This bill modifies how Medicare pays for certain cancer and complex therapies that are subject to price negotiations. Under current law, drugs selected for price negotiation receive reduced payments, but manufacturers only pay rebates if drug prices rise faster than inflation. This bill creates an additional rebate system where manufacturers must pay Medicare the difference between the standard payment rate (ASP+6) and the negotiated price (MFP+6) for each quarter, based on the number of units sold. The rebates collected go into Medicare's trust fund and help reduce what patients pay out-of-pocket for these drugs, as their coinsurance will be calculated based on the lower negotiated price rather than the standard rate. The rebate requirement applies to all selected drugs under price negotiation starting from the first price applicability period, with manufacturers required to submit rebates within 30 days of receiving quarterly usage data from the Department of Health and Human Services.
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