,,ii  #aafth ,,congress  #b;d ,session  
,s4 #cdff  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #ab1    
#bjbj,ms4 ,mc,sally 7for herself and    
,mr4 ,jones7 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 eliminate cost       
sharing for biosimilar biological       
products furnished under part ,b of the 
,medicare program during the first #e   
years such products are marketed4  #a4  
,short title ,this ,act may be cited as 
the ,acting to ,cancel ,copays and      
,ensure ,substantial ,savings for       
,biosimilars ,act of #bjbj or the       
,,access for ,biosimilars ,act of #bjbj4
  #b4 ,eliminating cost sharing for     
biosimilar biological products furnished
 under part ,b of the ,medicare program 
,section #ahcc of the ,social ,security 
,act 7#db ,u4,s4,c4 #aciel7 is amended--
 7#a7 in subsection 7a77#a77,s71 by     
inserting 7or1 in the case of such a    

biological that is a specified          
biosimilar biological product 7as       
defined in subsection 7cc77 furnished   
during a year 7beginning with #bjba7 to 
an individual who is a cost-sharing     
reduction eligible individual 7as       
defined in such subsection7 with respect
 to such year1 #ajj percent7 after #hj  
percent2 and  7#b7 by adding at the end 
the following new subsection3  7cc7     
,specified biosimilar biological product
 reduced cost-,sharing provisions  7#a7 
,definitions  7,a7 ,cost-sharing        
reduction eligible individual defined   
,for purposes of subsection 7a77#a77,s7 
and with respect to a year1 the term    
cost-sharing reduction eligible         
individual means an individual who1 as  
of ,january #a of such year-- 7i7 is    
enrolled under this part2 and  7ii7 does
 not have qualifying coverage 7as       
defined in subparagraph 7,b774  7,b7    
,qualifying coverage  7i7 ,in general   
,for purposes of subparagraph 7,a71 the 
term qualifying coverage means1 with    

respect to an individual1 coverage--    
7,i7 under-- 7aa7 a group health plan or
 health insurance coverage 7as such     
terms are defined in section #bgia of   
the ,public ,health ,service ,act72     
7bb7 a ,federal health care program 7as 
defined in section #aabh;,b7f771 other  
than the program established under this 
title2  7cc7 the health insurance       
program under chapter #hi of title #e1  
,united ,states ,code2  7dd7 a medicare 
supplemental policy under section #ahhb2
 or  7ee7 an ,,ma or ,,ma-,,pd plan2 and
  7,,ii7 that meets-- 7aa7 in the case  
of coverage described in any of items   
7aa7 through 7dd7 of subclause 7,i71 the
 condition described in clause 7ii72 and
  7bb7 in the case of coverage described
 in item 7ee7 of subclause 7,i71 the    
condition described in clause 7iii74    
7ii7 ,condition for coverage other than 
part ,c coverage ,for purposes of clause
 7i77,,ii77aa71 the condition described 
in this clause1 with respect to an      
individual enrolled in coverage         

described in any of items 7aa7 through  
7dd7 of clause 7i77,i7 during a year1 is
 that such coverage provides for the    
payment of all cost sharing owed by such
 individual under this part 7or1 if     
applicable1 under an ,,ma or ,,ma-,,pd  
plan7 with respect to a specified       
biosimilar biological product 7as       
defined in subparagraph 7,c77 furnished 
under this part 7or1 if applicable1     
under an ,,ma or ,,ma-,,pd plan7 during 
such year1 not taking into account the  
application of any deductible under such
 coverage4  7iii7 ,condition for part ,c
 coverage ,for purposes of clause       
7i77,,ii77bb71 the condition described  
in this clause1 with respect to an      
individual enrolled in an ,,ma or       
,,ma-,,pd plan during a year1 is that   
such plan provides for no cost sharing  
for such individual with respect to a   
specified biological biosimilar product 
7as defined in subparagraph 7,c77       
furnished under such plan during such   
year4  7,c7 ,specified biosimilar       

biological product ,for purposes of     
subsection 7a77#a77,s71 the term        
specified biosimilar biological product 
means a biosimilar biological product   
7as defined in subsection 7c77#f7 of    
section #ahdg;,a7-- 7i7 for which the   
payment amount determined under         
subsection 7b77#h7 of such section for  
such product is less than the payment   
amount determined under subsection      
7b77#d7 of such section for the         
reference biological product 7as defined
 in subsection 7c77#f7 of such section72
 and  7ii7 that is furnished during the 
#e-year period beginning on the later   
of-- 7,i7 ,january #a1 #bjba2 or  7,,ii7
 the date on which the biosimilar       
biological product is first marketed4   
7#b7 ,determinations ,the ,secretary    
shall establish a process-- 7,a7 for    
determining whether an individual is a  
cost-sharing reduction eligible         
individual for a year2 and  7,b7 for    
notifying ,,ma organizations of such a  
determination made with respect to an   

individual enrolled under an ,,ma plan  
or ,,ma-,,pd plan offered by such       
organization during such year4  4