I 

118TH CONGRESS 

2D SESSION H. R. 6965 

To amend title XXVII of the Public Health Service Act, the Employee 

Retirement Income Security Act of 1974, and the Internal Revenue 

Code of 1986 to establish requirements with respect to cost sharing 

for epinephrine injectors under group health plans and group and individual health insurance coverage. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 11, 2024 

Mr. FROST (for himself and Ms. MATSUI) introduced the following bill; which 

was referred to the Committee on Energy and Commerce, and in addition 

to the Committees on Ways and Means, and Education and the Workforce, 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 XXVII of the Public Health Service Act, 

the Employee Retirement Income Security Act of 1974, 

and the Internal Revenue Code of 1986 to establish 

requirements with respect to cost sharing for epinephrine 

injectors under group health plans and group and individual health insurance coverage. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Epinephrine’s Pharma 

3 Inflated Price Ends Now Act’’ or the ‘‘EPIPEN Act’’. 

4 SEC. 2. REQUIREMENTS WITH RESPECT TO COST SHARING 

5 FOR EPINEPHRINE INJECTORS. 

6 (a) PHSA.—Part D of title XXVII of the Public 

7 Health Service Act (42 U.S.C. 300gg–111 et seq.) is 

8 amended by adding at the end the following new section: 

9 ‘‘SEC. 2799A–11. REQUIREMENTS WITH RESPECT TO COST 

10 SHARING FOR EPINEPHRINE INJECTORS. 

11 ‘‘(a) IN GENERAL.—A group health plan, and a 

12 health insurance issuer offering group or individual health 

13 insurance coverage, shall provide coverage of epinephrine 

14 injectors, and with respect to such injectors, may not— 

15 ‘‘(1) apply any deductible; or 

16 ‘‘(2) impose any cost sharing in excess of $60 

17 per package of 2 injectors (or the equivalent). 

18 ‘‘(b) APPLICATION OF COST SHARING TOWARD

19 DEDUCTIBLES AND OUT-OF-POCKET MAXIMUMS.—Any 

20 cost-sharing payments made pursuant to subsection (a)(2) 

21 shall be counted toward any deductible or out-of-pocket 

22 maximum that applies under the plan or coverage. 

23 ‘‘(c) OUT-OF-NETWORK PROVIDERS.—Nothing in 

24 this section requires a plan or issuer that has a network 

25 of providers to provide benefits for an epinephrine injector 

26 described in this section that is delivered by an out-ofVerDate Sep 11 2014 05:32 Jan 19, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6965.IH H6965

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•HR 6965 IH

1 network provider, or precludes a plan or issuer that has 

2 a network of providers from imposing higher cost sharing 

3 than the levels specified in subsection (a)(2) for an epi4 nephrine injector described in this section that is delivered 

5 by an out-of-network provider. 

6 ‘‘(d) EPINEPHRINE INJECTOR DEFINED.—In this 

7 section, the term ‘epinephrine injector’ means an auto-in8 jector approved by the Food and Drug Administration for 

9 the administration of epinephrine.’’. 

10 (b) ERISA.— 

11 (1) IN GENERAL.—Subpart B of part 7 of sub12 title B of title I of the Employee Retirement Income 

13 Security Act of 1974 (29 U.S.C. 1185 et seq.) is 

14 amended by adding at the end the following new sec15 tion: 

16 ‘‘SEC. 726. REQUIREMENTS WITH RESPECT TO COST SHAR17 ING FOR EPINEPHRINE INJECTORS. 

18 ‘‘(a) IN GENERAL.—A group health plan, and a 

19 health insurance issuer offering group health insurance 

20 coverage, shall provide coverage of epinephrine injectors, 

21 and with respect to such injectors, may not— 

22 ‘‘(1) apply any deductible; or 

23 ‘‘(2) impose any cost sharing in excess of $60 

24 per package of 2 injectors (or the equivalent). 


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1 ‘‘(b) APPLICATION OF COST SHARING TOWARD

2 DEDUCTIBLES AND OUT-OF-POCKET MAXIMUMS.—Any 

3 cost-sharing payments made pursuant to subsection (a)(2) 

4 shall be counted toward any deductible or out-of-pocket 

5 maximum that applies under the plan or coverage. 

6 ‘‘(c) OUT-OF-NETWORK PROVIDERS.—Nothing in 

7 this section requires a plan or issuer that has a network 

8 of providers to provide benefits for an epinephrine injector 

9 described in this section that is delivered by an out-of10 network provider, or precludes a plan or issuer that has 

11 a network of providers from imposing higher cost sharing 

12 than the levels specified in subsection (a)(2) for an epi13 nephrine injector described in this section that is delivered 

14 by an out-of-network provider. 

15 ‘‘(d) EPINEPHRINE INJECTOR DEFINED.—In this 

16 section, the term ‘epinephrine injector’ means an auto-in17 jector approved by the Food and Drug Administration for 

18 the administration of epinephrine.’’. 

19 (2) CLERICAL AMENDMENT.—The table of con20 tents in section 1 of the Employee Retirement In21 come Security Act of 1974 (29 U.S.C. 1001 et seq.) 

22 is amended by inserting after the item relating to 

23 section 725 the following: 

‘‘Sec. 726. Requirements with respect to cost sharing for epinephrine 

injectors.’’. 

24 (c) IRC.— 


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1 (1) IN GENERAL.—Subchapter B of chapter 

2 100 of the Internal Revenue Code of 1986 is amend3 ed by adding at the end the following new section: 

4 ‘‘SEC. 9826. REQUIREMENTS WITH RESPECT TO COST SHAR5 ING FOR EPINEPHRINE INJECTORS. 

6 ‘‘(a) IN GENERAL.—A group health plan shall pro7 vide coverage of epinephrine injectors, and with respect 

8 to such injectors, may not— 

9 ‘‘(1) apply any deductible; or 

10 ‘‘(2) impose any cost sharing in excess of $60 

11 per package of 2 injectors (or the equivalent). 

12 ‘‘(b) APPLICATION OF COST SHARING TOWARD

13 DEDUCTIBLES AND OUT-OF-POCKET MAXIMUMS.—Any 

14 cost-sharing payments made pursuant to subsection (a)(2) 

15 shall be counted toward any deductible or out-of-pocket 

16 maximum that applies under the plan. 

17 ‘‘(c) OUT-OF-NETWORK PROVIDERS.—Nothing in 

18 this section requires a plan that has a network of providers 

19 to provide benefits for an epinephrine injector described 

20 in this section that is delivered by an out-of-network pro21 vider, or precludes a plan that has a network of providers 

22 from imposing higher cost sharing than the levels specified 

23 in subsection (a)(2) for an epinephrine injector described 

24 in this section that is delivered by an out-of-network pro25 vider. 


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1 ‘‘(d) EPINEPHRINE INJECTOR DEFINED.—In this 

2 section, the term ‘epinephrine injector’ means an auto-in3 jector approved by the Food and Drug Administration for 

4 the administration of epinephrine.’’. 

5 (2) CLERICAL AMENDMENT.—The table of sec6 tions for subchapter B of chapter 100 of the Inter7 nal Revenue Code of 1986 is amended by adding at 

8 the end the following new item: 

‘‘Sec. 9826. Requirements with respect to cost sharing for epinephrine 

injectors.’’. 

9 (d) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply with respect to plan years begin11 ning on or after January 1, 2025. 

Æ 


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