I 
118TH CONGRESS 
1ST SESSION H. R. 5376 
To amend title XVIII of the Social Security Act to ensure appropriate 
cost-sharing for chronic care drugs under Medicare part D. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 8, 2023 
Mrs. MILLER-MEEKS (for herself, Ms. ROSS, Mr. CARTER of Georgia, and Mr. 
PETERS) introduced the following bill; which was referred to the Com-
mittee 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 ensure 
appropriate cost-sharing for chronic care drugs under 
Medicare part D. 
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 ‘‘Share the Savings with 
Seniors Act’’. 
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SEC. 2. APPROPRIATE COST-SHARING FOR CHRONIC CARE 
DRUGS UNDER MEDICARE PART D. 
(a) IN GENERAL.—Section 1860D–2 of the Social 
Security Act (42 U.S.C. 1395w–102) is amended— 
(1) in subsection (b)— 
(A) in paragraph (1)(A), in the matter 
preceding clause (i), by striking ‘‘and (9)’’ and 
inserting ‘‘, (9), and (10)’’; 
(B) in paragraph (2)(A), in the matter 
preceding clause (i), by striking ‘‘and (9)’’ and 
inserting ‘‘, (9), and (10)’’; and 
(C) by adding at the end the following new 
paragraph: 
‘‘(10) COST-SHARING
FOR
CHRONIC
CARE 
DRUGS.— 
‘‘(A) IN GENERAL.—For plan years begin-
ning on or after January 1, 2025, in the case 
of a chronic care drug, the following shall 
apply: 
‘‘(i) For costs below the annual de-
ductible specified in paragraph (1), cost- 
sharing for such drug shall not exceed the 
net price of such drug. 
‘‘(ii) Subject to subparagraph (B), for 
costs above the annual deductible specified 
in paragraph (1) and below the out-of- 
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pocket threshold specified in paragraph 
(4), any coinsurance amount for such drug 
shall be based on a percentage of the net 
price of such drug. 
‘‘(B) EXCEPTION.—The requirement under 
subparagraph (A)(ii) shall not apply to a chron-
ic care drug under a prescription drug plan if 
the cost-sharing amount for such drug under 
such plan is based on a copayment that is not 
tied to a percentage of a drug price (such as 
the negotiated price, list price, or wholesale ac-
quisition cost), a drug benchmark price (such 
as the average wholesale price), or a drug cost. 
‘‘(C) DEFINITIONS.—In this paragraph: 
‘‘(i) CHRONIC CARE DRUG.—The term 
‘chronic care drug’ means a covered part D 
drug that is included under any of the fol-
lowing United States Pharmacopeia Con-
vention (USP) categories and classes of 
drugs, as included in the most recent 
version of the USP Medicare Model Guide-
lines: 
‘‘(I) Blood glucose regulators, 
other than insulins. 
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‘‘(II) 
Anti-inflammatories, 
in-
haled corticosteroids. 
‘‘(III) Bronchodilators, anticho-
linergic. 
‘‘(IV) 
Bronchodilators, 
sympathomimetic. 
‘‘(V) Respiratory tract agents, 
other. 
‘‘(VI) Anticoagulants. 
‘‘(VII) 
Cardiovascular 
agents, 
other. 
‘‘(VIII) Any category or class 
identified by the Secretary or USP as 
a successor to the categories and 
classes described in subclauses (I) 
through (VII) based on the most re-
cent USP Medicare Model Guidelines 
at the time of such identification. 
‘‘(ii) NET
PRICE.—The term ‘net 
price’ means the negotiated price of the 
drug net of all price concessions origi-
nating from manufacturers that are re-
ceived or expected to be received by the 
plan or pharmacy benefit manager on be-
half of the plan for such product and that 
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are not already reflected in the negotiated 
price.’’; and 
(2) in subsection (c), by adding at the end the 
following new paragraph: 
‘‘(7) COST-SHARING
FOR
COVERED
CHRONIC 
CARE DRUGS.—The coverage is provided in accord-
ance with subsection (b)(10).’’. 
(b) CONFORMING AMENDMENTS TO COST-SHARING 
FOR
LOW-INCOME
INDIVIDUALS.—Section 
1860D– 
14(a)(1)(D)(iii) of the Social Security Act (42 U.S.C. 
1395w–114(a)(1)(D)(iii)) is amended by adding at the 
end the following new sentence: ‘‘For plan year 2025 and 
subsequent plan years, the copayment amount applicable 
under the first sentence of this subclause for a chronic 
drug (as defined in section 1860D–2(b)(10)(B)) furnished 
to the individual may not exceed the applicable cost-shar-
ing for such drug under the prescription drug plan or MA– 
PD plan in which the individual is enrolled.’’. 
(c) REGULATIONS.—Notwithstanding any other pro-
vision of law, the Secretary of Health and Human Services 
shall initially implement the amendments made by this 
section through interim final regulations. 
Æ 
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