RxCAP Act of 2019

Bill: 116-s-475
Sponsor: full_name: Sen. Wyden, Ron [D-OR]
Introduced: 2019-02-13
Policy area: Health
Subjects: Medicare

Prescription drugs
Latest action: action_date: 2019-02-13
text: Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2019-02-13
action_desc: Introduced in Senate
text: <p><strong>Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 or the RxCAP Act of </strong><b>2019</b></p> <p>This bill eliminates beneficiary cost-sharing above the Medicare prescription drug benefit's annual out-of-pocket threshold beginning in plan year 2020. Under current law, the Medicare prescription drug benefit provides coverage above that threshold only with cost-sharing in the form of either copayment or coinsurance. </p>

tv_txt: II 116th CONGRESS 1st Session S. 475 IN THE SENATE OF THE UNITED STATES February 13, 2019 Mr. Wyden (for himself, Mr. Bennet , Mr. Cardin , Ms. Klobuchar , Mr. Merkley , and Mr. Whitehouse ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities.

1. Short title This Act may be cited as the Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 or the RxCAP Act of 2019 . 2. Elimination of cost-sharing above the Medicare part D annual out-of-pocket threshold (a) In general Section 1860D–2(b)(4)(A) of the Social Security Act ( 42 U.S.C. 1395w–102(b)(4)(A) ) is amended— (1) in clause (i)— (A) by redesignating subclauses (I) and (II) as items (aa) and (bb), respectively, and indenting appropriately; (B) by striking subparagraph (B), with cost-sharing and inserting the following: “subparagraph (B)— (I) for plan years 2006 through 2019, with cost-sharing ; (C) in item (bb), as redesignated by subparagraph (A), by striking the period at the end and inserting ; and ; and (D) by adding at the end the following new subclause: (II) for plan year 2020 and subsequent plan years, without any cost-sharing. ; and (2) in clause (ii)— (A) by striking clause (i)(I) and inserting clause (i)(I)(aa) ; and (B) by adding at the end the following new sentence: The Secretary shall continue to calculate the dollar amounts specified in clause (i)(I)(aa), including with the adjustment under this clause, after plan year 2019 for purposes of 1860D–14(a)(1)(D)(iii). . (b) Conforming amendments to low-Income subsidy Section 1860D–14(a) of the Social Security Act ( 42 U.S.C. 1395w–114(a) ) is amended— (1) in paragraph (1)— (A) in subparagraph (D)(iii), by striking 1860D–2(b)(4)(A)(i)(I) and inserting 1860D–2(b)(4)(A)(i)(I)(aa) ; and (B) in subparagraph (E)— (i) in the heading, by inserting prior to the elimination of such cost-sharing for all individuals after threshold ; and (ii) by striking The elimination and inserting For plan years 2006 through 2019, the elimination ; and (2) in paragraph (2)(E)— (A) in the heading, by inserting prior to the elimination of such cost-sharing for all individuals after threshold ; (B) by striking Subject to and inserting For plan years 2006 through 2019, subject to ; and (C) by striking 1860D–2(b)(4)(A)(i)(I) and inserting 1860D–2(b)(4)(A)(i)(I)(aa) .