United States · United States Congress · 19 May 2021
Save America’s Forgotten Equines Act of 2021 or the SAFE Act of 2021 This bill prohibits the transporting, receiving, possessing, purchasing, selling, or donation by a person of an equine (e.g., horse) that the person has reason to believe will be slaughtered for human consumption.
United States · United States Congress · 19 May 2021
Greyhound Protection Act of 2021 This bill modifies the federal criminal statute commonly known as the Wire Act. Currently, the Wire Act contains four prohibitions on the use of a wire transmission facility (e.g., the telephone or internet) for certain gambling activities. All four prohibitions apply to sports gambling. However, there have been conflicting interpretations of the applicability of the prohibitions to nonsports gambling (e.g., state lotteries). This bill amends the Wire Act to expressly state that the statute does not authorize the use of wire communications to gamble on commercial greyhound racing or permit the transport of animals for commercial dog racing or related activities.
United States · United States Congress · 19 May 2021
SOS: Sustaining Outpatient Services Act This bill allows for payment under the Medicare prospective payment system for hospital outpatient department services of certain items and services that are furnished at off-campus outpatient departments. Specifically, the bill allows for payment of items and services for which payments to physician specialists (under the Medicare physician fee schedule) did not exceed $2 million during the previous year.
United States · United States Congress · 19 May 2021
Youth Workforce Readiness Act of 2021 This bill requires the Department of Labor to award grants to certain national youth-serving organizations for comprehensive workforce readiness programs provided to youth that take place before or after school, during summer vacation or holiday, or on the weekend (i.e., out-of-school-time programs). Such grants must be used to develop and implement youth workforce readiness programs, including for activities such as on-the-job and leadership opportunities, internships, and other supportive services. The bill also requires local workforce development boards to establish youth councils as subgroups of the boards.
United States · United States Congress · 18 May 2021
Promoting Service in Transportation Act This bill directs the Department of Transportation to establish and administer a transportation workforce outreach program to (1) increase awareness of transportation career opportunities; and (2) increase diversity such as race, gender, ethnicity, and socioeconomic status of professionals in the transportation sector.
United States · United States Congress · 18 May 2021
Institutional Grants for New Infrastructure, Technology, and Education for HBCU Excellence Act or the IGNITE HBCU Excellence Act This bill establishes a grant program to support long-term improvements of historically Black colleges and universities (HBCUs) and graduate programs at HBCUs. Specifically, the bill requires the Department of Education (ED) to award grants to HBCUs to improve campus facilities. A recipient must use grant funds for certain activities, such as constructing or renovating facilities, carrying out major repairs, and strengthening the safety and security of a campus. Any new construction, modernization, or renovation projects must meet building code and energy and water conservation requirements. Further, HBCUs must seek to procure contracts from certain small businesses, including those owned and controlled by veterans and service-disabled veterans. The bill prohibits the use of grant funds for specified activities, including for the payment of routine and predictable maintenance costs, minor repairs, and utility bills. The Government Accountability Office must study the implementation of the grant program. The bill also requires ED to repay the outstanding balance of principal, interest, fees, and costs and any related reimbursements for certain capital financing loans.
United States · United States Congress · 17 May 2021
21st Century President Act This bill revises the definition of immediate family for purposes of a criminal offense involving a threat to kill, kidnap, or inflict bodily harm on a former President or a member of the immediate family of a former President. Specifically, it replaces gender-specific references to a former President's wife and widow with the gender-neutral terms spouse and surviving spouse .
United States · United States Congress · 17 May 2021
This resolution supports the goals and ideals of an International Day Against Homophobia, Transphobia, and Biphobia. The resolution encourages (1) health care providers to offer culturally and clinically competent care to the lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) community; (2) schools to support the creation of gender and sexuality alliances; (3) individuals to learn about national resources for those who identify as LGBTQ+; and (4) funding organizations, aid efforts, and governments to prioritize the health and human rights of LGBTQ+ people.
United States · United States Congress · 17 May 2021
Recognizing the Protection of Motorsports Act of 2019 or the RPM Act of 2019 [ sic ] This bill authorizes the modification of a vehicle's air emission controls for vehicles that are not legal for operation on a street or highway and are used solely for competition.
United States · United States Congress · 17 May 2021
This resolution expresses support for the designation of DIPG Awareness Day. DIPG is diffuse intrinsic pontine glioma, a terminal childhood brain cancer.
