I 
116TH CONGRESS 
2D SESSION 
H. R. 6739 
To amend title XVIII of the Social Security Act to require coverage under 
Medicare PDPs and MA–PD plans, without the imposition of cost shar-
ing or utilization management requirements, of drugs intended to treat 
COVID–19 during certain emergencies. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 8, 2020 
Mr. CASTEN of Illinois 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 require 
coverage under Medicare PDPs and MA–PD plans, with-
out the imposition of cost sharing or utilization manage-
ment requirements, of drugs intended to treat COVID– 
19 during certain emergencies. 
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 ‘‘Ensuring Seniors’ Ac-
cess to COVID Treatments Act’’. 
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SEC. 2. REQUIRING COVERAGE UNDER MEDICARE PDPS 
AND MA–PD PLANS, WITHOUT THE IMPOSI-
TION OF COST SHARING OR UTILIZATION 
MANAGEMENT REQUIREMENTS, OF DRUGS 
INTENDED TO TREAT COVID–19 DURING CER-
TAIN EMERGENCIES. 
(a) COVERAGE REQUIREMENT.— 
(1) IN
GENERAL.—Section 1860D–4(b)(3) of 
the Social Security Act (42 U.S.C. 1395w– 
104(b)(3)) is amended by adding at the end the fol-
lowing new subparagraph: 
‘‘(I) REQUIRED INCLUSION OF DRUGS IN-
TENDED TO TREAT COVID–19.— 
‘‘(i) IN
GENERAL.—Notwithstanding 
any other provision of law, a PDP sponsor 
offering a prescription drug plan shall, 
with respect to a plan year, any portion of 
which occurs during the period described 
in clause (ii), be required to— 
‘‘(I) include in any formulary— 
‘‘(aa) all covered part D 
drugs with a medically accepted 
indication (as defined in section 
1860D–2(e)(4)) to treat COVID– 
19 that are marketed in the 
United States; and 
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‘‘(bb) all drugs authorized 
under section 564 or 564A of the 
Federal Food Drug and Cosmetic 
Act to treat COVID–19; and 
‘‘(II) not impose any prior au-
thorization or other utilization man-
agement requirement with respect to 
such drugs described in item (aa) or 
(bb) of subclause (I) (other than such 
a requirement that limits the quantity 
of drugs due to safety). 
‘‘(ii) PERIOD DESCRIBED.—For pur-
poses of clause (i), the period described in 
this clause is the period during which there 
exists the public health emergency declared 
by the Secretary pursuant to section 319 
of the Public Health Service Act on Janu-
ary 31, 2020, entitled ‘Determination that 
a Public Health Emergency Exists Nation-
wide as the Result of the 2019 Novel 
Coronavirus’ (including any renewal of 
such declaration pursuant to such sec-
tion).’’. 
(b) ELIMINATION OF COST SHARING.— 
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(1) ELIMINATION
OF
COST
SHARING
FOR 
DRUGS
INTENDED
TO
TREAT
COVID–19
UNDER 
STANDARD AND ALTERNATIVE PRESCRIPTION DRUG 
COVERAGE.—Section 1860D–2 of the Social Security 
Act (42 U.S.C. 1395w–102) is amended— 
(A) in subsection (b)— 
(i) in paragraph (1)(A), by striking 
‘‘The coverage’’ and inserting ‘‘Subject to 
paragraph (8), the coverage’’; 
(ii) in paragraph (2)— 
(I) in subparagraph (A), by in-
serting after ‘‘Subject to subpara-
graphs (C) and (D)’’ the following: 
‘‘and paragraph (8)’’; 
(II) in subparagraph (C)(i), by 
striking ‘‘paragraph (4)’’ and insert-
ing ‘‘paragraphs (4) and (8)’’; and 
(III) in subparagraph (D)(i), by 
striking ‘‘paragraph (4)’’ and insert-
ing ‘‘paragraphs (4) and (8)’’; 
(iii) in paragraph (4)(A)(i), by strik-
ing ‘‘The coverage’’ and inserting ‘‘Subject 
to paragraph (8), the coverage’’; and 
(iv) by adding at the end the following 
new paragraph: 
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‘‘(8) ELIMINATION
OF
COST-SHARING
FOR 
DRUGS INTENDED TO TREAT COVID–19.—The cov-
erage does not impose any deductible, copayment, 
coinsurance, or other cost-sharing requirement for 
drugs described in section 1860D–4(b)(3)(I)(i)(I) 
with respect to a plan year, any portion of which oc-
curs during the period during which there exists the 
public health emergency declared by the Secretary 
pursuant to section 319 of the Public Health Service 
Act on January 31, 2020, entitled ‘Determination 
that a Public Health Emergency Exists Nationwide 
as the Result of the 2019 Novel Coronavirus’ (in-
cluding any renewal of such declaration pursuant to 
such section).’’; and 
(B) in subsection (c), by adding at the end 
the following new paragraph: 
‘‘(4) SAME ELIMINATION OF COST-SHARING FOR 
DRUGS INTENDED TO TREAT COVID–19.—The cov-
erage is in accordance with subsection (b)(8).’’. 
(2) ELIMINATION
OF
COST
SHARING
FOR 
DRUGS INTENDED TO TREAT COVID–19 DISPENSED 
TO INDIVIDUALS WHO ARE SUBSIDY ELIGIBLE INDI-
VIDUALS.—Section 1860D–14(a) of the Social Secu-
rity Act (42 U.S.C. 1395w–114(a)) is amended— 
(A) in paragraph (1)— 
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(i) in subparagraph (D)— 
(I) in clause (ii), by striking ‘‘In 
the case of’’ and inserting ‘‘Subject to 
subparagraph (F), in the case of’’; 
and 
(II) in clause (iii), by striking 
‘‘In the case of’’ and inserting ‘‘Sub-
ject to subparagraph (F), in the case 
of’’; and 
(ii) by adding at the end the following 
new subparagraph: 
‘‘(F) ELIMINATION OF COST-SHARING FOR 
DRUGS INTENDED TO TREAT COVID–19.—Cov-
erage that is in accordance with section 
1860D–2(b)(8).’’; and 
(B) in paragraph (2)— 
(i) in subparagraph (B), by striking 
‘‘A reduction’’ and inserting ‘‘Subject to 
subparagraph (F), a reduction’’; 
(ii) in subparagraph (D), by striking 
‘‘The substitution’’ and inserting ‘‘Subject 
to subparagraph (F), the substitution’’; 
(iii) in subparagraph (E), by inserting 
after ‘‘Subject to’’ the following: ‘‘subpara-
graph (F) and’’; and 
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(iv) by adding at the end the following 
new subparagraph: 
‘‘(F) ELIMINATION OF COST-SHARING FOR 
DRUGS INTENDED TO TREAT COVID–19.—Cov-
erage that is in accordance with section 
1860D–2(b)(8).’’. 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human 
Services may implement the amendments made by this 
section by program instruction or otherwise. 
Æ 
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