,,ii  #aai? ,,congress  #a/ ,session    
,s4 #bggj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #aa1 #bjbe   
,mr4 ,cornyn 7= himself1 ,ms4 ,ros51    
,mr4 ,tillis1 & ,mr4 ,wel*7 introduc$ ! 
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to am5d title ,,xviii ( ! ,social      
,security ,act to ensure appropriate    
co/-%>+ = *ronic c>e drugs "u ,m$ic>e "p
 ,d4  #a4  ,%ort title  ,?is ,act may be
 cit$ z ! ,%>e ! ,sav+s ) ,s5iors ,act4 
#b4  ,appropriate co/-%>+ = *ronic c>e  
drugs "u ,m$ic>e "p ,d  7a7  ,9 g5]al   
,section #ahfj;,d-#b ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7 is am5d$--  7#a7 9         
subsection 7b7-- 7,a7 9 p>agraph        
7#a77;,a71 9 ! matt] prec$+ clause 7i71 
by /rik+ & 7#i7 & ins]t+ 1 7#i71 &      
7#aj72  7,b7 9 p>agraph 7#b77;,a71 9 !  
matt] prec$+ clause 7i71 by /rik+ & 7#i7
 & ins]t+ 1 7#i71 & 7#aj72 &  7,c7 by   
add+ at ! end ! foll[+ new p>agraph3    
7#aj7 ,co/-%>+ = *ronic c>e drugs  7,a7 

,9 g5]al ,= plan ye>s beg9n+ on or aft] 
,janu>y #a1 #bjbg1 9 ! case ( a *ronic  
c>e drug1 ! foll[+ %all apply3  7i7 ,=  
co/s bel[ ! annual d$uctible specifi$ 9 
p>agraph 7#a71 co/-%>+ = su* drug %all n
 exce$ ! net price ( su* drug4  7ii7    
,subject to subp>agraph 7,b71 = co/s    
above ! annual d$uctible specifi$ 9     
p>agraph 7#a7 & bel[ ! out-(-pocket     
?re%old specifi$ 9 p>agraph 7#d71 any   
co9surance am\nt = su* drug %all be bas$
 on a p]c5tage ( ! net price ( su* drug4
  7,b7  ,exception  ,! requirem5t "u    
subp>agraph 7,a77ii7 %all n apply to a  
*ronic c>e drug "u a prescription drug  
plan if ! co/-%>+ am\nt = su* drug "u   
su* plan is bas$ on a copaym5t t is n   
ti$ to a p]c5tage ( a drug price 7su* z 
! negotiat$ price1 li/ price1 or        
:olesale acquisition co/71 a drug b5*m>k
 price 7su* z ! av]age :olesale price71 
or a drug co/4  7,c7  ,def9itions  ,9   
?is p>agraph3 7i7 ,*ronic c>e drug ,!   
t]m *ronic c>e drug means a cov]$ "p ,d 
drug t is includ$ "u any ( ! foll[+     

,unit$ ,/ates ,ph>macopeia ,conv5tion   
7,,usp7 categories & classes ( drugs1 z 
includ$ 9 ! mo/ rec5t v]sion ( ! ,,usp  
,m$ic>e ,model ,guidel9es3  7,i7 ,blood 
glucose regulators1 o!r ?an insul9s4    
7,,ii7 ,anti-inflammatories1 inhal$     
cortico/]oids4  7,,iii7 ,bron*odilators1
 anti*ol9]gic4  7,,iv7 ,bron*odilators1 
sympa?omimetic4  7,v7 ,respiratory tract
 ag5ts1 o!r4  7,,vi7 ,anticoagulants4   
7,,vii7 ,c>diovascul> ag5ts1 o!r4       
7,,viii7 ,any category or class id5tifi$
 by ! ,secret>y or ,,usp z a successor  
to ! categories & classes describ$ 9    
subclauses 7,i7 ?r\gh 7,,vii7 bas$ on ! 
mo/ rec5t ,,usp ,m$ic>e ,model          
,guidel9es at ! "t ( su* id5tification4 
7ii7  ,net price  ,! t]m net price means
 ! negotiat$ price ( ! drug net ( all   
price concessions orig9at+ f            
manufactur]s t are receiv$ or expect$ to
 be receiv$ by ! plan or ph>macy b5efit 
manag] on behalf ( ! plan = su* product 
& t are n already reflect$ 9 ! negotiat$
 price4  2 &  7#b7 9 subsection 7c71 by 

add+ at ! end ! foll[+ new p>agraph3    
7#g7  ,co/-%>+ = cov]$ *ronic c>e drugs 
,! cov]age is provid$ 9 accordance )    
subsection 7b77#aj74  4  7b7  ,con=m+   
am5dm5ts to co/-,%>+ = l[-,income       
individuals  ,section                   
#ahfj;,d-#ad7;a77#a77;,d77iii7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#aad7;a77#a77;,d77iii77 is am5d$ 
by add+ at ! end ! foll[+ new s5t5ce3 ,=
 plan ye> #bjbg & subsequ5t plan ye>s1 !
 copaym5t am\nt applicable "u ! fir/    
s5t5ce ( ?is subclause = a *ronic drug  
7z def9$ 9 section                      
#ahfj;,d-#b7;b77#aj77;,b77 furni%$ to ! 
individual may n exce$ ! applicable     
co/-%>+ = su* drug "u ! prescription    
drug plan or ,,ma-,,pd plan 9 :i* !     
individual is enroll$44  7c7            
,regulations  ,not)/&+ any o!r provision
 ( law1 ! ,secret>y ( ,heal? & ,human   
,s]vices %all initially implem5t !      
am5dm5ts made by ?is section ?r\gh      
int]im f9al regulations4