United States · United States Congress · 14 May 2021
Non-Opioids Prevent Addiction In the Nation Act or the NOPAIN Act This bill temporarily establishes separate payments for certain non-opioid treatments under the Medicare prospective payment system for hospital outpatient department services and the payment system for ambulatory surgical center services. The bill applies to pain management treatments that are able to replace or reduce opioid consumption, as shown through clinical trials or data.
United States · United States Congress · 14 May 2021
Teacher, Principal, and Leader Residency Access Act This bill expands the federal work-study programs at institutions of higher education (IHEs) to include work-study programs that compensate students serving in a residency program at the IHE. R esidency program refers to a school-based educator preparation program in which a prospective teacher, principal, or school leader (1) works for one academic year with a mentor teacher, principal, or other school leader; (2) receives concurrent instruction from the IHE; (3) acquires effective teaching or school leader skills; and (4) attains certification or licensure prior to completion of the program.
United States · United States Congress · 13 May 2021
Improving Seniors' Timely Access to Care Act of 2021 This bill establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans. Specifically, MA plans must (1) establish an electronic prior authorization program that meets specified standards, including the ability to provide real-time decisions in response to requests for items and services that are routinely approved; (2) annually publish specified prior authorization information, including the percentage of requests approved and the average response time; and (3) meet other standards, as set by the Centers for Medicare & Medicaid Services, relating to the quality and timeliness of prior authorization determinations.
United States · United States Congress · 13 May 2021
Temporary Family Visitation Act This bill establishes a new nonimmigrant visa classification for an alien temporarily entering the United States to visit a relative who is a U.S. citizen or lawful permanent resident. The maximum period of stay for a family visitor visa shall be 90 days. An alien seeking such a visa must have health insurance for the duration of the stay. An alien who holds such a visa may not change to another nonimmigrant visa classification except in certain limited instances. If an alien has been approved for a family-based immigrant visa and is waiting for one to become available, the alien may obtain a family visitor visa if the alien meets the eligibility requirements.
United States · United States Congress · 13 May 2021
This bill waives certain eligibility requirements for hospitals participating in the 340B drug discount program (i.e., a program that allows entities to receive covered outpatient drugs at reduced prices from manufacturers) during the COVID-19 (i.e., coronavirus disease 2019) public health emergency. Specifically, the bill waives the required minimum proportion of low-income patients served for hospitals that began participating in the program during or prior to the COVID-19 emergency.
United States · United States Congress · 13 May 2021
21st Century Workforce Partnerships Act This bill requires the Department of Education (ED) to establish grant programs for educational or career training programs for students. First, ED must establish a career pathways innovation grant program. Under the program, ED must award grants to address the specialized skill needs of business and industry by carrying out programs that support career pathways in high school or career exploration in the middle grades. Second, ED must award grants for partnerships—between certain educational entities and employers—that provide educational or career training programs leading to recognized postsecondary credentials.
United States · United States Congress · 13 May 2021
Metastatic Breast Cancer Access to Care Act This bill expedites payment of Social Security Disability Insurance (SSDI) benefits and eligibility for Medicare coverage for those with metastatic breast cancer (i.e., breast cancer that has spread to other sites in the body). Specifically, the bill eliminates the 5-month waiting period for SSDI benefits and the subsequent 24-month waiting period for Medicare coverage for individuals with metastatic breast cancer. Under current law, individuals generally must wait five months after the onset of disability to begin receiving SSDI benefits and an additional 24 months to become eligible for Medicare.
United States · United States Congress · 13 May 2021
I am Vanessa Guillén Act of 2021 This bill addresses the policies and procedures of the Department of Defense (DOD) for cases or allegations of sex-related offenses.
United States · United States Congress · 13 May 2021
Homes for Every Local Protector, Educator, and Responder Act of 2021 or the HELPER Act of 2021 This bill establishes a program administered by the Department of Housing and Urban Development to provide mortgage assistance to law enforcement officers, elementary and secondary school teachers, firefighters, or other first responders. Specifically, these individuals may be eligible for a one-time mortgage on a primary family residence with no down payment and no monthly mortgage insurance premium.
United States · United States Congress · 13 May 2021
This bill increases the applicable threshold amount for heads of household in 2021 to $150,000 for purposes of the income phaseout in the child tax credit (thus making it equal to the threshold amount for married individuals filing joint tax returns).
