rance ( ! goals ( provid+ 
quality c>e & conta9+ co/s "u ?is "p1 ! 

,secret>y %all1 ) respect to applicable 
cov]$ "p ,d drugs1 & may1 ) respect to  
o!r cov]$ "p ,d drugs1 negotiate1 z     
appropriate 79 a mann] :i* may be simil>
 to ,f$]al entities71 ) ph>maceutical   
manufactur]s ! prices 7:i* may include  
disc\nts1 rebates1 & o!r price          
concessions7 t may be *>g$ to ,,pdp     
sponsors & ,,ma organizations = su*     
drugs = "p ,d eligible individuals :o   
are enroll$ 9 a prescription drug plan  
or 9 an ,,ma-,,pd plan4  7#b7           
,applicable cov]$ "p ,d drug def9$ ,=   
purposes ( ?is subsection1 ! t]m        
applicable cov]$ "p ,d drug means a     
cov]$ "p ,d drug t ! ,secret>y det]m9es 
to be appropriate = negotiation "u      
p>agraph 7#a7 bas$ on "o or m ( ! foll[+
 factors z appli$ to su* drug3  7,a7    
,sp5d+ on a p] b5efici>y basis4  7,b7   
,sp5d+ "u ?is title4  7,c7 ,unit co/    
increases ov] ! prec$+ ye>s4  7,d7      
,initial laun* price4  7,e7 ,any o!r    
crit]ia det]m9$ by ! ,secret>y4  4  7#b7
 ,effective date ,! am5dm5t made by     

p>agraph 7#a7 %all take effect on ! date
 ( ! enactm5t ( ?is ,act & %all fir/    
apply to negotiations & prices = plan   
ye>s beg9n+ on ,janu>y #a1 #bjah4  7b7  
,biannual reports to ,congress  7#a7 ,9 
g5]al ,n lat] ?an #c ye>s aft] ! date ( 
! enactm5t ( ?is ,act1 & e #f mon?s     
!reaft]1 ! ,secret>y ( ,heal? & ,human  
,s]vices %all submit to ,congress a     
report on ! foll[+3  7,a7 ,!            
negotiations conduct$ by ! ,secret>y "u 
section #ahfj;,d-#aa7;i7 ( ! ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#aaa7;i771 z am5d$ by subsection 
7a71 includ+ a description ( h[ su*     
negotiations are a*iev+ l[] prices =    
cov]$ "p ,d drugs 7z def9$ 9 section    
#ahfj;,d-#b7;e7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #aciew-#ajb7;e777 = 
,m$ic>e b5efici>ies4  7,b7 ,data on     
sp5d+ "u "p ,d ( ! ,m$ic>e program on   
cov]$ "p ,d drugs1 includ+ data on cov]$
 "p ,d drugs )--  7i7 high sp5d+ on a p]
 b5efici>y basis2  7ii7 high sp5d+ = !  
program ov]all2 &  7iii7 high unit co/  

increases ov] ! pa/ five ye>s4  7,c7 ,a 
li/ ( ! cov]$ "p ,d drugs ) no !rapeutic
 sub/itute & data on sp5d+ "u "p ,d ( ! 
,m$ic>e program on su* drugs4  7#b7     
,public availability ( report ,!        
,secret>y ( ,heal? & ,human ,s]vices    
%all publi% on ! ,int]net website ( !   
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices a   
copy ( ea* report submitt$ "u p>agraph  
7#a74