,,ii  #aafth ,,congress  #ast ,session  
,s4 #cjjj  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #i1  
#bjai,mr4 ,cassidy 7for himself and ,ms4
 ,hassan7 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 allow ,,pdp sponsors  
of prescription drug plans and ,medicare
 ,advantage organizations offering      
,,ma-,,pd plans to share with enrollees 
a portion of savings from switching to  
lower cost therapeutic alternative      
medications4  #a4 ,short title ,this    
,act may be cited as the ,patient       
,shared ,savings ,act4  #b4 ,allowing   
prescription drug plans and ,,ma-,,pd   
plans to share with enrollees a portion 
of savings from switching to lower cost 
therapeutic alternative medications  7a7
 ,in general ,section #ahfj;,d-#d of the
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciew-#ajd7 is amended-- 7#a7 by       
redesignating subsection 7m7 7relating  

to program integrity transparency       
measures71 as added by section #fjfc7;c7
 of the ,substance ,use-,disorder       
,prevention that ,promotes ,opioid      
,recovery and ,treatment for ,patients  
and ,communities ,act 7,public ,law     
#aae-bga71 as subsection 7n72 and  7#b7 
by adding at the end the following new  
subsection3  7o7 ,sharing with enrollees
 a portion of savings from switching to 
a lower cost therapeutic alternative    
medication  7#a7 ,in general ,for plan  
years beginning on or after ,january #a1
 #bjba1 a ,,pdp sponsor of a            
prescription drug plan may have a       
program under which the ,,pdp sponsor   
shares with an enrollee in the plan a   
portion of savings to the ,,pdp sponsor 
as a result of the enrollee switching   
from a covered part ,d drug the enrollee
 is taking on an ongoing basis to a     
lower cost therapeutic alternative      
covered part ,d drug4  7#b7             
,requirements ,if a ,,pdp sponsor       
implements a program described in       

paragraph 7#a71 the following           
requirements shall apply with respect to
 the program3  7,a7 ,requirements with  
respect to enrollees ,the enrollee-- 7i7
 must have been taking the covered part 
,d drug on an ongoing basis for at least
 #b months as confirmed by claims       
analysis by the ,,pdp sponsor prior to  
switching to the lower cost therapeutic 
alternative covered part ,d drug2 and   
7ii7 must have agreed to make such      
switch after consulting with their      
physician4  7,b7 ,requirements with     
respect to ,,pdp sponsors ,the ,,pdp    
sponsor must--  7i7 make available a    
shared savings report with therapeutic  
alternatives to eligible enrollees      
through ,evidence of ,benefits or other 
information sent to enrollees1 or       
provide contracted providers with access
 to tools that include therapeutic      
alternatives and shared savings at the  
point of care2  7ii7 ensure that the    
total amount of savings shared with an  
enrollee with respect to the switch to a

 particular lower cost therapeutic      
alternative covered part ,d drug does   
not exceed an amount equal to #aj       
percent of the annualized net savings to
 the ,,pdp sponsor as a result of the   
enrollee making such switch2  7iii7 only
 share such savings after the ,,pdp     
sponsor confirms1 based on claims       
analysis1 that-- 7,i7 the enrollee has  
switched to the lower cost therapeutic  
alternative covered part ,d drug2 and   
7,,ii7 the switch does not result in an 
increased cost to the program under this
 part2  7iv7 provide a tangible reward  
or incentive for the amount of such     
shared savings1 which--  7,i7 shall     
directly benefit the enrollee2  7,,ii7  
such sponsor may not--  7aa7 use to     
reduce plan premiums for the enrollee2  
or  7bb7 direct an enrollee to use to   
pay such premiums2 and  7,,iii7 may be  
in the form of a monetary rebate1 gift  
card1 discount coupon1 or other item    
consistent with the ,president's        
,executive ,order on ,protecting and    

,improving ,medicare for ,our ,nation's 
,seniors1 issued on ,october #c1 #bjai2 
and  7v7 provide an annual report to the
 ,secretary1 with respect to the        
preceding plan year1 on the number of   
enrollees who receive shared savings    
under this subsection as a result of    
switching to a lower cost therapeutic   
alternative covered part ,d drug1 the   
total amount of such savings shared with
 the enrollee and in what form1 and the 
total savings to the ,,pdp sponsor as a 
result of enrollees making such switch4 
7#c7 ,authority to provide with respect 
to certain sub-populations or geographic
 areas ,a ,,pdp sponsor may provide     
shared savings pursuant to this         
subsection for only a certain           
sub-population of enrollees or a        
geographically limited population of    
enrollees if the ,secretary determines1 
based on a showing by the ,,pdp sponsor1
 that the ,,pdp sponsor is not          
discriminating based on the health      
status of enrollees4  4  7b7 ,exclusion 

from anti-,kickback prohibition ,section
 #aabh;,b7b77#c7 of the ,social         
,security ,act 7#db ,u4,s4,c4           
#acbj;a-#g;b7b77#c77 is amended-- 7#a7  
in subparagraph 7,j7--  7,a7 by moving  
such subparagraph #b ems to the left2   
and  7,b7 by striking and at the end2   
7#b7 in subparagraph 7,k7-- 7,a7 by     
moving such subparagraph #b ems to the  
left2 and  7,b7 by striking the period  
at the end and inserting 2 and2 and     
7#c7 by adding at the end the following 
new subparagraph3  7,l7 any shared      
savings provided under section          
#ahfj;,d-#d7o74  4