United States · United States Congress · 13 May 2021
Public Safety Employer-Employee Cooperation Act This bill requires the Federal Labor Relations Authority to determine whether a state substantially provides public safety officers or employees the right to form and join a labor organization; recognition by public safety employers of the employees' labor organization, agreement to bargain with the organization, and reduction of any agreements to writing in a contract or memorandum of understanding; the right to bargain over hours, wages, and terms and conditions of employment; and binding interest arbitration to resolve an impasse in collective bargaining negotiations. The bill makes the authority responsible for (1) determining the appropriateness of units for labor representation; (2) supervising elections; (3) conducting hearings and resolving complaints of unfair labor practices; and (4) protecting the right of employees to form, join, or assist any labor organization, or to refrain from doing so. An employer, public safety officer, or labor organization may not engage in a lockout, sickout, work slowdown, strike, or any other organized job action that will measurably disrupt the delivery of emergency services and is designed to compel an employer, public safety officer, or labor organization to agree to the terms of a proposed contract.
United States · United States Congress · 11 May 2021
Fair and Open Skies Act This bill prohibits the Department of Transportation (DOT) from issuing a foreign air carrier permit or an exemption from certain air carrier certificate requirements under the United States-European Union Air Transport Agreement of April 2007, unless DOT finds that issuing the permit or exemption would be consistent with Article 17 bis of the agreement, which provides that opportunities created by the agreement do not undermine labor standards or the labor-related rights and principles contained in the laws of the respective parties to the agreement; and imposes conditions on the permit or exemption necessary to ensure compliance with Article 17 bis . The bill modifies policy considerations relating to air carrier certificates to require DOT to consider preventing entry into U.S. markets by flag of convenience carriers (i.e., foreign air carriers established in a country other the home country of their majority owner in order to avoid regulations of the home country) and preventing the undermining of labor standards. In carrying out such air carrier certificate requirements, DOT must consider preventing entry of flag of convenience carriers into U.S. markets as being in the public interest and consistent with public convenience and necessity for safety in air transportation and air commerce. In formulating U.S. international air transportation policy relating to the elimination of discrimination and unfair competition, the Department of State and DOT must include in their considerations the undermining of labor standards.
United States · United States Congress · 11 May 2021
Postal Service Reform Act of 2021 This bill addresses the finances and operations of the U.S. Postal Service (USPS). The bill requires the Office of Personnel Management to establish the Postal Service Health Benefits Program for USPS employees and retirees and provides for coordinated enrollment of retirees under this program and Medicare. The bill repeals the requirement that the USPS annually prepay future retirement health benefits. Additionally, the USPS may establish a program to enter into agreements with an agency of any state government, local government, or tribal government, and with other government agencies, to provide certain nonpostal products and services that reasonably contribute to the costs of the USPS and meet other specified criteria. The USPS must develop and maintain a publicly available dashboard to track service performance and must report regularly on its operations and financial condition. The Postal Regulatory Commission must annually submit to the USPS a budget of its expenses. It must also conduct a study to identify the causes and effects of postal inefficiencies relating to flats (e.g., large envelopes). The USPS Office of Inspector General shall perform oversight of the Postal Regulatory Commission.
United States · United States Congress · 11 May 2021
Protect and Serve Act of 2021 This bill establishes a new criminal offense for knowingly assaulting a law enforcement officer and causing serious bodily injury (or attempting to do so) in circumstances that affect interstate commerce. It imposes criminal penalties—a prison term, a fine, or both—on a violator.
United States · United States Congress · 11 May 2021
Accelerating Kids' Access to Care Act This bill requires state Medicaid programs to establish a process through which qualifying out-of-state providers may enroll as participating providers without undergoing additional screening requirements. Among other things, a qualifying provider must (1) serve minors, or adults whose condition began as a minor; and (2) have previously been screened for Medicare participation or for participation in the Medicaid program of the state in which the provider is located.
United States · United States Congress · 11 May 2021
Medical Nutrition Therapy Act of 2021 This bill expands Medicare coverage of medical nutrition therapy services. Currently, Medicare covers such services for individuals with diabetes or kidney disease under certain circumstances; such services must also be provided by a registered dietitian or nutrition professional pursuant to a physician referral. The bill extends coverage to individuals with other diseases and conditions, including obesity, eating disorders, cancer, and HIV/AIDS; such services may also be referred by a physician assistant, nurse practitioner, clinical nurse specialist, or (for eating disorders) a clinical psychologist.
