Title: To provide for a COVID-19-related delay regarding annual limitation on cost-sharing for group health plans and individual and small group health insurance coverage.
Policy area: Health

Summary:
This bill delays until the first calendar year that is 12 months after the end of the COVID-19 (i.e., coronavirus disease 2019) public health emergency the application of the Centers for Medicare & Medicaid Services (CMS) rule dated May 14, 2020. That rule allows private health insurance plans to decide whether support provided by a prescription drug manufacturer to cover a patient's costs for a drug counts toward the patient's annual out-of-pocket limit. The bill requires enforcement of the previous rule, which allows plans to exclude drug manufacturer support from a patient's annual out-of-pocket limit only if a generic version of the drug is available.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7647 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 7647

To provide for a COVID-19-related delay regarding annual limitation on 
  cost-sharing for group health plans and individual and small group 
                       health insurance coverage.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 16, 2020

   Mr. McEachin (for himself, Mr. Rodney Davis of Illinois, and Mrs. 
 Watson Coleman) introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Committees 
    on Education and Labor, and 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 provide for a COVID-19-related delay regarding annual limitation on 
  cost-sharing for group health plans and individual and small group 
                       health insurance coverage.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. COVID-19-RELATED DELAY REGARDING ANNUAL LIMITATION ON COST-
              SHARING FOR GROUP HEALTH PLANS AND INDIVIDUAL AND SMALL 
              GROUP HEALTH INSURANCE COVERAGE.

    For a plan or policy year that begins on or after January 1, 2020, 
and prior to the first calendar year that begins on or after the date 
that is twelve months after the end of the public health emergency 
first declared by the Secretary of Health and Human Services on January 
27, 2020, with respect to the 2019 Novel Coronavirus--
            (1) section 156.130(h) of title 45, Code of Federal 
        Regulations, as published in the Federal Register on May 14, 
        2020, shall not apply; and
            (2) with respect to a group health plan or an issuer of 
        individual or small group health insurance coverage (as such 
        terms are defined in section 2791 of the Public Health Service 
        Act (42 U.S.C. 300gg-91)), the Secretary of the Treasury, the 
        Secretary of Labor, and the Secretary of Health and Human 
        Services shall enforce section 156.130(h) of title 45, Code of 
        Federal Regulations, as published in the Federal Register on 
        April 25, 2019, and in effect on October 1, 2019.
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