[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2554 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 2554
To amend title XVIII of the Social Security Act to apply prescription
drug inflation rebates to drugs furnished in the commercial market and
to change the base year for rebate calculations.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 1, 2025
Mr. Horsford (for himself, Mrs. Cherfilus-McCormick, and Mr. Johnson of
Georgia) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to apply prescription
drug inflation rebates to drugs furnished in the commercial market and
to change the base year for rebate calculations.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Lower Drug Costs for Families Act''.
SEC. 2. APPLICATION OF PRESCRIPTION DRUG INFLATION REBATES TO DRUGS
FURNISHED IN THE COMMERCIAL MARKET.
(a) Part B Drugs.--
(1) Application of prescription drug inflation rebates to
drugs furnished in the commercial market.--Section 1847A(i) of
the Social Security Act (42 U.S.C. 1395w-3a(i)) is amended--
(A) in paragraph (1)(A)(i), by striking ``units''
and inserting ``billing units'';
(B) in paragraph (2)(A), by striking ``for which
payment is made under this part'' and inserting ``that
would be payable under this part if such drug were
furnished to an individual enrolled under this part'';
(C) in paragraph (3)--
(i) in subparagraph (A)(i), by striking
``units'' and inserting ``billing units''; and
(ii) by striking subparagraph (B) and
inserting the following:
``(B) Total number of billing units.--For purposes
of subparagraph (A)(i), the total number of billing
units with respect to a part B rebatable drug is
determined as follows:
``(i) Determine the total number of units
equal to--
``(I) the total number of units, as
reported under subsection (c)(1)(B) for
each National Drug Code of such drug
during the calendar quarter that is two
calendar quarters prior to the calendar
quarter as described in subparagraph
(A), minus
``(II) the total number of units
with respect to each National Drug Code
of such drug for which payment was made
under a State plan under title XIX (or
waiver of such plan), as reported by
States under section 1927(b)(2)(A) for
the rebate period that is the same
calendar quarter as described in
subclause (I).
``(ii) Convert the units determined under
clause (i) to billing units for the billing and
payment code of such drug, using a methodology
similar to the methodology used under this
section, by dividing the units determined under
clause (i) for each National Drug Code of such
drug by the billing unit for the billing and
payment code of such drug.
``(iii) Compute the sum of the billing
units for each National Drug Code of such drug
in clause (ii).''.
(2) Change of base year for rebate calculation.--Section
1847A(i) of the Social Security Act (42 U.S.C. 1395w-3a(i)) is
amended--
(A) in paragraph (3)--
(i) in subparagraph (D), by striking ``July
1, 2021'' and inserting ``July 1, 2016''; and
(ii) in subparagraph (E), by striking
``January 2021'' and inserting ``January
2016''; and
(B) in paragraph (4)--
(i) in subparagraph (A)--
(I) by striking ``December 1,
2020'' and inserting ``December 31,
2015''; and
(II) by striking ``January 2021''
and inserting ``January 2016'';
(ii) in subparagraph (B), by striking
``December 1, 2020'' and inserting ``December
31, 2015''; and
(iii) in subparagraph (C), by striking
``January 2021'' and inserting ``January
2016''.
(3) Effective date.--The amendments made by this subsection
shall apply with respect to calendar quarters beginning on or
after January 1, 2026.
(b) Covered Part D Drugs.--
(1) Application of prescription drug inflation rebates to
drugs furnished in the commercial market.--Section 1860D-14B of
the Social Security Act (42 U.S.C. 1395w-114b) is amended--
(A) in subsection (b)--
(i) in paragraph (1)--
(I) in subparagraph (A)(i), by
striking ``the total number of units''
and all that follows through the
semicolon and inserting the following:
``the total number of units that are
used to calculate the average
manufacturer price of such dosage form
and strength with respect to such part
D rebatable drug, as reported by the
manufacturer of such drug under section
1927 for each month, with respect to
such period;''; and
(II) by striking subparagraph (B)
and inserting the following:
``(B) Excluded units.--For purposes of subparagraph
(A)(i), the Secretary shall exclude from the total
number of units for a dosage form and strength with
respect to a part D rebatable drug, with respect to an
applicable period, the following:
``(i) Units of each dosage form and
strength of such part D rebatable drug for
which payment was made under a State plan under
title XIX (or waiver of such plan), as reported
by States under section 1927(b)(2)(A).
``(ii) Units of each dosage form and
strength of such part D rebatable drug for
which a rebate is paid under section 1847A(i).
``(iii) Beginning with plan year 2026,
units of each dosage form and strength of such
part D rebatable drug for which the
manufacturer provides a discount under the
program under section 340B of the Public Health
Service Act.''; and
(ii) in paragraph (6), by striking
``information.--The Secretary'' and all that
follows through ``rebatable covered part D drug
dispensed'' and inserting the following: ``AMP
reports.--The Secretary shall provide for a
method and process under which, in the case of
a manufacturer of a part D rebatable drug that
submits revisions to information submitted
under section 1927 by the manufacturer with
respect to such drug''; and
(B) by striking subsection (d) and inserting the
following:
``(d) Information.--For purposes of carrying out this section, the
Secretary shall use information submitted by manufacturers under
section 1927(b)(3) and information submitted by States under section
1927(b)(2)(A).''.
(2) Change of base year for rebate calculation.--Section
1860D-14B of the Social Security Act (42 U.S.C. 1395w-114b) is
amended--
(A) in subsection (b)(5)--
(i) in subparagraph (A)--
(I) by striking ``October 1, 2021''
and inserting ``October 1, 2016''; and
(II) by striking ``January 2021''
and inserting ``January 2016''; and
(ii) in subparagraph (C), by striking
``January 2021'' and inserting ``January
2016''; and
(B) in subsection (g)--
(i) in paragraph (3)--
(I) by striking ``January 1, 2021''
and inserting ``January 1, 2016''; and
(II) by striking ``October 1,
2021'' and inserting ``October 1,
2016''; and
(ii) in paragraph (4), by striking
``January 2021'' and inserting ``January
2016''.
(3) Effective date.--The amendments made by this subsection
shall take apply with respect to applicable periods (as defined
in section 1860D-14B(g)(7) of the Social Security Act (42
U.S.C. 1395w-114b(g)(7))) beginning on or after October 1,
2025.
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