United States · United States Congress · 11 May 2021
Equity in Neuroscience and Alzheimer's Clinical Trials Act of 2021 or the ENACT Act of 2021 This bill sets out activities and requirements to increase the participation of underrepresented populations in research and clinical trials for Alzheimer's disease and related dementias. Specifically, the National Institute on Aging (NIA) must establish and provide technical assistance to Alzheimer's research centers located in areas with higher concentrations of minority groups. These centers must establish diagnostic and treatment clinics designed to serve minority, rural, and other underserved populations; operate clinical trials; and carry out public outreach to encourage members of minority populations to participate in clinical trials and research. Additionally, the NIA must disseminate information to members of minority populations about participating in clinical trials and take other actions to enhance diversity with respect to the Alzheimer's research that it conducts or supports. The bill also directs the NIA to increase diversity among Alzheimer's researchers by encouraging the participation of individuals who are from groups that are underrepresented in clinical, behavioral, and social sciences.
United States · United States Congress · 11 May 2021
Ryan Frascone Memorial Student Loan Relief Act of 2021 This bill retroactively applies certain borrower protections related to cosigners of private student loans. Specifically, all private student loan agreements must (1) prohibit creditors from declaring a default or accelerating the debt of a private student loan on the sole basis of the death or bankruptcy of a cosigner to such a loan, and (2) require loan holders to release a cosigner from any obligation upon the death of the student borrower. Under current law, these protections apply only to private student loan agreements entered into on or after November 20, 2018. Additionally, the Department of the Treasury must establish a program to purchase and retire such private student loans from loan holders suffering financial injury as a result of this bill.
United States · United States Congress · 11 May 2021
Personal Health Investment Today Act of 2021 or the PHIT Act of 2021 This bill allows a medical care tax deduction for up to $1,000 ($2,000 for a joint return or a head of household) of qualified sports and fitness expenses per year. The bill defines qualified sports and fitness expenses as amounts paid exclusively for participating in a physical activity, including (1) fitness facility memberships, (2) physical exercise or activity programs, or (3) equipment for a physical exercise or activity program.
United States · United States Congress · 7 May 2021
Raise the Age Act This bill establishes new restrictions on the sale or transfer of certain semiautomatic firearms to individuals under 21 years of age. Specifically, this bill makes it unlawful for a licensed gun dealer, importer, manufacturer, or collector to sell or deliver a semiautomatic center-fire rifle that has (or has the capacity to accept) an ammunition feeding device with a capacity of more than five rounds to an individual who the licensee knows or has reasonable cause to believe is under age 21. The prohibition does not apply if the individual under age 21 is a full-time law enforcement officer or active-duty member of the Armed Forces. The bill also requires the Federal Bureau of Investigation to report on the operation of its public access line, including a description of information sharing protocols and recommendations for improving such protocols.
United States · United States Congress · 7 May 2021
Convening Operations Assistance for Childcare Heroes Act or the COACH Act This bill requires the Small Business Administration to maintain a resource guide for small businesses operating as child care providers that includes guidance on topics such as operations, finances, and compliance with relevant laws.
United States · United States Congress · 4 May 2021
Military Spouse Hiring Act This bill expands the Work Opportunity Tax Credit (WOTC) to include the hiring of a qualified military spouse. (The WOTC permits employers who hire individuals who are members of a targeted group such as qualified veterans, ex-felons, or long-term unemployment recipients to claim a tax credit equal to a portion of the wages paid to those individuals.) A qualified military spouse is any individual who is certified by the designated local agency as being (as of the hiring date) a spouse of a member of the Armed Forces.
United States · United States Congress · 4 May 2021
Securing a Strong Retirement Act of 2021 This bill makes various changes with respect to employer-sponsored retirement plans, including providing for the automatic enrollment of employees in certain plans and increasing the age at which participants are required to begin receiving mandatory distributions.
