‘‘(ii) APPLICATION
OF
COST-SHAR-
ING.— 
‘‘(I) PLAN YEAR 2023.—For plan 
year 2023, the coverage provides ben-
efits for such insulin products, regard-
less of whether an individual has 
reached the initial coverage limit 
under paragraph (3) or the out-of- 
pocket threshold under paragraph (4), 
with cost-sharing that is equal to the 
applicable copayment amount. 
‘‘(II) PLAN YEAR 2024 AND SUB-
SEQUENT
PLAN
YEARS.—For plan 
year 2024 and subsequent plan years, 
the coverage provides benefits for 
such insulin products, prior to an in-
dividual reaching the out-of-pocket 
threshold under paragraph (4), with 
cost-sharing that is equal to the appli-
cable copayment amount. 
‘‘(III) APPLICABLE
COPAYMENT 
AMOUNT.—For 
purposes 
of 
this 
clause, the term ‘applicable copayment 
amount’ means, with respect to an in-
sulin product under a prescription 
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drug plan or an MA–PD plan, an 
amount that is not more than $35. 
‘‘(B) INSULIN PRODUCT.—For purposes of 
this paragraph, the term ‘insulin product’ 
means an insulin product that is approved 
under section 505 of the Federal Food, Drug, 
and Cosmetic Act or licensed under section 351 
of the Public Health Service Act and marketed 
pursuant to such approval or licensure, includ-
ing any insulin product that has been deemed 
to be licensed under section 351 of the Public 
Health 
Service 
Act 
pursuant 
to 
section 
7002(e)(4) of the Biologics Price Competition 
and Innovation Act of 2009 and marketed pur-
suant to such section.’’; and 
(2) in subsection (c), by adding at the end the 
following new paragraph: 
‘‘(4) TREATMENT OF COST-SHARING FOR INSU-
LIN PRODUCTS.—The coverage is provided in accord-
ance with subsection (b)(8).’’. 
(b) CONFORMING AMENDMENTS TO COST-SHARING 
FOR LOW-INCOME INDIVIDUALS.—Section 1860D–14(a) 
of the Social Security Act (42 U.S.C. 1395w–114(a)) is 
amended— 
(1) in paragraph (1)— 
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(A) in subparagraph (D)(iii), by adding at 
the end the following new sentence: ‘‘For plan 
year 2023 and subsequent plan years, the co-
payment amount applicable under the preceding 
sentence to an insulin product (as defined in 
section 1860D–2(b)(8)(B)) furnished to the in-
dividual may not exceed the applicable copay-
ment amount for the product under the pre-
scription drug plan or MA–PD plan in which 
the individual is enrolled.’’; and 
(B) in subparagraph (E), by inserting the 
following before the period at the end ‘‘or under 
section 1860D–2(b)(8) in the case of an insulin 
product (as defined in subparagraph (B) of 
such section)’’; and 
(2) in paragraph (2)— 
(A) in subparagraph (D), by adding at the 
end the following new sentence: ‘‘For plan year 
2023 and subsequent plan years, the amount of 
the coinsurance applicable under the preceding 
sentence to an insulin product (as defined in 
section 1860D–2(b)(8)(B)) furnished to the in-
dividual may not exceed the applicable copay-
ment amount for the product under the pre-
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scription drug plan or MA–PD plan in which 
the individual is enrolled.’’; and 
(B) in subparagraph (E), by adding at the 
end the following new sentence: ‘‘For plan year 
2023, the amount of the copayment or coinsur-
ance applicable under the preceding sentence to 
an insulin product (as defined in section 
1860D–2(b)(8)(B)) furnished to the individual 
may not exceed the applicable copayment 
amount for the product under the prescription 
drug plan or MA–PD plan in which the indi-
vidual is enrolled.’’ 
(c) IMPLEMENTATION.—The Secretary shall imple-
ment this section for plan years 2023 and 2024 by pro-
gram instruction or otherwise. 
Æ 
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