,,ii  #aafth ,,congress  #ast ,session  
,s4 #achd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,may #i1       
#bjai,mr4 ,romney 7for himself and ,mr4 
,braun7 introduced the following bill2  
which was read twice and referred to the
 ,committee on ,health1 ,education1     
,labor1 and ,pensions  ,a ,,bill  ,to   
reform prescription drug pricing and    
reduce out-of-pocket costs by ensuring  
consumers benefit from negotiated       
rebates4  #a4 ,short title ,this ,act   
may be cited as the ,prescription ,drug 
,rebate ,reform ,act of #bjai4  #b4     
,cost-sharing with respect to           
prescription drugs  7a7 ,in general     
,subpart ,,ii of part ,a of title       
,,xxvii of the ,public ,health ,service 
,act 7#db ,u4,s4,c4 #cjj;gg-#aa et seq47
 is amended by adding at the end the    
following3  #bgbi;,a4 ,cost-sharing with
 respect to prescription drugs  7a7 ,in 
general ,a group health plan or health  
insurance issuer offering group or      
individual health insurance coverage    

shall set any coinsurance obligation an 
enrollee has with respect to a          
prescription drug covered by the plan or
 coverage based on the net price of the 
drug1 such that no payment by the       
enrollee with respect to the drug is    
based on a percentage of the list price 
of a drug4  7b7 ,applicability          
,subsection 7a7-- 7#a7 shall apply with 
respect to a prescription drug benefit  
when the enrollee is required to pay a  
deductible with respect to such benefits
 and-- 7,a7 has not yet satisfied the   
deductible under the plan or coverage2  
or  7,b7 has another coinsurance        
obligation with respect to such benefits
 under the plan or coverage2 and  7#b7  
shall not apply if1 with respect to the 
dispensed quantity of a prescription    
drug1 the net price and list price are  
the same1 or are different by not more  
than #a cent4  7c7 ,copayments ,nothing 
in this section prevents a group health 
plan or health insurance issuer from    
requiring a copayment for any           

prescription drug if such copayment is  
not tied to a percent of the specified  
cost of the drug4  7d7 ,definitions ,in 
this section-- 7#a7 the term coinsurance
 means1 with respect to prescription    
drug coverage under a group health plan 
or group or individual health insurance 
coverage1 a payment obligation of an    
enrollee in such health plan or health  
insurance coverage that is based on a   
portion or percentage of the specified  
cost of a prescription drug1 which may  
be up to #ajj percent of that cost2     
7#b7 the term deductible means the      
payment obligation of an enrollee in a  
group health plan or group or individual
 health insurance coverage before the   
group health plan or group or individual
 health insurance coverage will pay any 
portion of the cost of prescription drug
 coverage2  7#c7 the term list price has
 the meaning given the term wholesale   
acquisition cost in section             
#ahdg;,a7c77#f77;,b7 of the ,social     
,security ,act2  7#d7 the term net price

 means1 with respect to prescription    
drug coverage under a group health plan 
or group or individual health insurance 
coverage1 the list price of the drug net
 all rebates1 discounts1 concessions1   
and other adjustments applied to the    
cost paid by the group health plan or   
health insurance issuer1 or by any other
 entity that provides pharmacy benefit  
management services under a contract    
with any such group health plan or      
health insurance issuer1 regardless of  
whether such adjustments are prospective
 or retrospective2 and  7#e7 the term   
prescription drug mean a drug1 as       
defined in section #bja7;g7 of the      
,federal ,food1 ,drug1 and ,cosmetic    
,act1 that is subject to section        
#ejc7;b77#a7 of such ,act4  4  7b7      
,effective date ,section #bgbi;,a of the
 ,public ,health ,service ,act1 as added
 by subsection 7a71 shall apply with    
respect to plan years beginning on or   
after ,january #a1 #bjba4