United States · United States Congress · 4 May 2021
Vietnam Human Rights Act This bill requires actions related to human rights in Vietnam and addresses related issues. The Department of State must assist eligible individuals and entities working to secure the release of political and religious prisoners in Vietnam. The Office of Internet Freedom within the U.S. Agency for Global Media and the Bureau of Democracy, Human Rights, and Labor within the State Department shall prioritize (1) the immediate distribution of censorship circumvention tools for computers and smartphones in Vietnam; and (2) projects to ensure the safety and privacy of bloggers, journalists, and human rights defenders in Vietnam. Foreign assistance may not be used to assist any unit of the Vietnamese government engaged in cyberespionage activities. The State Department may establish programs to (1) monitor and halt sex trafficking of women from Vietnam and other Asian countries, and (2) address Vietnam's growing sex-ratio disparity. The bill also requires various reports to Congress, including reports on (1) persons subject to U.S. sanctions for human rights violations in Vietnam, (2) a strategy to promote internet freedom in Vietnam, and (3) cyberespionage activities sanctioned by the Vietnamese government targeting Vietnamese dissidents and human rights advocates living outside of Vietnam.
United States · United States Congress · 4 May 2021
Special Guerrilla Unit Veterans Service Recognition Expansion Act of 2021 This bill expands eligibility for internment in national cemeteries to include certain individuals who the Department of Veterans Affairs determines served honorably with a special guerilla unit or irregular forces in Laos in support of the U.S. Armed Forces between February 28, 1961, and May 7, 1975. Such individuals are eligible if, at the time of their death, they resided in the United States and were a U.S. citizen or alien lawfully admitted for permanent residence in the United States.
United States · United States Congress · 30 April 2021
This resolution promotes increased public awareness of motorcyclist profiling. The resolution also encourages the motorcyclist community and law enforcement to collaborate and communicate on efforts to end motorcyclist profiling.
United States · United States Congress · 30 April 2021
Safeguard Tribal Objects of Patrimony Act of 2021 This bill prohibits the exportation of Native American cultural items and archaeological resources that were illegally obtained; provides for the return of such items, including voluntary returns; and establishes and increases related criminal penalties. The bill requires the Department of the Interior and the Department of State to each designate a liaison to facilitate and hold trainings and workshops on the voluntary return of human remains and cultural items. Additionally, Interior must refer individuals and organizations to Indian tribes and Native Hawaiian organizations to facilitate the voluntary return of human remains and cultural items; convene an interagency working group; and convene a Native working group consisting of representatives of Indian tribes and Native Hawaiian organizations to provide advice on issues concerning the return of, and illegal trade in, human remains and cultural items. The bill also increases from 5 years to 10 years the maximum prison term for an individual convicted of selling, purchasing, using for profit, or transporting for sale or profit human remains or cultural items that were illegally obtained.
United States · United States Congress · 30 April 2021
This resolution expresses support for the goals and values of the 53rd anniversary of the Fair Housing Act and for efforts to strengthen housing protections, particularly during the COVID-19 public health emergency.
United States · United States Congress · 30 April 2021
Continuous Improvement and Accountability in Organic Standards Act This bill requires the Department of Agriculture (USDA) to undertake rulemaking and other activities to implement certain recommendations of the National Organic Standards Board (a federal advisory board that considers and makes recommendations concerning the production, handling, and processing of organic products). Specifically, USDA must issue within a specified time line final rules for implementing recommendations approved (1) by the board between December 31, 2000, and the date of the bill's enactment; and (2) with at least two-thirds of the votes cast at a meeting where a quorum was present. If USDA determines issuing rules for such recommendations is not practicable, it must identify and report to Congress about the specific constraints that preclude rulemaking. In addition, the bill sets out a process and time line for USDA to implement through rulemaking future recommendations of the board that are approved by at least two-thirds of the votes cast at a meeting where a quorum was present. The bill also requires state officials or entities that certify organic farms or handling operations to report annually concerning the implementation of and compliance with any new rule or guidance.
United States · United States Congress · 30 April 2021
This resolution (1) expresses support for the designation of Motorcycle Safety Awareness Month; (2) recognizes the contribution of motorcycles to the transportation mix; (3) encourages motorcycle awareness by all road users; (4) recognizes that motorcyclists have a right to the road and that all motorists should safely share the roadways; (5) encourages rider safety education, training, and proper gear for safe motorcycle operation; and (6) supports the goals of Motorcycle Safety Awareness Month.
United States · United States Congress · 30 April 2021
This resolution thanks the teachers of the United States and promotes the teaching profession by encouraging students, parents, school administrators, and public officials to recognize National Teacher Appreciation Week.
