,,ii  #aaith ,,congress  #ast ,session  
,s4 #fid  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,february #bd1      
#bjbe,mr4 ,tillis 7for himself and ,mr4 
,kelly7 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 provide a phase-in for
 plasma-derived products under the      
manufacturer discount program4  #a4     
,short title ,this ,act may be cited as 
the ,preserving ,life-saving ,access to 
,specialty ,medicines in ,america ,act  
or the ,,plasma ,act4  #b4 ,phase-in for
 plasma-derived products under          
manufacturer discount program ,section  
#ahfj;,d-#ad;,c7g77#d7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#aciew-#aad;c7g77#d77 is amended-- 7#a7 
in subparagraph 7,a71 in the matter     
preceding clause 7i71 by striking and   
7,c7 and inserting 1 7,c71 and 7,d72    
7#b7 by redesignating subparagraphs 7,d7
 and 7,e7 as subparagraphs 7,e7 and     

7,f71 respectively2 and  7#c7 by        
inserting after subparagraph 7,c7 the   
following3  7,d7 ,phase-in for          
plasma-derived products  7i7 ,in general
 ,for #bjbf and subsequent years1       
subject to clause 7iv71 in the case of  
an applicable drug of a manufacturer    
that is a plasma-derived product 7as    
defined in clause 7ii771 and that is    
marketed as of ,august #af1 #bjbb1 and  
dispensed for an applicable beneficiary1
 the term discounted price means the    
specified plasma-derived product percent
 7as defined in clause 7iii77 of the    
negotiated price of the applicable drug 
of the manufacturer4  7ii7              
,plasma-derived product ,in this        
subparagraph1 the term plasma-derived   
product means an applicable drug that is
 a biological product that is derived   
from human whole blood or plasma4  7iii7
 ,specified plasma-derived product      
percent ,in this subparagraph1 the term 
specified plasma-derived product percent
 means1 with respect to a year-- 7,i7   

for an applicable drug that is a        
plasma-derived product dispensed for an 
applicable beneficiary who has not      
incurred costs1 as determined in        
accordance with section                 
#ahfj;,d-#b7;b77#d77;,c71 for covered   
part ,d drugs in the year that are equal
 to or exceed the annual out-of-pocket  
threshold specified in section          
#ahfj;,d-#b7;b77#d77;,b77i7 for the     
year-- 7aa7 for #bjbf1 #ii percent2     
7bb7 for #bjbg1 #ih percent2  7cc7 for  
#bjbh1 #ie percent2  7dd7 for #bjbi1 #ib
 percent2 and  7ee7 for #bjcj and each  
subsequent year1 #ij percent2 and       
7,,ii7 for an applicable drug that is a 
plasma-derived product dispensed for an 
applicable beneficiary who has incurred 
costs1 as determined in accordance with 
section #ahfj;,d-#b7;b77#d77;,c71 for   
covered part ,d drugs in the year that  
are equal to or exceed the annual       
out-of-pocket threshold specified in    
section #ahfj;,d-#b7;b77#d77;,b77i7 for 
the year-- 7aa7 for #bjbf1 #ii percent2 

7bb7 for #bjbg1 #ih percent2  7cc7 for  
#bjbh1 #ie percent2  7dd7 for #bjbi1 #ib
 percent2  7ee7 for #bjcj1 #ij percent2 
7ff7 for #bjca1 #he percent2 and  7gg7  
for #bjcb and each subsequent year1 #hj 
percent4  7iv7 ,limitations ,this       
subparagraph shall not apply with       
respect to the following3 7,i7 ,certain 
drugs dispensed to ,,lis beneficiaries  
,an applicable drug described in        
subparagraph 7,b77i74  7,,ii7 ,specified
 small manufacturers ,an applicable drug
 described in subparagraph 7,c77i74  4