,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #fgeg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,febru>y #ah1         
#bjbb,mr4 ,burgess 7= himself & ,mrs4   
,mill]-,meeks7 introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
e/abli% "u ! ,m$ic>e prescription drug  
program a m9imum am\nt ( price          
concessions = insul9 to be pass$ ?r\gh  
to b5efici>ies at ! po9t-(-sale1 & = o!r
 purposes4  #a4 ,%ort title ,?is ,act   
may be cit$ z ! ,insul9 ,sav+s =        
,pati5ts ,act 4  #b4 ,negotiat$ price   
concessions = insul9 at po9t-(-sale "u  
"p ,d ( ,m$ic>e program  7a7 ,9 g5]al   
,section #ahfj;,d-#b7;d77#a7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#ajb7;d77#a77 is am5d$-- 7#a7 9  

subp>agraph 7,a71 by /rik+ ,"u & ins]t+ 
,subject to subp>agraph 7,d71 "u2 &     
7#b7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,d7 ,negotiat$ price     
concessions = insul9 at po9t-(-sale  7i7
 ,9 g5]al ,= drugs disp5s$ 9 plan ye>   
#bjbb or a subsequ5t plan ye>1 ! m9imum 
p]c5tage describ$ 9 clause 7ii7 = su*   
plan ye> ( price concessions negotiat$  
betwe5 manufactur]s & a prescription    
drug plan or ,,ma-,,pd plan 7or any     
entity t provides ph>macy b5efits       
managem5t s]vices "u a contract ) any   
su* prescription drug plan or ,,ma-,,pd 
plan7 & tak5 into acc\nt "u subp>agraph 
7,b7 9 det]m9+ negotiat$ prices = ! plan
 ye> = cov]$ "p ,d drugs t are insul9   
provid$ "u su* a plan %all be provid$ to
 enrollees ( su* a plan at ph>macies or 
by mail ord] s]vice at ! po9t-(-sale (  
su* drugs4  7ii7 ,am\nt ( price         
concession ,= purposes ( clause 7i71 &  
subject to clause 7iii71 ! m9imum       
p]c5tage describ$ 9 ?is clause is-- 7,i7
 = drugs disp5s$ 9 plan ye> #bjbb1 #ej  

p]c5t2  7,,ii7 = drugs disp5s$ 9 plan   
ye> #bjbc1 #ge p]c5t2 &  7,,iii7 = drugs
 disp5s$ 9 plan ye> #bjbd or a subsequ5t
 plan ye>1 #ajj p]c5t4  7iii7           
,modification ( m9imum p]c5tage ,= plan 
ye>s beg9n+ on or aft] ,janu>y #a1      
#bjbd1 ! ,secret>y may1 ?r\gh notice &  
comm5t rulemak+1 specify a p]c5tage o!r 
?an ! p]c5tage describ$ 9 clause 7ii7 = 
a plan ye>1 except t 9 specify+ su*     
p]c5tage ! ,secret>y %all n specify a   
p]c5tage t is less ?an #ej p]c5t ( !    
negotiat$ price concession = su* plan   
ye>4 ,any p]c5tage specifi$ pursuant to 
! au?ority ( ! previ\s s5t5ce = a plan  
ye> t w\ld be less ?an ! p]c5tage       
o!rwise describ$ 9 clause 7ii7 = ! plan 
ye> may only be appli$ if su* r$uction 9
 p]c5tage is ju/ifi$ z a b5efit to      
individuals enroll$ "u ?is title4  4    
7b7 ,inclusion ( in=mation 9 bid        
submission ,section #ahfj;,d-#aa7;b77#b7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciew-#aa7;b77#b77 is am5d$--
 7#a7 by r$esignat+ subp>agraph 7,f7 z  

subp>agraph 7,g72 &  7#b7 by ins]t+ aft]
 subp>agraph 7,e7 ! foll[+ new          
subp>agraph3  7,f7 ,po9t-(-sale price   
concessions = insul9 ,= plan ye>s beg9n+
 on or aft] ,janu>y #a1 #bjbb1 an       
e/imate ( ! aggregate price concessions 
= all insul9 negotiat$ by ! plan = su*  
plan ye>4  4  7c7 ,,gao /udy & report on
 insul9 pric+ ,n lat] ?an #b ye>s aft] !
 date ( ! enactm5t ( ?is ,act1 &        
annually !reaft]1 ! ,comptroll] ,g5]al (
 ! ,unit$ ,/ates %all-- 7#a7 conduct a  
/udy on ! effects ( ! implem5tation ( ! 
requirem5t describ$ 9 subp>agraph 7,d7 (
 section #ahfj;,d-#b7;d77#a7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#ajb7;d77#a771 z add$ by         
subsection 7a71 includ+ an analysis (-- 
7,a7 tr5ds 9 ! li/ & net prices ( insul9
 = qualifi$ prescription drug cov]age   
(f]$ by a prescription drug plan "u "p  
,d ( ! ,social ,security ,act or an     
,,ma-,,pd plan "u "p ,c ( su* title2    
7,b7 sav+s on insul9 = individuals      
enroll$ 9 a prescription drug plan "u "p

 ,d ( ! ,social ,security ,act or an    
,,ma-,,pd plan "u "p ,c ( su* title2    
7,c7 tr5ds 9 out-(-pocket co/s =        
individuals enroll$ 9 su* plans1 z      
comp>$ to individuals enroll$ 9 a gr\p  
heal? plan 7z def9$ 9 section #bgia7;a7 
( ! ,public ,heal? ,s]vice ,act 7#db    
,u4,s4,c4 #cjj;gg-#ia7;a771 a ,/ate plan
 "u title ,,xix ( ! ,social ,security   
,act1 or a qualifi$ heal? plan (f]$     
?r\gh an ,ex*ange e/abli%$ "u title ,i (
 ! ,pati5t ,protection & ,af=dable ,c>e 
,act 7#db ,u4,s4,c4 #ahjja et seq472 &  
7,d7 approval & m>ket entry ( biosimil> 
insul9 "u section #cea7k7 ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bfb72 &  7#b7 submit to ! ,committee on
 ,en]gy & ,comm]ce & ! ,committee on    
,ways & ,means 9 ! ,h\se (              
,repres5tatives1 & ! ,committee on      
,f9ance 9 ! ,s5ate1 a report on ! /udy  
conduct$ "u p>agraph 7#a71 )            
recomm5dations on h[ to enhance ! access
 ( individuals enroll$ 9 a prescription 
drug plan "u "p ,d ( ! ,social ,security

 ,act or an ,,ma-,,pd plan "u "p ,c (   
su* title to l[] out-(-pocket co/s =    
insul94  7d7 ,transp>5cy ,section       
#ahfj;,d-#a7;c77#c7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#aciew-#aja7;c77#c77 is am5d$ by add+ at
 ! end ! foll[+ new subp>agraph3  7,c7  
,additional in=mation ,= plan ye> #bjbb 
& ea* subsequ5t plan ye>1 su* in=mation 
ref]r$ to 9 p>agraph 7#b77;,a7 %all also
 include1 = a plan ye>1 in=mation reg>d+
 ! requirem5t describ$ 9 subp>agraph    
7,d7 ( section #ahfj;,d-#b7;d77#a7 )    
respect to insul9 negotiat$ by ! plan = 
su* plan ye>4  4