I 
119TH CONGRESS 
1ST SESSION H. R. 1244 
To amend title XVIII of the Social Security Act to require that coinsurance 
for drugs under Medicare part D be based on the drug’s actual acquisi-
tion cost and not the drug’s wholesale acquisition cost. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 12, 2025 
Mr. DAVIS of North Carolina (for himself and Mr. PFLUGER) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to require 
that coinsurance for drugs under Medicare part D be 
based on the drug’s actual acquisition cost and not the 
drug’s wholesale acquisition cost. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Reducing Drug Prices 
for Seniors Act’’. 
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SEC. 2. REQUIRING THAT COINSURANCE FOR DRUGS 
UNDER MEDICARE PART D BE BASED ON THE 
DRUG’S ACTUAL ACQUISITION COST AND NOT 
THE DRUG’S WHOLESALE ACQUISITION COST. 
Section 1860D–2 of the Social Security Act (42 
U.S.C. 1395w–102) is amended— 
(1) in subsection (b)— 
(A) in paragraph (2)(A), in the matter 
preceding clause (i), by striking ‘‘and (9)’’ and 
inserting ‘‘, (9), and (10)’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(10) REQUIREMENT THAT COINSURANCE FOR 
COVERED PART D DRUGS BE BASED ON THE ACTUAL 
ACQUISITION COST OF THE DRUG.— 
‘‘(A) IN GENERAL.—For plan years begin-
ning on or after January 1, 2026, for costs 
above the annual deductible specified in para-
graph (1) and below the annual out-of-pocket 
threshold specified in paragraph (4), any coin-
surance amount for a covered part D drug (in-
sofar as such covered part D drug is included 
on the formulary and subject to coinsurance 
rather than a copayment) shall be calculated 
based on the actual acquisition cost (and not 
the wholesale acquisition cost) of such covered 
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part D drug if such actual acquisition cost is 
lower than the wholesale acquisition cost of 
such covered part D drug. The preceding sen-
tence shall not apply to a covered part D drug 
described in paragraph (8) or (9). 
‘‘(B) ACTUAL
ACQUISITION
COST
DE-
FINED.—In this paragraph, the term ‘actual ac-
quisition cost’ means, with respect to a covered 
part D drug, the negotiated price of the covered 
part D drug under the prescription drug plan 
or MA–PD plan, net of any manufacturer-pro-
vided price concessions (as defined under sec-
tion 423.100 of title 42, Code of Federal Regu-
lations (or any successor regulation)), as re-
ported for such drug in the Detailed DIR Re-
port (or any successor report) submitted by the 
sponsor or organization offering the plan for 
the previous plan year.’’; and 
(2) in subsection (c), by adding at the end the 
following new paragraph: 
‘‘(7) REQUIREMENT THAT COINSURANCE FOR 
COVERED PART D DRUGS BE BASED ON THE NET 
PRICE OF THE DRUG.—The coverage is provided in 
accordance with subsection (b)(10).’’. 
Æ 
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