,,ii  #aagth ,,congress  #ast ,session  
,s4 #aacb  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,april #ae1    
#bjba,mr4 ,kennedy introduced the       
following bill2 which was read twice and
 referred to the ,committee on ,health1 
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to establish a cap on          
out-of-pocket costs for insulin4  #a4   
,short title ,this ,act may be cited as 
the ,ending ,pricey ,insulin ,act or the
 ,,epi ,act4  #b4 ,capping              
out-of-pockets cost of insulin  7a7     
,individuals enrolled in certain health 
plans ,title ,,xxvii of the ,public     
,health ,service ,act 7#db ,u4,s4,c4    
#cjj;gg et seq47 is amended by inserting
 after section #bgbi the following3     
#bgbi;,a4 ,coverage of insulin drugs    
,beginning with plan year #bjbb1 a group
 health plan or health insurance issuer 
offering group or individual health     
insurance coverage that provides        
coverage for prescription insulin drugs 
may not impose any deductible1          

copayment1 coinsurance1 or other        
cost-sharing requirement with respect to
 such drugs that results in             
out-of-pocket costs to the enrollee that
 exceed #ej per prescription for a      
#cj-;day supply of covered prescription 
insulin drugs1 regardless of the amount 
of insulin drugs needed to fill the     
enrollee's insulin prescriptions4  4    
7b7 ,individuals enrolled in other      
coverage  7#a7 ,medicare1 ,medicaid1 and
 ,,chip ,the ,secretary of ,health and  
,human ,services shall take such        
administrative action as is necessary to
 ensure that in no event shall any      
,state plan or waiver under title ,,xix 
or ,,xxi of the ,social ,security ,act  
or prescription drug plan under part ,d 
of title ,,xviii of such ,act or        
,,ma-,,pd plan under part ,c of such    
title of such ,act that provides        
coverage for prescription insulin drugs 
impose any deductible1 copayment1       
coinsurance1 or other cost-sharing      
requirement with respect to such drugs  

that results in out-of-pocket costs to  
an individual enrolled in such coverage 
that exceeds #ej per prescription for a 
#cj-;day supply of covered prescription 
insulin drugs1 regardless of the amount 
of insulin drugs needed to fill the     
enrollee's insulin prescriptions4  7#b7 
,veterans ,the ,secretary of ,veterans  
,affairs shall take such administrative 
action as is necessary to ensure that   
prescription insulin drugs written by   
eligible health care providers for      
veterans do not impose any deductible1  
copayment1 coinsurance1 or other        
cost-sharing requirement with respect to
 such drugs that results in             
out-of-pocket costs to the veteran that 
exceeds #ej per prescription for a      
#cj-;day supply of covered prescription 
insulin drugs1 regardless of the amount 
of insulin drugs needed to fill the     
veteran's insulin prescriptions4 ,for   
purposes of the preceding sentence1 the 
term eligible health care provider means
 a health care provider under section   

#agjc7;c7 of title #ch1 ,united ,states 
,code1 or an eligible entity or provider
 under section #agjc;,a7b7 of such      
title4  7#c7 ,,tricare ,the ,secretary  
of ,defense shall take such             
administrative action as is necessary to
 ensure that prescription insulin drugs 
written by health care providers for    
enrollees in the ,,tricare program under
 chapter #ee of title #aj1 ,united      
,states ,code1 do not impose any        
deductible1 copayment1 coinsurance1 or  
other cost-sharing requirement with     
respect to such drugs that results in   
out-of-pocket costs to enrollees that   
exceeds #ej per prescription for a      
#cj-;day supply of covered prescription 
insulin drugs1 regardless of the amount 
of insulin drugs needed to fill the     
enrollee's insulin prescriptions4  #c4  
,cap on cash price for insulin for      
individuals without health insurance    
,beginning on ,january #a1 #bjbb1 in the
 case of an individual who is not       
enrolled in any public or private health

 plan1 the cash price for a #cj-;day    
supply of such individual's prescription
 insulin drugs1 regardless of the amount
 of insulin drugs needed to fill the    
individual's insulin prescriptions1     
shall be not more than #ej4  #d4        
,retroactive effect ,in the event that  
this ,act is enacted after ,january #a1 
#bjbb-- 7#a7 any out-of-pocket cost to  
an enrollee for insulin in plan year    
#bjbb or a subsequent plan year that is 
in excess of the amount specified in    
section #bgbi;,a of the ,public ,health 
,service ,act 7as added by section #b7  
shall be reimbursed by the group health 
plan or health insurance issuer to the  
enrollee2  7#b7 any amount paid by an   
uninsured individual for insulin on or  
after ,january #a1 #bjbb1 that is in    
excess of the amount specified in       
section #c shall be reimbursed by the   
insulin manufacturer to the individual2 
and  7#c7 any amount paid by an enrollee
 or veteran for insulin on or after     
,january #a1 #bjbb1 that is in excess of

 the amount specified in paragraph 7#a7 
7#b71 or 7#c71 as applicable1 of section
 #b7;b7 shall be reimbursed by the      
,secretary of ,health and ,human        
,services1 the ,secretary of ,veterans  
,affairs1 or the ,secretary of ,defense1
 as applicable1 to the enrollee or      
veteran4