Title: PING Act
Policy area: Health

Summary:
Preserving Innovation for the Next Generation Act or the PING Act
This bill expresses the sense of the Senate that the current restrictions prohibiting the Centers for Medicare & Medicaid Services from negotiating the prices or establishing a formulary for drugs under the Medicare prescription drug benefit should not be repealed. The bill also prohibits the Center for Medicare and Medicaid Innovation from testing any model that would repeal or require a waiver of such restrictions.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 1123 Introduced in Senate (IS)]

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117th CONGRESS
  1st Session
                                S. 1123

  To preserve non-interference under the Medicare part D Prescription 
                         Drug Benefit program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 14, 2021

Mrs. Blackburn introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To preserve non-interference under the Medicare part D Prescription 
                         Drug Benefit program.

    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 ``Preserving Innovation for the Next 
Generation Act'' or the ``PING Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Since implementation, the Medicare Prescription Drug 
        Benefit program under part D of title XVIII of the Social 
        Security Act (42 U.S.C. 1395w-101 et seq.) (referred to in this 
        section as ``Medicare part D'') has succeeded beyond 
        expectations in providing affordable prescription drug coverage 
        for more than 45,000,000 seniors and disabled individuals.
            (2) The competitive market has kept total Medicare part D 
        costs below original estimates, while still offering 
        beneficiaries steady premiums and a variety of alternative 
        formularies and benefit design.
            (3) This competitive pricing structure works, in large 
        part, due to the ``non-interference clause'' under Medicare 
        part D which provides for robust private market negotiation 
        without undue government interference.
            (4) The Congressional Budget Office repeatedly has said 
        that government negotiation would have a negligible impact on 
        Medicare part D spending unless the government also restricted 
        access to medications.
            (5) To achieve any significant savings, the government 
        would need to impose access or coverage restrictions on 
        medications. In fact, limiting options will likely result in 
        costs shifting to higher spending for other Medicare services 
        and negatively impact the health of seniors without helping to 
        reduce government spending.
            (6) Having a broad range of treatment options is 
        fundamental to providing good care to all patients, but 
        particularly so for the Medicare population, who are more 
        likely to be affected by multiple chronic conditions. With the 
        advent of personalized medicines and targeted therapies--where 
        the underlying molecular drivers of disease help identify and 
        direct precise, targeted treatment choices--limiting access 
        reduces the vast potential of breakthrough science to 
        revolutionize care. Therefore, it is imperative to ensure 
        beneficiaries have access to a broader range of medicines to 
        best meet their health needs.
            (7) Medicare beneficiaries would not be better off if 
        Medicare part D drug coverage were administered by the Federal 
        Government in the same way as the Veterans Administration. Many 
        veterans rely on other sources to supplement their Veterans 
        Administration drug coverage due to restrictions that limit 
        their access to needed medications. More than half of all 
        veterans supplement their Veterans Administration benefits with 
        other sources of drug coverage, including Medicare part D. A 
        recent Veterans Administration survey shows that approximately 
        80.4 percent of veterans had both Veterans Administration and 
        non-Veterans Administration health coverage and, among those in 
        Medicare, 33.2 percent have Medicare part D for prescription 
        drug coverage.
            (8) Imposing a restrictive Veterans Administration-type 
        formulary on Medicare part D is unlikely to work for the 
        diverse group of more than 45,000,000 beneficiaries enrolled in 
        Medicare part D. Evidence show that seniors would have limited 
        choices and fewer medicines available to them. A recent 
        analysis by Xcenda found that of the top 200 part D brand name 
        drugs, 74 percent or more were covered across stand-alone 
        prescription drug plans and Medicare Advantage prescription 
        drug plans, compared with 52 percent that could be covered by 
        the Veterans Administration formulary.
            (9) A national formulary would restrict access to 
        affordable and vital prescriptions many Medicare beneficiaries 
        rely on. Robust patient access to a full range of medicines has 
        been a cornerstone of Medicare part D. Restricting access to 
        medicines can significantly reduce adherence. Poorer medication 
        adherence, in turn, can lead to worse health outcomes and 
        higher overall spending.
            (10) Price controls or large penalties to force companies 
        to comply with so-called ``negotiations'' have resulted in 
        restricted access abroad and threaten similar restrictions on 
        access in the United States. Research demonstrates that 
        government price setting reduces access for patients and 
        results in fewer or delayed treatment options--nearly 90 
        percent of new medicines launched globally in the past decade 
        are currently available to patients in the United States, only 
        about half are available to patients in other countries like 
        France and Canada.
            (11) Limiting patient access to medicines contradicts the 
        foundational principles of Medicare part D and the value 
        beneficiaries derive from the program--a recent survey shows 
        that more than 90 percent of Medicare beneficiaries are 
        satisfied with their drug coverage and more than 80 percent 
        said it is important to them to have a variety of prescription 
        drug plans under Medicare part D from which to choose.

SEC. 3. SENSE OF THE SENATE.

    It is the sense of the Senate that non-interference in the Medicare 
part D Prescription Drug Benefit program under section 1860D-11(i) of 
the Social Security Act (42 U.S.C. 1395w-111(i)) should not be 
repealed.

SEC. 4. PROHIBITION ON CMI TESTING OF MODELS THAT WOULD REPEAL 
              NONINTERFERENCE.

    Section 1115A(b) of the Social Security Act (42 U.S.C. 1315a(b)) is 
amended by adding at the end the following new paragraph:
            ``(5) Prohibition on testing of models that would repeal 
        noninterference.--The CMI shall not test any model that would 
        repeal or require a waiver of section 1860D-11(i).''.
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