[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6401 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 6401
To require the Secretary of Health and Human Services to submit to
Congress a report on the option to elect to pay cost-sharing under a
prescription drug plan or MA-PD plan in monthly capped amounts.
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IN THE HOUSE OF REPRESENTATIVES
December 3, 2025
Mrs. Kiggans of Virginia (for herself and Mr. Krishnamoorthi)
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
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A BILL
To require the Secretary of Health and Human Services to submit to
Congress a report on the option to elect to pay cost-sharing under a
prescription drug plan or MA-PD plan in monthly capped amounts.
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 ``Increasing Medication Access for
Seniors Act of 2025''.
SEC. 2. REPORTS ON MEDICARE PART D MONTHLY CAPPED COST-SHARING OPTION.
(a) Reports.--Not later than the date that is 3 months after the
date of the enactment of this section, not less frequently than every 3
months thereafter until the date that is 1 year after the date of the
enactment of this section, and not less frequently than annually
thereafter until March 31, 2031, the Secretary of Health and Human
Services (in this section referred to as the ``Secretary'') shall
submit to Congress a report on the option to elect to pay cost-sharing
under a prescription drug plan or MA-PD plan in monthly capped amounts
under section 1860D-2(b)(2)(E)(i) of the Social Security Act (42 U.S.C.
1395w-102(b)(2)(E)(i)), including, with respect to the 1-year period
ending on the date that is 1 year before the date on which the report
is required to be submitted--
(1) the number of Medicare part D enrollees who made such
an election during such period, including--
(A) the number of such enrollees residing in each
census region (as designated by the Bureau of the
Census);
(B) the number of such enrollees who are enrolled
in a prescription drug plan; and
(C) the number of such enrollees who are enrolled
in an MA-PD plan;
(2) an estimate of the number of Medicare part D enrollees
who did not make such an election and incurred out-of-pocket
costs with respect to covered part D drugs during such period
that make it likely such enrollees may benefit from making such
an election, as determined by the Secretary;
(3) a description of any steps taken by the Secretary
during such period to implement a mechanism to allow a Medicare
part D enrollee to make such election at the point-of-sale of a
covered part D drug, including information on how such a
mechanism may be made available for every Medicare part D
enrollee;
(4) a description of each method used by the Secretary
during such period to facilitate making such an election,
including--
(A) the Medicare.gov website;
(B) the notice distributed pursuant to section
1804(a) of the Social Security Act (42 U.S.C. 1395b-
2(a)) (commonly known as the Medicare & You handbook);
(C) the toll-free telephone number 1-800-MEDICARE;
and
(D) resources for health care providers; and
(5) a description of any other outreach efforts the
Secretary conducted with respect to such option during such
period, including outreach to--
(A) health care provider associations and
societies;
(B) patient and consumer advocacy groups that
represent Medicare part D enrollees;
(C) pharmacy benefit managers;
(D) pharmacies; and
(E) health insurance providers.
(b) Definitions.--In this section:
(1) Medicare part d enrollee.--The term ``Medicare part D
enrollee'' means an individual enrolled in a prescription drug
plan or MA-PD plan under part D of title XVIII of the Social
Security Act (42 U.S.C. 1395w-101 et seq.).
(2) Medicare part d terms.--The terms ``covered part D
drug'', ``prescription drug plan'', and ``MA-PD plan'' have the
meanings given each such term in part D of title XVIII of the
Social Security Act (42 U.S.C. 1395w-101 et seq.).
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