II 

116TH CONGRESS 

2D SESSION S. 4448 

To amend titles XIX and XXI of the Social Security Act to give States 

the option to extend the Medicaid drug rebate program to the Children’s 

Health Insurance Program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 5, 2020 

Mr. WARNER (for himself and Mr. BOOKER) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend titles XIX and XXI of the Social Security Act 

to give States the option to extend the Medicaid drug 

rebate program to the Children’s Health Insurance Program, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Fair Drug Prices for 

5 Kids Act’’. 


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1 SEC. 2. REDUCING PRESCRIPTION DRUG COSTS FOR CHIL2 DREN’S MEDICINE. 

3 (a) IN GENERAL.—Section 1927(a) of the Social Se4 curity Act (42 U.S.C. 1396r–8(a)) is amended by adding 

5 at the end the following new paragraph: 

6 ‘‘(8) STATE OPTION TO APPLY REBATE RE7 QUIREMENTS TO THE STATE CHILD HEALTH

8 PLAN.— 

9 ‘‘(A) IN GENERAL.—A State may elect to 

10 apply the requirements of this section and regu11 lations promulgated to carry out this section to 

12 covered outpatient drugs for which payment is 

13 available under the State child health plan 

14 under title XXI in the same manner as such re15 quirements apply to the State plan under this 

16 title, subject to such guidance as the Secretary 

17 shall establish. 

18 ‘‘(B) APPLICATION RULES.—If a State 

19 makes an election under subparagraph (A), 

20 then, in applying this section with respect to 

21 that State— 

22 ‘‘(i) paragraph (1) of this subsection 

23 shall be applied as if ‘or section 2105 (if 

24 the State has elected to apply this section 

25 to the State child health plan under title 

26 XXI)’ were inserted after ‘1903(a)’; 


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1 ‘‘(ii) paragraph (7)(A) of this sub2 section shall be applied— 

3 ‘‘(I) as if ‘or section 2105 (if the 

4 State has elected to apply this section 

5 to the State child health plan under 

6 title XXI)’ were inserted after 

7 ‘1903(a)’; and 

8 ‘‘(II) as if ‘(or, if the State has 

9 elected to apply this section to the 

10 State child health plan under title 

11 XXI, on or after the date this section 

12 first applies to the State)’ were in13 serted after ‘January 1, 2006’; 

14 ‘‘(iii) paragraph (7)(B)(ii) of this sub15 section shall be applied— 

16 ‘‘(I) as if ‘or section 2105 (if the 

17 State has elected to apply this section 

18 to the State child health plan under 

19 title XXI)’ were inserted after 

20 ‘1903(a)’; and 

21 ‘‘(II) as if ‘(or, if the State has 

22 elected to apply this section to the 

23 State child health plan under title 

24 XXI, on or after the date this section 


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1 first applies to the State)’ were in2 serted after ‘January 1, 2008’; 

3 ‘‘(iv) subsection (b)(1)(A) shall be ap4 plied as if ‘(or, if the State has elected to 

5 apply this section to the State child health 

6 plan under title XXI, on or after the date 

7 this section first applies to the State, to 

8 each State child health plan for which pay9 ment was made under such State child 

10 health plan for such period)’ were inserted 

11 after ‘such period’; 

12 ‘‘(v) subsection (b)(1)(B) shall be ap13 plied as if ‘(or a reduction in the amount 

14 expended under the State child health plan 

15 in the quarter for child health assistance 

16 or pregnancy-related assistance for pur17 poses of section 2105 if the State has 

18 elected to apply this section to the State 

19 child health plan under title XXI)’ were in20 serted after ‘1903(a)(1)’; and 

21 ‘‘(vi) paragraphs (2)(A)(i) and 

22 (3)(A)(ii) of subsection (c) shall each be 

23 applied as if ‘(or, if the State has elected 

24 to apply this section to the State child 

25 health plan under title XXI, on or after 


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1 the date this section first applies to the 

2 State)’ were inserted after ‘December 31, 

3 1990’ each place it appears.’’. 

4 (b) CONFORMING AMENDMENTS.— 

5 (1) Section 2107(e)(1) of the Social Security 

6 Act (42 U.S.C. 1397gg(e)(1)) is amended— 

7 (A) by redesignating subparagraphs (D) 

8 through (S) as subparagraphs (E) through (T), 

9 respectively; and 

10 (B) by inserting after subparagraph (C) 

11 the following new subparagraph: 

12 ‘‘(D) Section 1902(a)(54) (relating to com13 pliance with the requirements of section 1927 

14 but only if the State has elected to apply such 

15 requirements to the State child health plan 

16 under this title).’’. 

17 (2) Section 2110(a)(6) of the Social Security 

18 Act (42 U.S.C. 1397jj(a)(6)) is amended by insert19 ing ‘‘and, if the State has elected to apply the re20 quirements of section 1927 to the State child health 

21 plan under this title, covered outpatient drugs, as 

22 defined in section 1927(k)(2),’’ after ‘‘Prescription 

23 drugs and biologicals’’. 

Æ 


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