I 
116TH CONGRESS 
2D SESSION 
H. R. 6557 
To amend title XIX of the Social Security Act to increase the Federal 
medical assistance percentage under the Medicaid program for States 
providing certain coverage relating to covered outpatient drugs, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 17, 2020 
Ms. ESHOO (for herself and Ms. BLUNT ROCHESTER) introduced the following 
bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to increase 
the Federal medical assistance percentage under the 
Medicaid program for States providing certain coverage 
relating to covered outpatient drugs, and for other pur-
poses. 
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 ‘‘Medication Access Im-
proves Lives Act’’ or the ‘‘MAIL Act’’. 
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SEC. 2. INCREASE IN MEDICAID FMAP FOR STATES PRO-
VIDING CERTAIN COVERAGE RELATING TO 
COVERED OUTPATIENT DRUGS. 
(a) IN GENERAL.—Section 1905(b) of the Social Se-
curity Act (42 U.S.C. 1396d(b)) is amended by adding 
at the end the following new sentence: ‘‘Beginning April 
1, 2020, in the case of a State that provides medical as-
sistance for covered outpatient drugs (as defined in section 
1927(k)), including such drugs dispensed by a mail order 
pharmacy, the Federal medical assistance percentage de-
termined under this subsection (and subsections (y) and 
(ff) (as applicable)) shall be increased by 1 percentage 
point with respect to medical assistance for such drugs, 
but in no case may such percentage exceed 100 percent 
for such medical assistance.’’. 
(b) CONFORMING AMENDMENTS.—Section 1905 of 
the Social Security Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (y)(1), by inserting after 
‘‘Notwithstanding subsection (b)’’ the following: 
‘‘(but subject to the sixth sentence of such sub-
section (relating to a Federal medical assistance per-
centage increase with respect to medical assistance 
for covered outpatient drugs))’’; and 
(2) in subsection (ff), by inserting after ‘‘Not-
withstanding subsection (b)’’ the following: ‘‘(but 
subject to the sixth sentence of such subsection (re-
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lating to a Federal medical assistance percentage in-
crease with respect to medical assistance for covered 
outpatient drugs))’’. 
SEC. 3. REQUIRING STATES THAT PROVIDE MEDICAL AS-
SISTANCE 
FOR 
COVERED 
OUTPATIENT 
DRUGS TO ALLOW FOR UP TO 3-MONTH SUP-
PLY OF FILLS AND REFILLS OF SUCH DRUGS. 
Section 1927(a) of the Social Security Act (42 U.S.C. 
1396r–8(a)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(8) REQUIREMENT TO ALLOW FOR UP TO 3- 
MONTH SUPPLY OF FILLS AND REFILLS.— 
‘‘(A) IN GENERAL.—In order for payment 
to be available under section 1903(a) for a cov-
ered outpatient drug that is administered on or 
after the first day of the first full month fol-
lowing the date of the enactment of this para-
graph, the State shall permit any individual en-
rolled under the State plan (or a waiver of such 
plan) to obtain in a single fill or refill, at the 
option of such individual, the total day supply 
(not to exceed a 90-day supply) prescribed for 
such individual for a covered outpatient drug, 
without regard to any cost and utilization man-
agement, medication therapy management, or 
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