SEC. 2. APPLYING THE MEDICAID ADDITIONAL REBATE RE-
QUIREMENT TO GENERIC DRUGS. 
(a) IN GENERAL.—Section 1927(c)(3) of the Social 
Security Act (42 U.S.C. 1396r–8(c)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘The 
amount’’ and inserting ‘‘Except as provided in sub-
paragraph (C), the amount’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(C) ADDITIONAL REBATE.— 
‘‘(i) IN
GENERAL.—The amount of 
the rebate specified in this paragraph for 
a rebate period, with respect to each dos-
age form and strength of a covered out-
patient drug other than a single source 
drug or an innovator multiple source drug, 
shall be increased in the manner that the 
rebate for a dosage form and strength of 
a single source drug or an innovator mul-
tiple source drug is increased under sub-
paragraphs (A) and (D) of paragraph (2), 
except as provided in clause (ii). 
‘‘(ii) SPECIAL
RULES
FOR
APPLICA-
TION
OF
PROVISION.—In applying sub-
paragraphs (A) and (D) of paragraph (2) 
under clause (i)— 
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‘‘(I) the reference in subpara-
graph (A)(i) of such paragraph to 
‘1990’ shall be deemed a reference to 
‘2014’; 
‘‘(II) subject to clause (iii), the 
reference in subparagraph (A)(ii) of 
such paragraph to ‘calendar quarter 
beginning July 1, 1990’ shall be 
deemed a reference to the ‘calendar 
quarter in which the average manu-
facturer price for the drug is the low-
est during the 12-calendar quarter pe-
riod ending on September 30, 2014’; 
‘‘(III) subject to clause (iii), the 
reference in subparagraph (A)(ii) of 
such paragraph to ‘September 1990’ 
shall be deemed a reference to ‘the 
last month of such calendar quarter’; 
‘‘(IV) the references in subpara-
graph (D) of such paragraph to ‘para-
graph (1)(A)(ii)’, ‘this paragraph’, 
and ‘December 31, 2009’ shall be 
deemed references to ‘subparagraph 
(A)’, ‘this subparagraph’, and ‘De-
cember 31, 2014’, respectively; and 
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‘‘(V) any reference in such para-
graph to a ‘single source drug or an 
innovator multiple source drug’ shall 
be deemed to be a reference to a drug 
to which clause (i) applies. 
‘‘(iii) SPECIAL
RULE
FOR
CERTAIN 
NONINNOVATOR
MULTIPLE
SOURCE 
DRUGS.—In 
applying 
paragraph 
(2)(A)(ii)(II) under clause (i) with respect 
to a covered outpatient drug that is first 
sold as a drug other than a single source 
drug or an innovator multiple source drug 
after the date that is 3 years before the 
date of the enactment of this subpara-
graph, such paragraph shall be applied— 
‘‘(I) by substituting ‘the applica-
ble quarter’ for ‘the calendar quarter 
beginning July 1, 1990’; and 
‘‘(II) by substituting ‘the last 
month in such applicable quarter’ for 
‘September 1990’. 
‘‘(iv) 
APPLICABLE
QUARTER
DE-
FINED.—In this subsection, the term ‘ap-
plicable quarter’ means, with respect to a 
drug described in clause (iii), the fifth full 
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calendar quarter in which the drug is sold 
as a drug other than a single source drug 
or an innovator multiple source drug.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to rebate periods beginning after 
December 31, 2014. 
Æ 
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