Title: A bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information.
Policy area: Health

Summary:
This bill allows certain payment information relating to covered drugs under the Medicare prescription drug benefit and Medicaid to be disclosed to additional entities. Specifically, certain subsidy and rebate information, as reported by prescription drug plan sponsors and drug manufacturers, may be disclosed to the Medicare Payment Advisory Commission and the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission, in accordance with specified confidentiality restrictions.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 801 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                 S. 801

To amend titles XVIII and XIX of the Social Security Act to provide the 
Medicare Payment Advisory Commission and the Medicaid and CHIP Payment 
and Access Commission with access to certain drug payment information, 
                 including certain rebate information.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 14, 2019

Ms. Cortez Masto (for herself, Mr. Cornyn, Mr. Carper, and Mr. Cassidy) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
To amend titles XVIII and XIX of the Social Security Act to provide the 
Medicare Payment Advisory Commission and the Medicaid and CHIP Payment 
and Access Commission with access to certain drug payment information, 
                 including certain rebate information.

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

SECTION 1. PROVIDING THE MEDICARE PAYMENT ADVISORY COMMISSION AND 
              MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION WITH 
              ACCESS TO CERTAIN DRUG PAYMENT INFORMATION, INCLUDING 
              CERTAIN REBATE INFORMATION.

    (a) Access to Certain Part D Payment Data.--Section 1860D-15(f) of 
the Social Security Act (42 U.S.C. 1395w-115(f)) is amended--
            (1) in paragraph (2)--
                    (A) in subparagraph (A)(ii), by striking ``and'' at 
                the end;
                    (B) in subparagraph (B), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by inserting at the end the following new 
                subparagraph:
                    ``(C) by the Executive Director of the Medicare 
                Payment Advisory Commission for purposes of monitoring, 
                making recommendations, and analysis of the program 
                under this title and by the Executive Director of the 
                Medicaid and CHIP Payment and Access Commission for 
                purposes of monitoring, making recommendations, and 
                analysis of the Medicaid program established under 
                title XIX and the Children's Health Insurance Program 
                under title XXI.''; and
            (2) by adding at the end the following new paragraph:
            ``(3) Additional restrictions on disclosure of 
        information.--The Executive Directors described in paragraph 
        (2)(C) shall not disclose any of the following information 
        disclosed to such Executive Directors or obtained by such 
        Executive Directors pursuant to such paragraph, with respect to 
        a prescription drug plan offered by a PDP sponsor:
                    ``(A) The specific amounts or the identity of the 
                source of any rebates, price concessions, or other 
                forms of direct or indirect remuneration under such 
                prescription drug plan.
                    ``(B) Information submitted with the bid submitted 
                under section 1860D-11 by such PDP sponsor.
                    ``(C) In the case of such information from 
                prescription drug event records, in a form that would 
                not be permitted under section 423.505(m) of title 42, 
                Code of Federal Regulations, or any successor 
                regulation, if made by the Centers for Medicare & 
                Medicaid Services.''.
    (b) Access to Certain Rebate and Payment Data Under Medicare and 
Medicaid.--Section 1927(b)(3)(D) of the Social Security Act (42 U.S.C. 
1396r-8(b)(3)(D)) is amended--
            (1) in the matter before clause (i), by striking 
        ``subsection (a)(6)(A)(ii)'' and inserting ``subsection 
        (a)(6)(A)'';
            (2) in clause (iv), by striking ``and'' at the end;
            (3) in clause (v), by striking the period at the end and 
        inserting ``, and'';
            (4) by inserting after clause (v) the following new clause:
                            ``(vi) to permit the Executive Director of 
                        the Medicare Payment Advisory Commission and 
                        the Executive Director of the Medicaid and CHIP 
                        Payment and Access Commission to review the 
                        information provided.'';
            (5) in the matter at the end, by striking ``1860D-
        4(c)(2)(E)'' and inserting ``1860D-4(c)(2)(G)''; and
            (6) by adding at the end the following new sentence: ``Any 
        information disclosed to the Executive Director of the Medicare 
        Payment Advisory Commission or the Executive Director of the 
        Medicaid and CHIP Payment and Access Commission pursuant to 
        this subparagraph shall not be disclosed by either such 
        Executive Director in a form which discloses the identity of a 
        specific manufacturer or wholesaler or prices charged for drugs 
        by such manufacturer or wholesaler.''.
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