United States · United States Congress · 28 April 2021
Increasing Access to Biosimilars Act of 2021 This bill requires the Centers for Medicare & Medicaid Services to establish a demonstration project to evaluate the benefits of providing additional payments to providers of biosimilars under Medicare. Specifically, under the demonstration project, participating providers receive an additional payment based on the difference between the costs to the provider of furnishing the biosimilar and the cost if the provider had furnished the underlying reference biological product instead.
United States · United States Congress · 28 April 2021
Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021 or the CONNECT for Health Act of 2021 This bill expands coverage of telehealth services under Medicare. Among other provisions, the bill allows the Centers for Medicare & Medicaid Services (CMS) to waive certain restrictions, such as restrictions on the types of technology that may be used; permanently removes geographic restrictions on originating sites (i.e., the location of the beneficiary) and allows the home of the beneficiary to serve as the originating site for all services; permanently allows federally qualified health centers and rural health clinics to serve as the distant site (i.e., the location of the health care practitioner); and allows the CMS to generally waive coverage restrictions during any public health emergency. Additionally, the CMS must report on the effects of expanded telehealth services during the COVID-19 public health emergency, including with respect to the utilization, quality, and outcomes of services. The Center for Medicare and Medicaid Innovation may also test alternative payment models relating to expanded telehealth services.
United States · United States Congress · 28 April 2021
Railroad Employee Equity and Fairness Act or the REEF Act This bill permanently exempts payments made from the Railroad Unemployment Insurance Account from sequestration. Sequestration is a process of automatic, usually across-the-board spending reductions under which budgetary resources are permanently cancelled to enforce specific budget policy goals. Currently, this exemption ends 30 days after the termination of the COVID-19 national emergency period.
United States · United States Congress · 26 April 2021
Puppy Protection Act of 2021 This bill requires the Department of Agriculture to expand standards that govern the humane handling, care, treatment, and transportation of animals to include new requirements for commercial dog dealers. Specifically, the standards must require dog dealers to provide to dogs adequate housing, exercise, and veterinary care; appropriate and nutritious food; continuous access to potable water; and meaningful socialization with humans and compatible dogs for at least 30 minutes each day. The standards must also include requirements for breeders to use safe breeding practices and make all reasonable efforts to find humane placement for retired breeding dogs.
United States · United States Congress · 26 April 2021
Ensuring Access to Lower-Cost Medicines for Seniors Act of 2021 This bill establishes additional requirements for prescription drug plan (PDP) sponsors that use formularies under the Medicare prescription drug benefit. Specifically, the bill requires PDP formularies to include covered generic drugs and biosimilars for which the wholesale acquisition cost is less than that of the reference (i.e., brand-name) product. PDP sponsors must also establish specific cost-sharing tiers that apply lower cost-sharing requirements for such covered generic drugs and biosimilars as compared to those for brand-name products. The bill also prohibits PDP sponsors from instituting certain requirements relating to access to such covered generic drugs and biosimilars that are more restrictive than those for brand-name products (e.g., prior authorization requirements).
United States · United States Congress · 22 April 2021
Elijah E. Cummings Lower Drug Costs Now Act This bill establishes several programs and requirements relating to the prices of prescription drugs. In particular, the bill requires the Department of Health and Human Services (HHS) to negotiate prices for certain drugs (current law prohibits HHS from doing so). Specifically, HHS must negotiate maximum prices for single-source, brand-name drugs that lack certain generics and that are among either the 125 drugs that account for the greatest national spending or the 125 drugs that account for the greatest Medicare spending. HHS must negotiate the prices of at least 25 such drugs for 2024 and of at least 50 such drugs thereafter and must also negotiate prices for certain newly approved drugs and for insulin products. The negotiated prices must be offered under Medicare and may also be offered under private health insurance unless the insurer opts out. The negotiated maximum price may not exceed (1) 120% of the average price in Australia, Canada, France, Germany, Japan, and the United Kingdom; or (2) if such information is not available, 85% of the U.S. average manufacturer price. Drug manufacturers that fail to comply with the bill's negotiation requirements are subject to civil and tax penalties. The bill also makes a series of additional changes to Medicare prescription drug coverage and pricing, including by (1) requiring drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services for covered drugs that cost $100 or more and for which the average manufacturer price increases faster than inflation, and (2) capping annual out-of-pocket spending under the Medicare prescription drug benefit. The bill also requires drug manufacturers to report specified information for certain high-cost drugs, and it provides funds for opioid epidemic initiatives and biomedical research.