Title: The Insulin Cost Reduction Act
Policy area: Health

Summary:
The Insulin Cost Reduction Act
This bill prohibits the negotiation of price concessions between insulin manufacturers and prescription drug plans under the Medicare prescription drug benefit unless the price concessions are either provided at the point of sale to beneficiaries or are reflected in cost-sharing requirements.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5623 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 5623

   To amend title XVIII of the Social Security Act to prohibit price 
 concessions with respect to insulin drugs and exceptions under part D 
                  of Medicare, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 19, 2021

 Mr. Grothman introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   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 amend title XVIII of the Social Security Act to prohibit price 
 concessions with respect to insulin drugs and exceptions under part D 
                  of Medicare, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``The Insulin Cost Reduction Act''.

SEC. 2. PROHIBITION OF PRICE CONCESSIONS WITH RESPECT TO INSULIN DRUGS 
              AND EXCEPTIONS UNDER PART D OF MEDICARE.

    (a) In General.--Section 1860D-2(d)(1) of the Social Security Act 
(42 U.S.C. 1395w-102(d)(1)) is amended--
            (1) in subparagraph (A), by striking ``Under'' and 
        inserting ``Subject to subparagraph (D), under''; and
            (2) by adding at the end the following new subparagraph:
                    ``(D) Prohibition of price concessions with respect 
                to insulin drugs and exceptions.--For plan years 
                beginning 180 days after the date of the enactment of 
                this subparagraph, no price concessions negotiated 
                between manufacturers and a prescription drug plan or 
                MA-PD plan shall be permitted with respect to an 
                insulin drug (as determined by the Secretary), unless--
                            ``(i) such price concessions provided under 
                        such a plan shall be provided to enrollees of 
                        such a plan at pharmacies or by mail order 
                        service at the point-of-sale of such insulin 
                        drugs; or
                            ``(ii) the cost-sharing required with 
                        respect to such insulin drugs shall be 
                        calculated in a manner that takes into account 
                        any amounts received pursuant to such price 
                        concessions.''.
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