I 
115TH CONGRESS 
1ST SESSION H. R. 4138 
To amend title XVIII of the Social Security Act to provide for the negotiation 
of lower covered part D drug prices on behalf of Medicare beneficiaries 
and the establishment and application of a formulary by the Secretary 
of Health and Human Services under Medicare part D, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 26, 2017 
Mr. CUMMINGS (for himself, Mr. DOGGETT, Mr. WELCH, Mr. POCAN, Mr. 
HIGGINS of New York, Mr. ELLISON, Ms. SCHAKOWSKY, Ms. KAPTUR, 
Ms. NORTON, Ms. JAYAPAL, Mr. COHEN, Ms. GABBARD, Mr. GRIJALVA, 
Mr. NADLER, Ms. DELAURO, Mr. KHANNA, Mr. O’ROURKE, and Ms. 
SHEA-PORTER) 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 provide 
for the negotiation of lower covered part D drug prices 
on behalf of Medicare beneficiaries and the establishment 
and application of a formulary by the Secretary of 
Health and Human Services under Medicare part D, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Drug Price 
Negotiation Act’’. 
SEC. 2. NEGOTIATION OF LOWER COVERED PART D DRUG 
PRICES ON BEHALF OF MEDICARE BENE-
FICIARIES AND ESTABLISHMENT AND APPLI-
CATION OF FORMULARY BY THE SECRETARY 
OF HEALTH AND HUMAN SERVICES UNDER 
MEDICARE PART D. 
(a) IN GENERAL.—Section 1860D–11 of the Social 
Security Act (42 U.S.C. 1395w–111) is amended by strik-
ing subsection (i) (relating to noninterference) and insert-
ing the following: 
‘‘(i) NEGOTIATION OF LOWER DRUG PRICES; ESTAB-
LISHMENT AND APPLICATION OF FORMULARY.— 
‘‘(1) NEGOTIATION.— 
‘‘(A) IN GENERAL.—Notwithstanding any 
other provision of law, subject to subparagraph 
(B), the Secretary shall during a negotiation 
year and with respect to the negotiation drug 
grouping identified under subparagraph (C) 
with respect to such negotiation year— 
‘‘(i) negotiate with pharmaceutical 
manufacturers the prices (including dis-
counts, rebates, and all other price conces-
sions) that may be charged for each plan 
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year during the negotiated price period, 
with respect to such negotiation year, to 
PDP sponsors and MA organizations for 
covered part D drugs identified as included 
within such negotiation drug grouping for 
part D eligible individuals who are enrolled 
under a prescription drug plan or under an 
MA–PD plan; and 
‘‘(ii) complete such negotiations 30 
days before the first day of the application 
review process for the first plan year dur-
ing such negotiated price period for new 
contracts or expanding existing contracts 
with PDP sponsors and MA organizations 
to offer prescription drug plans or MA–PD 
plans, respectively. 
‘‘(B) USE OF FALLBACK IF NEGOTIATIONS 
FAIL.—If, after attempting to negotiate the 
price during a negotiation year for a covered 
part D drug that is identified as included with-
in the negotiation drug grouping for such nego-
tiation year, the Secretary is not successful in 
obtaining an appropriate price (as determined 
by the Secretary in accordance with guidance 
described in subparagraph (E)), the price that 
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