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1,251 records in US in 2019
United States · United States Congress · 26 February 2019
Children and Media Research Advancement Act or the CAMRA Act This bill requires the National Institutes of Health to fund research regarding the effects of media on infants, children, and adolescents. Such research must examine the impact of media (e.g., social media, television, video games) on cognitive, physical, and social-emotional development.
United States · United States Congress · 26 February 2019
Mark Takai Atomic Veterans Healthcare Parity Act of 2019 This bill includes veterans who participated in the cleanup of Enewetak Atoll in the Marshall Islands between January 1, 1977, and December 31, 1980, as radiation-exposed veterans for purposes of the Department of Veterans Affairs presumption of service-connection for specified cancers. Under a presumption of service-connection, specific diseases diagnosed in certain veterans are presumed to have been caused by the circumstances of their military service. Health care benefits and disability compensation may then be awarded.
United States · United States Congress · 25 February 2019
Medicare Buy-In and Health Care Stabilization Act of 2019 This bill establishes a Medicare buy-in option for certain qualifying individuals and makes a series of other changes relating to health care costs. Specifically, the bill allows individuals aged 50 to 64 to enroll in Medicare if such individuals would otherwise qualify for Medicare at the age of 65. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations for outreach and enrollment activities relating to the buy-in option. The bill also (1) establishes a supplemental option under Medicare to cover cost-sharing for beneficiaries; (2) repeals provisions that prohibit the CMS from negotiating the prices of prescription drugs; and (3) establishes an individual market reinsurance program relating to coverage of high-cost individuals, as specified.
United States · United States Congress · 25 February 2019
Competitive Deals Resulting in Unleashed Generics and Savings Act of 2019 or the Competitive DRUGS Act of 2019 This bill authorizes the Federal Trade Commission to initiate a proceeding against parties to an agreement resolving or settling a patent infringement claim in connection with the sale of a drug. Such an agreement is generally presumed to be an unfair method of competition and is a violation of this bill if the filer of the generic drug application receives something of value and agrees to limit or forgo research, development, manufacturing, marketing, or sales of the generic drug. However, an agreement is exempted if the only consideration granted to the generic manufacturer is (1) the right to market the generic drug prior to the expiration of any statutory exclusivity, (2) a payment for reasonable litigation expenses, or (3) a covenant not to sue on a claim that the generic drug infringes a patent. An agreement if also exempt if the agreement's pro-competitive benefits outweigh its anticompetitive effects. The bill establishes penalties for violations of the bill.
United States · United States Congress · 25 February 2019
Mental Health Care for Children Inhumanely Separated from Parents by the Federal Government Act of 2019 This bill requires the federal government to ensure that children who are separated from their parents at the border by the Department of Homeland Security receive mental health services for free, including a mental health assessment within 24 hours of such separation and annually thereafter, as needed. Children who have already been separated (since April 6, 2018) must receive a mental health assessment within 24 hours after enactment of this bill.
United States · United States Congress · 25 February 2019
Saving America's Pollinators Act of 2019 This bill requires the Environmental Protection Agency (EPA) to establish a Pollinator Protection Board to develop an independent review process for pesticides that pose a threat to pollinators and their habitats. The bill also requires the EPA to cancel the registrations of any pesticides containing imidacloprid, clothianidin, thiamethoxam, dinotefuran, acetamiprid, sulfoxaflor, flupyradifurone, or fipronil until the board has made a determination that such insecticide will not cause unreasonable adverse effects on pollinators based on findings that include results of studies of neonicotinoids and the effects of residues, repeated applications, and multiple chemical exposures. Under the bill, the EPA shall not issue any new registrations for any seed treatment, soil application, and foliar treatment on bee-attractive plants, trees, and cereals until the board has made determinations on such insecticides. The bill requires the Department of the Interior, the EPA, and the Department of Agriculture to coordinate monitoring activities and report on the health and population status of native bees and other pollinators. The bill prohibits unregistered uses of pesticides by a federal or state agency to address emergency conditions except (1) to avert significant risk to threatened or endangered species, (2) to quarantine invasive species, or (3) to protect public health.
