,,ii  #aafth ,,congress  #ast ,session  
,s4 #biaa  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #bj1 
#bjai,mr4 ,cassidy 7for himself and ,mr4
 ,menendez7 introduced the following    
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xviii of the ,social
 ,security ,act to provide a monthly    
out-of-pocket cost sharing maximum for  
enrollees who incur a significant       
portion of costs for covered part ,d    
drugs towards the annual out-of-pocket  
threshold during a month4  #a4 ,short   
title ,this ,act may be cited as the    
,seniors ,prescription ,drug ,relief    
,act of #bjai4  #b4 ,monthly            
out-of-pocket cost sharing maximum for  
enrollees who incur a significant       
portion of costs towards annual         
out-of-pocket threshold  7a7 ,standard  
prescription drug coverage ,section     
#ahfj;,d-#b7;b77#b7 of the ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7;b77#b77 is amended-- 7#a7  

in subparagraph 7,a71 by striking and   
7,d7 and inserting 1 7,d71 and 7,e72    
7#b7 in each of subparagraphs 7,c77i7   
and 7,d77i71 by striking paragraph 7#d7 
and inserting paragraph 7#d71 and       
subject to subparagraph 7,e72 and  7#c7 
by adding at the end the following new  
subparagraph3  7,e7 ,monthly            
out-of-pocket cost sharing maximum  7i7 
,in general ,for plan years beginning on
 or after ,january #a1 #bjbb1 the       
,secretary shall through regulation     
establish a process to allow an enrollee
 in a prescription drug plan who incurs 
costs 7as described in paragraph        
7#d77;,c77 equal to or greater than a   
significant percentage of the annual    
out-of-pocket threshold specified in    
paragraph 7#d77;,b7 within a one month  
time period to choose to pay the total  
amount of such costs owed1 in equal     
installments in the remaining months of 
the plan year up to the total amount of 
such annual out-of-pocket threshold4    
7ii7 ,definition of significant percent 

,for purposes of the process described  
in clause 7i71 the ,secretary shall     
through regulation provide for a        
definition of the term significant      
percentage with respect to a percentage 
of the annual out-of-pocket threshold   
specified in paragraph 7#d77;,b7 but in 
no case shall the significant percentage
 be less than #ej percent or more than  
#ajj percent of the annual out-of-pocket
 threshold4  4  7b7 ,alternative        
prescription drug coverage ,section     
#ahfj;,d-#b7;c7 of the ,social ,security
 ,act 7#db ,u4,s4,c4 #aciew-#ajb7;c77 is
 amended by adding at the end the       
following new paragraph3  7#d7 ,same    
monthly out-of-pocket cost sharing      
maximum ,for plan years beginning on or 
after ,january #a1 #bjbb1 the coverage  
provides the monthly out-of-pocket cost 
sharing maximum required under          
subsection 7b77#b77;,e74  4