,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #cjjj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #i1 #bjai,mr4 
,cassidy 7= himself & ,ms4 ,hassan7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
all[ ,,pdp sponsors ( prescription drug 
plans & ,m$ic>e ,advantage organizations
 (f]+ ,,ma-,,pd plans to %>e ) enrollees
 a portion ( sav+s f swit*+ to l[] co/  
!rapeutic alt]native m$ications4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,pati5t ,%>$ ,sav+s ,act4  #b4 ,all[+   
prescription drug plans & ,,ma-,,pd     
plans to %>e ) enrollees a portion (    
sav+s f swit*+ to l[] co/ !rapeutic     
alt]native m$ications  7a7 ,9 g5]al     
,section #ahfj;,d-#d ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajd7 is am5d$-- 7#a7 by         
r$esignat+ subsection 7m7 7relat+ to    
program integrity transp>5cy measures71 
z add$ by section #fjfc7;c7 ( !         

,sub/ance ,use-,disord] ,prev5tion t    
,promotes ,opioid ,recov]y & ,treatm5t =
 ,pati5ts & ,communities ,act 7,public  
,law #aae-bga71 z subsection 7n72 &     
7#b7 by add+ at ! end ! foll[+ new      
subsection3  7o7 ,%>+ ) enrollees a     
portion ( sav+s f swit*+ to a l[] co/   
!rapeutic alt]native m$ication  7#a7 ,9 
g5]al ,= plan ye>s beg9n+ on or aft]    
,janu>y #a1 #bjba1 a ,,pdp sponsor ( a  
prescription drug plan may h a program  
"u :i* ! ,,pdp sponsor %>es ) an        
enrollee 9 ! plan a portion ( sav+s to !
 ,,pdp sponsor z a result ( ! enrollee  
swit*+ f a cov]$ "p ,d drug ! enrollee  
is tak+ on an ongo+ basis to a l[] co/  
!rapeutic alt]native cov]$ "p ,d drug4  
7#b7 ,requirem5ts ,if a ,,pdp sponsor   
implem5ts a program describ$ 9 p>agraph 
7#a71 ! foll[+ requirem5ts %all apply ) 
respect to ! program3  7,a7 ,requirem5ts
 ) respect to enrollees ,! enrollee--   
7i7 mu/ h be5 tak+ ! cov]$ "p ,d drug on
 an ongo+ basis = at lea/ #b mon?s z    
confirm$ by claims analysis by ! ,,pdp  

sponsor prior to swit*+ to ! l[] co/    
!rapeutic alt]native cov]$ "p ,d drug2 &
  7ii7 mu/ h agre$ to make su* swit*    
aft] consult+ ) _! physician4  7,b7     
,requirem5ts ) respect to ,,pdp sponsors
 ,! ,,pdp sponsor mu/--  7i7 make       
available a %>$ sav+s report ) !rapeutic
 alt]natives to eligible enrollees ?r\gh
 ,evid5ce ( ,b5efits or o!r in=mation   
s5t to enrollees1 or provide contract$  
provid]s ) access to tools t include    
!rapeutic alt]natives & %>$ sav+s at !  
po9t ( c>e2  7ii7 ensure t ! total am\nt
 ( sav+s %>$ ) an enrollee ) respect to 
! swit* to a p>ticul> l[] co/ !rapeutic 
alt]native cov]$ "p ,d drug does n exce$
 an am\nt equal to #aj p]c5t ( !        
annualiz$ net sav+s to ! ,,pdp sponsor z
 a result ( ! enrollee mak+ su* swit*2  
7iii7 only %>e su* sav+s aft] ! ,,pdp   
sponsor confirms1 bas$ on claims        
analysis1 t-- 7,i7 ! enrollee has swit*$
 to ! l[] co/ !rapeutic alt]native cov]$
 "p ,d drug2 &  7,,ii7 ! swit* does n   
result 9 an increas$ co/ to ! program "u

 ?is "p2  7iv7 provide a tangible rew>d 
or inc5tive = ! am\nt ( su* %>$ sav+s1  
:i*--  7,i7 %all directly b5efit !      
enrollee2  7,,ii7 su* sponsor may n--   
7aa7 use to r$uce plan premiums = !     
enrollee2 or  7bb7 direct an enrollee to
 use to pay su* premiums2 &  7,,iii7 may
 be 9 ! =m ( a monet>y rebate1 gift c>d1
 disc\nt c\pon1 or o!r item consi/5t ) !
 ,presid5t's ,executive ,ord] on        
,protect+ & ,improv+ ,m$ic>e = ,our     
,nation's ,s5iors1 issu$ on ,octob] #c1 
#bjai2 &  7v7 provide an annual report  
to ! ,secret>y1 ) respect to ! prec$+   
plan ye>1 on ! numb] ( enrollees :o     
receive %>$ sav+s "u ?is subsection z a 
result ( swit*+ to a l[] co/ !rapeutic  
alt]native cov]$ "p ,d drug1 ! total    
am\nt ( su* sav+s %>$ ) ! enrollee & 9  
:at =m1 & ! total sav+s to ! ,,pdp      
sponsor z a result ( enrollees mak+ su* 
swit*4  7#c7 ,au?ority to provide )     
respect to c]ta9 sub-populations or     
geographic areas ,a ,,pdp sponsor may   
provide %>$ sav+s pursuant to ?is       

subsection = only a c]ta9 sub-population
 ( enrollees or a geographically limit$ 
population ( enrollees if ! ,secret>y   
det]m9es1 bas$ on a %[+ by ! ,,pdp      
sponsor1 t ! ,,pdp sponsor is n         
discrim9at+ bas$ on ! heal? /atus (     
enrollees4  4  7b7 ,exclusion f         
anti-,kickback prohibition ,section     
#aabh;,b7b77#c7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #acbj;a-#g;b7b77#c77
 is am5d$-- 7#a7 9 subp>agraph 7,j7--   
7,a7 by mov+ su* subp>agraph #b ems to !
 left2 &  7,b7 by /rik+ & at ! end2     
7#b7 9 subp>agraph 7,k7-- 7,a7 by mov+  
su* subp>agraph #b ems to ! left2 &     
7,b7 by /rik+ ! p]iod at ! end & ins]t+ 
2 &2 &  7#c7 by add+ at ! end ! foll[+  
new subp>agraph3  7,l7 any %>$ sav+s    
provid$ "u section #ahfj;,d-#d7o74  4