Prescription Drug and Health Improvement Act of 2016

Bill: 114-s-2858
Sponsor: full_name: Sen. Franken, Al [D-MN]
Introduced: 2016-04-27
Policy area: Health
Subjects: Congressional oversight

Drug therapy

Government information and archives

Health care costs and insurance

Medicare

Prescription drugs

Public contracts and procurement
Latest action: action_date: 2016-04-27
text: Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2016-04-27
action_desc: Introduced in Senate
text: <p><strong>Prescription Drug and Health Improvement Act of 2016</strong></p> <p>This bill amends title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare &amp; Medicaid Services (CMS) to negotiate lower prices on behalf of Medicare and Medicare Advantage (MA) beneficiaries for covered prescription drugs that CMS deems appropriate for negotiation based on: (1) program and per-beneficiary spending, (2) unit cost increases over the preceding years, (3) initial launch price, and (4) any other criteria determined by CMS. </p> <p>CMS may negotiate lower prices on behalf of Medicare and MA beneficiaries for other covered prescription drugs, as well.</p>

tv_txt: II 114th CONGRESS 2d Session S. 2858 IN THE SENATE OF THE UNITED STATES April 27, 2016 Mr. Franken (for himself and Ms. Klobuchar ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend part D of title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate for lower prices for Medicare prescription drugs.

1. Short title This Act may be cited as the Prescription Drug and Health Improvement Act of 2016 . 2. Negotiating fair prices for Medicare prescription drugs (a) Negotiating fair prices (1) In general Section 1860D–11 of the Social Security Act ( 42 U.S.C. 1395w–111 ) is amended by striking subsection (i) (relating to noninterference) and by inserting the following: (i) Negotiating fair prices with manufacturers (1) In general Notwithstanding any other provision of law, in furtherance of the goals of providing quality care and containing costs under this part, the Secretary shall, with respect to applicable covered part D drugs, and may, with respect to other covered part D drugs, negotiate, as appropriate (in a manner which may be similar to Federal entities), with pharmaceutical manufacturers the prices (which may include discounts, rebates, and other price concessions) that may be charged to PDP sponsors and MA organizations for such drugs for part D eligible individuals who are enrolled in a prescription drug plan or in an MA–PD plan. (2) Applicable covered part D drug defined For purposes of this subsection, the term applicable covered part D drug means a covered part D drug that the Secretary determines to be appropriate for negotiation under paragraph (1) based on one or more of the following factors as applied to such drug: (A) Spending on a per beneficiary basis. (B) Spending under this title. (C) Unit cost increases over the preceding years. (D) Initial launch price. (E) Any other criteria determined by the Secretary. . (2) Effective date The amendment made by paragraph (1) shall take effect on the date of the enactment of this Act and shall first apply to negotiations and prices for plan years beginning on January 1, 2018. (b) Biannual reports to Congress (1) In general Not later than 3 years after the date of the enactment of this Act, and every 6 months thereafter, the Secretary of Health and Human Services shall submit to Congress a report on the following: (A) The negotiations conducted by the Secretary under section 1860D–11(i) of the Social Security Act ( 42 U.S.C. 1395w–111(i) ), as amended by subsection (a), including a description of how such negotiations are achieving lower prices for covered part D drugs (as defined in section 1860D–2(e) of the Social Security Act ( 42 U.S.C. 1395w–102(e) )) for Medicare beneficiaries. (B) Data on spending under part D of the Medicare program on covered part D drugs, including data on covered part D drugs with— (i) high spending on a per beneficiary basis; (ii) high spending for the program overall; and (iii) high unit cost increases over the past five years. (C) A list of the covered part D drugs with no therapeutic substitute and data on spending under part D of the Medicare program on such drugs. (2) Public availability of report The Secretary of Health and Human Services shall publish on the Internet website of the Centers for Medicare & Medicaid Services a copy of each report submitted under paragraph (1).