United States · United States Congress · 25 February 2019
Territories Health Equity Act of 2019 This bill alters provisions under Medicaid, Medicare, and Medicare Advantage relating to U.S. territories, and generally modifies and establishes programs to expand health insurance coverage for residents. Among other things, the bill eliminates Medicaid funding limitations for U.S. territories beginning in FY2020; repeals provisions that exclude residents of Puerto Rico from a certain automatic enrollment process for Medicare medical services; establishes minimum criteria for certain elements used in Medicare Advantage payment calculations for areas within U.S. territories; and allows residents of U.S. territories who are unable to obtain health insurance through their employer or a health insurance exchange to instead obtain coverage through the District of Columbia exchange, including coverage that is available to Members of Congress and their staff.
United States · United States Congress · 25 February 2019
Restoring the Partnership for County Health Care Costs Act of 2019 This bill allows an otherwise eligible individual who is in custody pending disposition of charges (i.e., pretrial detainees) to receive Supplemental Security Income (SSI), Medicare, Medicaid, or Children's Health Insurance Program (CHIP) benefits. Any SSI benefits payable to such an individual (1) must be withheld until the individual is no longer in custody; and (2) if the individual dies while in custody, shall be paid to the individual's estate.
United States · United States Congress · 25 February 2019
Protecting Married Seniors from Impoverishment Act This bill makes permanent certain provisions regarding Medicaid eligibility that protect against spousal impoverishment for recipients of home and community-based services. Under current law, these provisions expire on March 31, 2019.
United States · United States Congress · 25 February 2019
Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act or the EMPOWER Care Act This bill extends funding through FY2023 for the Money Follows the Person Rebalancing Demonstration Program and otherwise revises the program. (Under this program, the Centers for Medicare & Medicaid Services may award grants to state Medicaid programs to assist states in increasing the use of home and community care for long-term care and decreasing the use of institutional care.)
United States · United States Congress · 25 February 2019
Fair Care Act of 2019 This bill addresses the health care system, including Medicare, Medicaid, the private health insurance market, and the prescription drug approval process. The bill also revises tax provisions related to certain health care costs and establishes requirements for lawsuits involving health care provided, at least in part, through a federal program or with federal funds.
United States · United States Congress · 25 February 2019
Medicaid Reentry Act This bill allows Medicaid payment for medical services furnished to an incarcerated individual during the 30-day period preceding the individual's release.
United States · United States Congress · 25 February 2019
This resolution expresses support for the designation of World Hearing Day. It also recognizes the importance of preventing hearing loss through self-protective behavior and the importance of patient access to early detection and intervention by health care professionals in the process of identification, treatment, and rehabilitation of hearing loss.
United States · United States Congress · 25 February 2019
This resolution expresses support for the goals and ideals of Polycystic Ovary Syndrome (PCOS) Awareness Month. PCOS is caused by a hormone imbalance. Symptoms can include infertility, weight gain, excess hair growth, and acne. It recognizes the need for further research, improved treatment and care options, and a cure for PCOS. It also acknowledges the struggles affecting all women and girls afflicted with PCOS.
United States · United States Congress · 25 February 2019
Recovering Excessive Funds for Unused and Needless Drugs Act of 2019 or the REFUND Act of 2019 This bill requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) in relation to discarded amounts (i.e., amounts remaining after administration) of single-dose vial drugs that are covered under Medicare. Manufacturers that fail to comply are subject to civil penalties. The CMS must determine rebate amounts based on payment claims from providers. (Currently, providers may receive payment under Medicare for discarded amounts of single-dose vial drugs through the use of a specific claims modifier.)
United States · United States Congress · 25 February 2019
Ensuring Medicaid Provides Opportunities for Widespread Equity, Resources, and Care Act or the EMPOWER Care Act This bill extends funding through FY2023 for the Money Follows the Person Rebalancing Demonstration Program and otherwise revises the program. (Under this program, the Centers for Medicare & Medicaid Services may award grants to state Medicaid programs to assist states in increasing the use of home and community care for long-term care and decreasing the use of institutional care.)
