I 

117TH CONGRESS 

2D SESSION H. R. 6757 

To amend title XVIII of the Social Security Act to establish under the 

Medicare prescription drug program a minimum amount of price concessions for insulin to be passed through to beneficiaries at the pointof-sale, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 18, 2022 

Mr. BURGESS (for himself and Mrs. MILLER-MEEKS) 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 establish 

under the Medicare prescription drug program a minimum amount of price concessions for insulin to be 

passed through to beneficiaries at the point-of-sale, 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 ‘‘Insulin Savings for 

5 Patients Act’’. 


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1 SEC. 2. NEGOTIATED PRICE CONCESSIONS FOR INSULIN AT 

2 POINT-OF-SALE UNDER PART D OF MEDI3 CARE PROGRAM. 

4 (a) IN GENERAL.—Section 1860D–2(d)(1) of the So5 cial Security Act (42 U.S.C. 1395w–102(d)(1)) is amend6 ed— 

7 (1) in subparagraph (A), by striking ‘‘Under’’ 

8 and inserting ‘‘Subject to subparagraph (D), 

9 under’’; and 

10 (2) by adding at the end the following new sub11 paragraph: 

12 ‘‘(D) NEGOTIATED PRICE CONCESSIONS

13 FOR INSULIN AT POINT-OF-SALE.— 

14 ‘‘(i) IN GENERAL.—For drugs dis15 pensed in plan year 2022 or a subsequent 

16 plan year, the minimum percentage de17 scribed in clause (ii) for such plan year of 

18 price concessions negotiated between man19 ufacturers and a prescription drug plan or 

20 MA–PD plan (or any entity that provides 

21 pharmacy benefits management services 

22 under a contract with any such prescrip23 tion drug plan or MA–PD plan) and taken 

24 into account under subparagraph (B) in 

25 determining negotiated prices for the plan 

26 year for covered part D drugs that are inVerDate Sep 11 2014 05:35 Feb 24, 2022 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6757.IH H6757

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1 sulin provided under such a plan shall be 

2 provided to enrollees of such a plan at 

3 pharmacies or by mail order service at the 

4 point-of-sale of such drugs. 

5 ‘‘(ii) AMOUNT OF PRICE CONCES6 SION.—For purposes of clause (i), and 

7 subject to clause (iii), the minimum per8 centage described in this clause is— 

9 ‘‘(I) for drugs dispensed in plan 

10 year 2022, 50 percent; 

11 ‘‘(II) for drugs dispensed in plan 

12 year 2023, 75 percent; and 

13 ‘‘(III) for drugs dispensed in 

14 plan year 2024 or a subsequent plan 

15 year, 100 percent. 

16 ‘‘(iii) MODIFICATION OF MINIMUM

17 PERCENTAGE.—For plan years beginning 

18 on or after January 1, 2024, the Secretary 

19 may, through notice and comment rule20 making, specify a percentage other than 

21 the percentage described in clause (ii) for 

22 a plan year, except that in specifying such 

23 percentage the Secretary shall not specify 

24 a percentage that is less than 50 percent 

25 of the negotiated price concession for such 


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1 plan year. Any percentage specified pursu2 ant to the authority of the previous sen3 tence for a plan year that would be less 

4 than the percentage otherwise described in 

5 clause (ii) for the plan year may only be 

6 applied if such reduction in percentage is 

7 justified as a benefit to individuals enrolled 

8 under this title.’’. 

9 (b) INCLUSION OF INFORMATION IN BID SUBMIS10 SION.—Section 1860D–11(b)(2) of the Social Security Act 

11 (42 U.S.C. 1395w–11(b)(2)) is amended— 

12 (1) by redesignating subparagraph (F) as sub13 paragraph (G); and 

14 (2) by inserting after subparagraph (E) the fol15 lowing new subparagraph: 

16 ‘‘(F) POINT-OF-SALE PRICE CONCESSIONS

17 FOR INSULIN.—For plan years beginning on or 

18 after January 1, 2022, an estimate of the ag19 gregate price concessions for all insulin nego20 tiated by the plan for such plan year.’’. 

21 (c) GAO STUDY AND REPORT ON INSULIN PRIC22 ING.—Not later than 2 years after the date of the enact23 ment of this Act, and annually thereafter, the Comptroller 

24 General of the United States shall— 


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1 (1) conduct a study on the effects of the imple2 mentation of the requirement described in subpara3 graph (D) of section 1860D–2(d)(1) of the Social 

4 Security Act (42 U.S.C. 1395w–102(d)(1)), as 

5 added by subsection (a), including an analysis of— 

6 (A) trends in the list and net prices of in7 sulin for qualified prescription drug coverage 

8 offered by a prescription drug plan under part 

9 D of the Social Security Act or an MA–PD 

10 plan under part C of such title; 

11 (B) savings on insulin for individuals en12 rolled in a prescription drug plan under part D 

13 of the Social Security Act or an MA–PD plan 

14 under part C of such title; 

15 (C) trends in out-of-pocket costs for indi16 viduals enrolled in such plans, as compared to 

17 individuals enrolled in a group health plan (as 

18 defined in section 2791(a) of the Public Health 

19 Service Act (42 U.S.C. 300gg–91(a)), a State 

20 plan under title XIX of the Social Security Act, 

21 or a qualified health plan offered through an 

22 Exchange established under title I of the Pa23 tient Protection and Affordable Care Act (42 

24 U.S.C. 18001 et seq.); and 


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1 (D) approval and market entry of bio2 similar insulin under section 351(k) of the Pub3 lic Health Service Act (42 U.S.C. 262); and 

4 (2) submit to the Committee on Energy and 

5 Commerce and the Committee on Ways and Means 

6 in the House of Representatives, and the Committee 

7 on Finance in the Senate, a report on the study con8 ducted under paragraph (1), with recommendations 

9 on how to enhance the access of individuals enrolled 

10 in a prescription drug plan under part D of the So11 cial Security Act or an MA–PD plan under part C 

12 of such title to lower out-of-pocket costs for insulin. 

13 (d) TRANSPARENCY.—Section 1860D–1(c)(3) of the 

14 Social Security Act (42 U.S.C. 1395w–101(c)(3)) is 

15 amended by adding at the end the following new subpara16 graph: 

17 ‘‘(C) ADDITIONAL INFORMATION.—For 

18 plan year 2022 and each subsequent plan year, 

19 such information referred to in paragraph 

20 (2)(A) shall also include, for a plan year, infor21 mation regarding the requirement described in 

22 subparagraph (D) of section 1860D–2(d)(1) 

23 with respect to insulin negotiated by the plan 

24 for such plan year.’’. 

Æ 


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