Prescription Drugs
US Congress 116th Congress
CURE High Drug Prices Act Combatting Unreasonable Rises and Excessively High Drug Prices Act [S.637]
Prohibits price gouging by manufacturers of prescription drugs (including a combination of a drug, device, or biological product) that are covered by a federal health care program. The bill specifies percentage increases in price at which price gouging is presumed.
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Treat and Reduce Obesity Act of 2019 [S.595]
Expands Medicare coverage of intensive behavioral therapy for obesity. Specifically, the bill allows coverage for therapy that is provided by (1) a physician who is not a primary care physician; or (2) other health care providers (e.g., physician assistants and nurse practitioners) and approved counseling programs, if provided upon a referral from, and in coordination with, a physician or primary care practitioner. Currently, such therapy is covered only if provided by a primary care practitioner. The bill also allows coverage under Medicare's prescription
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Medicare for All Act of 2019 [HB-1384]
Establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). Among other requirements, the program must (1) cover all U.S. residents; (2) provide for automatic enrollment of individuals upon birth or residency in the United States; and (3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance abuse treatment, dental and
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Medicare for All Act of 2019 [HB-1384]
Establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS). Among other requirements, the program must (1) cover all U.S. residents; (2) provide for automatic enrollment of individuals upon birth or residency in the United States; and (3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance abuse treatment, dental and
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REFUND Act of 2019 Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 [S.551]
Requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) in relation to discarded amounts (i.e., amounts remaining after administration) of single-dose vial drugs that are covered under Medicare. Manufacturers that fail to comply are subject to civil penalties. The CMS must determine rebate amounts based on payment claims from providers. (Currently, providers may receive payment under Medicare for discarded amounts of single-dose vial drugs through the use of a specific claims modifier.)
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Competitive DRUGS Act of 2019 Competitive Deals Resulting in Unleashed Generics and Savings Act of 2019 [HB-1344]
To prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market, and for other purposes.
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Territories Health Equity Act of 2019 [HB-1354]
Alters provisions under Medicaid, Medicare, and Medicare Advantage relating to U.S. territories, and generally modifies and establishes programs to expand health insurance coverage for residents. Among other things, the bill eliminates Medicaid funding limitations for U.S. territories beginning in FY2020; repeals provisions that exclude residents of Puerto Rico from a certain automatic enrollment process for Medicare medical services; establishes minimum criteria for certain elements used in Medicare Advantage payment calculations for areas within
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Medicare Buy-In and Health Care Stabilization Act of 2019 [HB-1346]
Establishes a Medicare buy-in option for certain qualifying individuals and makes a series of other changes relating to health care costs. Specifically, the bill allows individuals aged 50 to 64 to enroll in Medicare if such individuals would otherwise qualify for Medicare at the age of 65. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations
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To address the high costs of health care services, prescription drugs, and health insurance coverage in the United States, and for other purposes. [HB-1332]
Addresses the health care system, including Medicare, Medicaid, the private health insurance market, and the prescription drug approval process. The bill also revises tax provisions related to certain health care costs and establishes requirements for lawsuits involving health care provided, at least in part, through a federal program or with federal funds.
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Rural Hospital Frontier Fairness Act [HB-1323]
Alters the Medicare prospective payment system for inpatient hospital services furnished at sole community hospitals (i.e., rural hospitals or hospitals that are the sole source of inpatient care in a certain geographic area). Specifically, the bill applies a minimum area wage adjustment to payments to sole community hospitals that are located up to 75 miles from the closest frontier (i.e., predominantly rural) state. Currently, the minimum area wage adjustment applies only to hospitals in frontier states. The bill also allows such sole community
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Prescription Drug Monitoring Act of 2019 [S.516]
Expands the notification and reporting requirements with respect to potentially addictive prescription drugs for states receiving funds for a Prescription Drug Monitoring Program (PDMP). Dispensers of these drugs, which includes substances listed in schedule II, III, or IV of the Controlled Substances Act, must consult with the PDMP before starting treatment involving such drugs and report each prescription of such drugs to the PDMP within 24 hours.The state agency administering a PDMP must analyze reported data for patterns of controlled substance
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Payment Commission Data Act of 2019 [HB-1264]
Allows certain payment information relating to covered drugs under the Medicare prescription drug benefit and Medicaid to be disclosed to additional entities. Specifically, certain subsidy and rebate information, as reported by prescription drug plan sponsors and drug manufacturers, may be disclosed to the Medicare Payment Advisory Commission and the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission, in accordance with specified confidentiality restrictions.
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Stopping the Pharmaceutical Industry from Keeping drugs Expensive (SPIKE) Act of 2019 [S.474]
Requires manufacturers of drugs with specified percentage increases in their wholesale costs to submit to the Centers for Medicare & Medicaid Services (CMS) written justification for certain increases in drug prices. The CMS shall publish each submission, together with an easily understandable summary, on its website. Certain proprietary information may be excluded from publication, as specified by the bill. A manufacturer that does not comply with the bill's requirements shall be subject to civil monetary penalties.
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Creating Transparency to Have Drug Rebates Unlocked (C–THRU) Act of 2019 [S.476]
Establishes a series of requirements relating to drug rebates and discounts under Medicare and Medicare Advantage (MA). Specifically, for each pharmacy benefits manager (PBM) that contracts with a prescription drug plan (PDP) under Medicare or MA, or with a qualified health benefits plan offered through a health insurance exchange, HHS must publish on its website (1) the amount and type of rebates and discounts negotiated by the PBM and the extent to which these rebates and discounts are passed on to the plan sponsor, and (2) the difference between
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Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 RxCAP Act of 2019 [S.475]
Eliminates beneficiary cost-sharing above the Medicare prescription drug benefit's annual out-of-pocket threshold beginning in plan year 2020. Under current law, the Medicare prescription drug benefit provides coverage above that threshold only with cost-sharing in the form of either copayment or coinsurance.
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Medicare at 50 Act [S.470]
Establishes a Medicare buy-in option for certain qualifying individuals and also repeals restrictions relating to prescription drug prices under the Medicare prescription drug benefit. Specifically, the bill allows individuals aged 50 to 64 to enroll in Medicare if such individuals would otherwise qualify for Medicare at the age of 65. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also
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FLAT Prices Act Forcing Limits on Abusive and Tumultuous Prices [HB-1188]
To shorten monopoly periods for prescription drugs that are the subjects of sudden price hikes.
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Budgeting for Opioid Addiction Treatment Act [S.425]
Imposes a one cent per milligram fee on the sale of active opioids by the manufacturer, producer, or importer. The fee excludes prescription drugs used exclusively for the treatment of opioid addiction as part of a medically assisted treatment effort. The Department of Health and Human Services (HHS) must establish a program to provide rebates or discounts to cancer and hospice patients to ensure that they do not pay the fee. Any increase in federal revenues from the fee after rebates and discounts are subtracted must be distributed to states under
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Protecting Americans from Dangerous Opioids Act [S.419]
Requires the Food and Drug Administration (FDA) to revoke approval for an opioid drug for every new opioid drug approved. (Opioids are drugs with effects similar to opium, such as certain pain medications.) In determining the drug for which to revoke approval, the FDA must prioritize revoking approval for drugs that are not abuse deterrent and consider the public health impact of drugs on the market.
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FDA Accountability for Public Safety Act [S.418]
A bill to establish procedures regarding the approval of opioid drugs by the Food and Drug Administration.