United States · United States Congress · 22 February 2019
Rural Hospital Frontier Fairness Act This bill alters the Medicare prospective payment system for inpatient hospital services furnished at sole community hospitals (i.e., rural hospitals or hospitals that are the sole source of inpatient care in a certain geographic area). Specifically, the bill applies a minimum area wage adjustment to payments to sole community hospitals that are located up to 75 miles from the closest frontier (i.e., predominantly rural) state. Currently, the minimum area wage adjustment applies only to hospitals in frontier states. The bill also allows such sole community hospitals to participate in the 340B drug pricing program (i.e., a program that allows entities to receive covered outpatient drugs at reduced prices from manufacturers).
United States · United States Congress · 19 February 2019
Workplace Violence Prevention for Health Care and Social Service Workers Act This bill requires the Department of Labor to address workplace violence in the health care and social service sectors. Specifically, Labor must promulgate an occupational safety and health standard that requires certain employers in the health care and social service sectors, as well as employers in sectors that conduct activities similar to the activities in the health care and social service sectors, to develop and implement a comprehensive plan for protecting health care workers, social service workers, and other personnel from workplace violence. In addition, those employers must investigate workplace violence incidents, risks, or hazards as soon as practicable; provide training and education to employees who may be exposed to workplace violence hazards and risks; meet record keeping requirements; and prohibit acts of discrimination or retaliation against employees for reporting workplace violence incidents, threats, or concerns.
United States · United States Congress · 15 February 2019
Examining Opioid Treatment Infrastructure Act of 2019 This bill requires the Government Accountability Office to report on inpatient and outpatient treatment capacity, availability, and needs across the United States. The report must include information relating to detoxification programs, clinical stabilization programs, transitional residential support services, rehabilitation programs, treatment programs for pregnant women or adolescents, and treatment through Indian health programs. The report must also include information about the barriers to real-time reporting of drug overdoses at the federal, state, and local levels and ways to overcome those barriers.
United States · United States Congress · 15 February 2019
Expanding Opportunities for Recovery Act of 2019 This bill requires the Center for Substance Abuse Treatment in the Substance Abuse and Mental Health Services Administration to award grants to states to expand access to clinically appropriate services for opioid abuse or addiction. States must use these grants to provide up to 60 consecutive days of services to individuals who otherwise would not have access to substance abuse services.
United States · United States Congress · 15 February 2019
Mental Health Telemedicine Expansion Act This bill excludes certain mental health telehealth services from specified requirements under Medicare, including originating site requirements.
United States · United States Congress · 14 February 2019
Deborah Sampson Act This bill implements or expands various programs and services related to health care, readjustment assistance, legal and supportive services, newborn care, and benefits for women veterans at the Department of Veterans Affairs.
United States · United States Congress · 14 February 2019
State Public Option Act This bill allows residents who are not already eligible for Medicaid and not concurrently enrolled in other health insurance coverage to buy into a state Medicaid plan beginning January 1, 2020, at the option of the state. State Medicaid programs may set premiums and cost-sharing requirements for such coverage in accordance with specified limitations. The bill also (1) provides the enhanced Federal Medical Assistance Percentage (FMAP) to every state that expands Medicaid coverage for individuals who are newly eligible under the Patient Protection and Affordable Care Act, regardless of when such expansion takes place; and (2) requires state Medicaid programs to cover comprehensive reproductive health care services, including abortion services.
United States · United States Congress · 14 February 2019
Nursing Home Workforce Quality Act This bill repeals certain restrictions under Medicare and Medicaid that prohibit the approval of nurse-aide training and competency evaluation programs in skilled nursing facilities that have been subject to specified regulatory actions (e.g., civil penalties) for substandard quality of care. The Centers for Medicare & Medicaid Services (CMS) may still disapprove such programs; however, the CMS must rescind the disapproval upon completion of corrective action.
United States · United States Congress · 14 February 2019
Payment Commission Data Act of 2019 This bill allows certain payment information relating to covered drugs under the Medicare prescription drug benefit and Medicaid to be disclosed to additional entities. Specifically, certain subsidy and rebate information, as reported by prescription drug plan sponsors and drug manufacturers, may be disclosed to the Medicare Payment Advisory Commission and the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission, in accordance with specified confidentiality restrictions.
