‘‘(9) PROHIBITION
ON
USE
OF
QUALITY-AD-
JUSTED
LIFE
YEARS.—The provisions of section 
1182(e) shall apply to the utilization of a dollars- 
per-quality adjusted life year or similar measure (as 
described in such section) by a medicaid managed 
care organization under this title (or a prepaid inpa-
tient health plan or prepaid ambulatory health plan, 
as defined in section 438.2 of title 42, Code of Fed-
eral Regulations (or any successor regulation), under 
a contract with the State) in the same manner as 
such provisions apply to the utilization of such a 
year or measure by a State under this title.’’. 
(2) CHIP.—Section 2102 of the Social Security 
Act (42 U.S.C. 1397bb) is amended by adding at 
the end the following new subsection: 
‘‘(e) PROHIBITION ON THE USE OF QUALITY-AD-
JUSTED LIFE YEARS AND SIMILAR MEASURES.—A State 
child health plan shall provide for compliance with the re-
quirements of section 1182(e) (relating to prohibiting the 
use of certain measures in coverage determinations, reim-
bursement, and incentive programs).’’. 
(3) MEDICARE ADVANTAGE.—Section 1852 of 
the Social Security Act (42 U.S.C. 1395w–22) is 
amended by adding at the end the following new 
subsection: 
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‘‘(o) PROHIBITION ON USE OF QUALITY-ADJUSTED 
LIFE YEARS.—The provisions of section 1182(e) shall 
apply to the utilization of a dollars-per-quality adjusted 
life year or similar measure (as described in such section) 
by an MA plan in the same manner as such provisions 
apply to the utilization of such a year or measure by the 
Secretary under this title.’’. 
(4) MEDICARE PART D.—Section 1860D–12 of 
the Social Security Act (42 U.S.C. 1395w–112) is 
amended by adding at the end the following new 
subsection: 
‘‘(h) PROHIBITION ON USE OF QUALITY-ADJUSTED 
LIFE YEARS.—The provisions of section 1182(e) shall 
apply to the utilization of a dollars-per-quality adjusted 
life year or similar measure (as described in such section) 
by a prescription drug plan in the same manner as such 
provisions apply to the utilization of such a year or meas-
ure by the Secretary under this title.’’. 
(c) IMPLEMENTATION.—The amendments made by 
this section shall apply beginning on January 1, 2027. 
SEC. 3. PREVENTION AND PUBLIC HEALTH FUND. 
Section 4002(b) of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 300u–11) is amended by 
striking paragraphs (7), (8), and (9) and inserting the fol-
lowing: 
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‘‘(7) for each of fiscal years 2026 and 2027, 
$1,102,000,000; 
‘‘(8) for each of fiscal years 2028 and 2029, 
$1,327,000,000; 
‘‘(9) for each of fiscal years 2030 and 2031, 
$1,526,000,000; and’’. 
SEC. 4. REPORT. 
Not later than 1 year after the date of the enactment 
of this Act, and annually thereafter, the Comptroller Gen-
eral of the United States shall submit to Congress a report 
on how quality-adjusted life years negatively impacts indi-
viduals with intellectual and developmental disabilities and 
their access to care. 
Æ 
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