I 
119TH CONGRESS 
1ST SESSION H. R. 5139 
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 delivery systems under group health plans and group 
and individual health insurance coverage. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 4, 2025 
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 Education and Workforce, and 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 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 
delivery systems under group health plans and group 
and individual health insurance coverage. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Sep 11 2014 
00:36 Sep 05, 2025
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H5139.IH
H5139
ssavage on LAPJG3WLY3PROD with BILLS
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Epinephrine’s Pharma 
Inflated Price Ends Now Act’’ or the ‘‘EPIPEN Act’’. 
SEC. 2. REQUIREMENTS WITH RESPECT TO COST SHARING 
FOR EPINEPHRINE DELIVERY SYSTEMS. 
(a) PHSA.—Part D of title XXVII of the Public 
Health Service Act (42 U.S.C. 300gg–111 et seq.) is 
amended by adding at the end the following new section: 
‘‘SEC. 2799A–11. REQUIREMENTS WITH RESPECT TO COST 
SHARING FOR EPINEPHRINE DELIVERY SYS-
TEMS. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group or individual health 
insurance coverage, shall provide coverage of epinephrine 
delivery systems, and with respect to such delivery sys-
tems, may not— 
‘‘(1) apply any deductible; or 
‘‘(2) impose any cost sharing in excess of $60 
per package of 2 delivery systems (or the equiva-
lent). 
‘‘(b) APPLICATION
OF
COST
SHARING
TOWARD 
DEDUCTIBLES
AND OUT-OF-POCKET MAXIMUMS.—Any 
cost-sharing payments made pursuant to subsection (a)(2) 
shall be counted toward any deductible or out-of-pocket 
maximum that applies under the plan or coverage. 
VerDate Sep 11 2014 
00:36 Sep 05, 2025
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H5139.IH
H5139
ssavage on LAPJG3WLY3PROD with BILLS
‘‘(c) OUT-OF-NETWORK
PROVIDERS.—Nothing in 
this section requires a plan or issuer that has a network 
of providers to provide benefits for an epinephrine delivery 
system described in this section that is delivered by an 
out-of-network provider, or precludes a plan or issuer that 
has a network of providers from imposing higher cost 
sharing than the levels specified in subsection (a)(2) for 
an epinephrine delivery system described in this section 
that is delivered by an out-of-network provider. 
‘‘(d) EPINEPHRINE DELIVERY SYSTEM DEFINED.— 
In this section, the term ‘epinephrine delivery system’ 
means a delivery system approved by the Food and Drug 
Administration for the administration of epinephrine, in-
cluding any auto-injector, nasal spray, or sublingual deliv-
ery system that is so approved.’’. 
(b) ERISA.— 
(1) IN GENERAL.—Subpart B of part 7 of sub-
title B of title I of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1185 et seq.) is 
amended by adding at the end the following new sec-
tion: 
‘‘SEC. 726. REQUIREMENTS WITH RESPECT TO COST SHAR-
ING FOR EPINEPHRINE DELIVERY SYSTEMS. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insurance 
VerDate Sep 11 2014 
00:36 Sep 05, 2025
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5139.IH
H5139
ssavage on LAPJG3WLY3PROD with BILLS
coverage, shall provide coverage of epinephrine delivery 
systems, and with respect to such delivery systems, may 
not— 
‘‘(1) apply any deductible; or 
‘‘(2) impose any cost sharing in excess of $60 
per package of 2 delivery systems (or the equiva-
lent). 
‘‘(b) APPLICATION
OF
COST
SHARING
TOWARD 
DEDUCTIBLES
AND OUT-OF-POCKET MAXIMUMS.—Any 
cost-sharing payments made pursuant to subsection (a)(2) 
shall be counted toward any deductible or out-of-pocket 
maximum that applies under the plan or coverage. 
‘‘(c) OUT-OF-NETWORK
PROVIDERS.—Nothing in 
this section requires a plan or issuer that has a network 
of providers to provide benefits for an epinephrine delivery 
system described in this section that is delivered by an 
out-of-network provider, or precludes a plan or issuer that 
has a network of providers from imposing higher cost 
sharing than the levels specified in subsection (a)(2) for 
an epinephrine delivery system described in this section 
that is delivered by an out-of-network provider. 
‘‘(d) EPINEPHRINE DELIVERY SYSTEM DEFINED.— 
In this section, the term ‘epinephrine delivery system’ 
means a delivery system approved by the Food and Drug 
Administration for the administration of epinephrine, in-
VerDate Sep 11 2014 
00:36 Sep 05, 2025
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5139.IH
H5139
ssavage on LAPJG3WLY3PROD with BILLS
cluding any auto-injector, nasal spray, or sublingual deliv-
ery system that is so approved.’’. 
(2) CLERICAL AMENDMENT.—The table of con-
tents in section 1 of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1001 et seq.) 
is amended by inserting after the item relating to 
section 725 the following: 
‘‘Sec. 726. Requirements with respect to cost sharing for epinephrine delivery 
systems.’’. 
(c) IRC.— 
(1) IN
GENERAL.—Subchapter B of chapter 
100 of the Internal Revenue Code of 1986 is amend-
ed by adding at the end the following new section: 
‘‘SEC. 9826. REQUIREMENTS WITH RESPECT TO COST SHAR-
ING FOR EPINEPHRINE DELIVERY SYSTEMS. 
‘‘(a) IN GENERAL.—A group health plan shall pro-
vide coverage of epinephrine delivery systems, and with re-
spect to such delivery systems, may not— 
‘‘(1) apply any deductible; or 
‘‘(2) impose any cost sharing in excess of $60 
per package of 2 delivery systems (or the equiva-
lent). 
‘‘(b) APPLICATION
OF
COST
SHARING
TOWARD 
DEDUCTIBLES
AND OUT-OF-POCKET MAXIMUMS.—Any 
cost-sharing payments made pursuant to subsection (a)(2) 
VerDate Sep 11 2014 
00:36 Sep 05, 2025
Jkt 059200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H5139.IH
H5139
ssavage on LAPJG3WLY3PROD with BILLS
shall be counted toward any deductible or out-of-pocket 
maximum that applies under the plan. 
‘‘(c) OUT-OF-NETWORK
PROVIDERS.—Nothing in 
this section requires a plan that has a network of providers 
to provide benefits for an epinephrine delivery system de-
scribed in this section that is delivered by an out-of-net-
work provider, or precludes a plan that has a network of 
providers from imposing higher cost sharing than the lev-
els specified in subsection (a)(2) for an epinephrine deliv-
ery system described in this section that is delivered by 
an out-of-network provider. 
‘‘(d) EPINEPHRINE DELIVERY SYSTEM DEFINED.— 
In this section, the term ‘epinephrine delivery system’ 
means a delivery system approved by the Food and Drug 
Administration for the administration of epinephrine, in-
cluding any auto-injector, nasal spray, or sublingual deliv-
ery system that is so approved.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for subchapter B of chapter 100 of the Inter-
nal Revenue Code of 1986 is amended by adding at 
the end the following new item: 
‘‘Sec. 9826. Requirements with respect to cost sharing for epinephrine delivery 
systems.’’. 
VerDate Sep 11 2014 
00:36 Sep 05, 2025
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6211
E:\BILLS\H5139.IH
H5139
ssavage on LAPJG3WLY3PROD with BILLS
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to plan years begin-
ning on or after January 1, 2026. 
Æ 
VerDate Sep 11 2014 
00:36 Sep 05, 2025
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6301
E:\BILLS\H5139.IH
H5139
ssavage on LAPJG3WLY3PROD with BILLS