,,ii  #aai? ,,congress  #a/ ,session    
,s4 #hfd  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,m>* #e1 #bjbe,mr4     
,m>%all 7= himself1 ,mr4 ,ka9e1 ,mr4    
,tillis1 ,mr4 ,m>key1 ,ms4 ,murk[ski1 & 
,mr4 ,m]kley7 introduc$ ! foll[+ bill2  
:i* 0 read twice & ref]r$ to !          
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions  ,a ,,bill  ,to am5d 
title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act to apply f9ancial assi/ance t[>ds 
! co/-%>+ requirem5ts ( heal? insurance 
plans1 & = o!r purposes4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,help   
,ensure ,l[] ,pati5t ,copays ,act or !  
,,help ,copays ,act4  #b4 ,application (
 f9ancial assi/ance t[>d co/-%>+        
requirem5ts  7a7 ,application t[>d      
co/-,%>+ requirem5ts ,section           
#bgae7;g77#a7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4                    
#cjj;gg-#ae7;g77#a77 is am5d$ by add+ at
 ! end ! foll[+3 ,9 develop+ ! /&>ds =  
def9+ ! t]ms d$uctible1 co9surance1     
copaym5t1 & out-(-pocket limit 7z       

describ$ 9 p>agraph 7#b771 su* /&>ds    
%all provide t su* t]ms include am\nts  
paid by1 or on behalf (1 an individual  
enroll$ 9 a gr\p heal? plan or gr\p or  
individual heal? insurance cov]age1     
includ+ f9ancial assi/ance (f]$ by      
non-pr(it organizations & prescription  
drug manufactur]s1 & t su* am\nts %all  
be c\nt$ t[>d su* d$uctible1 co9surance1
 copaym5t1 or limit1 respectively44  7b7
 ,con=m+ am5dm5ts  7#a7 ,,ppaca ,section
 #acjb7;c77#c7 ( ! ,pati5t ,protection &
 ,af=dable ,c>e ,act 7#db ,u4,s4,c4     
#ahjbb7;c77#c77 is am5d$ by add+ at !   
end ! foll[+ new subp>agraph3  7,c7     
,application ( t]ms ,= purposes (       
subp>agraph 7,a71 ! t]ms d$uctible1     
co9surance1 copaym5t1 or simil> *>ge &  
any o!r exp5diture describ$ 9 clause    
7ii7 ( su* subp>agraph %all include     
am\nts paid by1 or on behalf (1 an      
individual enroll$ 9 a gr\p heal? plan  
or gr\p or individual heal? insurance   
cov]age1 includ+ f9ancial assi/ance (f]$
 by non-pr(it organizations &           

prescription drug manufactur]s1 & su*   
am\nts %all be c\nt$ t[>d su* d$uctible1
 co-insurance1 co-paym5t1 *>ge1 or o!r  
exp5diture1 respectively4  4  7#b7      
,,phsa ,section #bgjg7;b7 ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg-#f7;b77 is am5d$ by add+ at !   
end ! foll[+ new s5t5ce3 ,= purposes ( !
 previ\s s5t5ce1 su* limitation %all be 
appli$ to prescription drugs z if !     
ref]5ce to ess5tial heal? b5efits 9     
section #acjb7;c77#c7 ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act 7 a   
ref]5ce to any item or s]vice cov]$ "u !
 plan includ$ )9 ! prescription drug    
category ( ess5tial heal? b5efits z     
describ$ 9 7b77#a77;,f7 ( su* section44 
7#c7 ,int]nal ,rev5ue ,code ( #aihf safe
 h>bor = c]ta9 am\nts appli$ to         
d$uctibles ,section #bbc7;c77#b7 ( !    
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by add+ at ! end ! foll[+ new           
subp>agraph3  7,h7 ,safe h>bor = c]ta9  
am\nts appli$ to d$uctibles ,9 ! case ( 
plan ye>s beg9n+ aft] ,decemb] #ca1     

#bjbe1 a plan %all n fail to be treat$ z
 a high d$uctible heal? plan by reason (
 c\nt+ am\nts paid by1 or on behalf (1  
an individual1 includ+ f9ancial         
assi/ance (f]$ by non-pr(it             
organizations & prescription drug       
manufactur]s = outpati5t prescription   
drugs1 :5 det]m9+ :e!r ! m9imum         
d$uctible "u subp>agraph 7,a7 has be5   
satisfi$4  4  7c7 ,rule ( con/ruction ,!
 am5dm5ts made by ?is section %all --   
7#a7 apply to /&>ds relat+ to           
d$uctibles1 co9surance1 copaym5ts1 or   
limits ) respect to prescription drugs t
 are specialty drugs2  7#b7 apply to    
/&>ds relat+ to d$uctibles1 co9surance1 
copaym5ts1 or limits ) respect to drugs 
t are subject to utilization managem5t2 
&  7#c7 n impact ! use ( utilization    
managem5t tools1 includ+ prior          
au?orization & /ep !rapy4  7d7          
,effective date ,?is section1 & !       
am5dm5ts made by ?is section1 %all apply
 to gr\p heal? plans & heal? insurance  
issu]s = plan ye>s beg9n+ on or aft]    

,janu>y #a1 #bjbf4