United States · United States Congress · 14 February 2019
Climate Change Health Protection and Promotion Act of 2019 This bill requires the Department of Health and Human Services (HHS) to take a series of actions to address the potential impacts of climate change on public health. Specifically, HHS must develop a strategic action plan and a climate and health program to ensure the public health and health care systems in the United States and other nations are prepared for, and can respond to, the impacts of climate change on health. The bill directs HHS to revise the plan periodically to reflect new scientific developments and information. HHS must establish a permanent science advisory board to provide (1) scientific and technical recommendations on the impacts of climate change on public health, and (2) advice for purposes of issuing the plan and conducting the program.
United States · United States Congress · 14 February 2019
Climate Change Health Protection and Promotion Act of 2019 This bill requires the Department of Health and Human Services (HHS) to take a series of actions to address the potential impacts of climate change on public health. Specifically, HHS must develop a strategic action plan and a climate and health program to ensure the public health and health care systems in the United States and other nations are prepared for, and can respond to, the impacts of climate change on health. The bill directs HHS to revise the plan periodically to reflect new scientific developments and information. HHS must establish a permanent science advisory board to provide (1) scientific and technical recommendations on the impacts of climate change on public health, and (2) advice for purposes of issuing the plan and conducting the program.
United States · United States Congress · 14 February 2019
Lymphedema Treatment Act This bill includes certain lymphedema compression treatment items as covered durable medical equipment under Medicare. (Lymphedema is a condition of localized fluid retention and tissue swelling that is caused when the lymphatic system is damaged or blocked.)
United States · United States Congress · 14 February 2019
Prescription Drug Monitoring Act of 2019 This bill expands the notification and reporting requirements with respect to potentially addictive prescription drugs for states receiving funds for a Prescription Drug Monitoring Program (PDMP). Dispensers of these drugs, which includes substances listed in schedule II, III, or IV of the Controlled Substances Act, must consult with the PDMP before starting treatment involving such drugs and report each prescription of such drugs to the PDMP within 24 hours. The state agency administering a PDMP must analyze reported data for patterns of controlled substance misuse or abuse and provide certain information to law enforcement, the public, and other states.
United States · United States Congress · 14 February 2019
Living Donor Protection Act of 2019 This bill prohibits discrimination based on an individual's status as a living organ donor in the offering, issuance, cancellation, coverage, price, or any other condition of a life-insurance policy, disability-insurance policy, or long-term-care insurance policy. The bill also specifically includes recovery from organ-donation surgery as a serious health condition that entitles covered private-sector and federal civil-service employees to medical leave. The Department of Health and Human Services must update public-service announcements, websites, and other media regarding live organ donation to educate the public on the benefits of live organ donation and on access to insurance for living organ donors.
United States · United States Congress · 14 February 2019
Assessment of the Indian Health Service Act of 2019 This bill requires the Department of Health and Human Services to contract with private entities to assess the health care delivery systems and financial management of the Indian Health Service. The assessment must cover a variety of areas, including the demographics and health care needs of the patient population, health care capabilities and resources, staffing levels at medical facilities and the productivity of each health care provider, information technology strategies related to providing health care, business processes, the competency of leadership regarding specified issues, tracking patients eligible for other federal health care programs, and the number of procurement contracts and awards under the Buy Indian Act.
United States · United States Congress · 14 February 2019
State Public Option Act This bill allows residents who are not already eligible for Medicaid and not concurrently enrolled in other health insurance coverage to buy into a state Medicaid plan beginning January 1, 2020, at the option of the state. State Medicaid programs may set premiums and cost-sharing requirements for such coverage in accordance with specified limitations. The bill also (1) provides the enhanced Federal Medical Assistance Percentage (FMAP) to every state that expands Medicaid coverage for individuals who are newly eligible under the Patient Protection and Affordable Care Act, regardless of when such expansion takes place; and (2) requires state Medicaid programs to cover comprehensive reproductive health care services, including abortion services.
United States · United States Congress · 14 February 2019
This resolution commemorates the victims killed in the attack on February 14, 2018, at Marjory Stoneman Douglas High School in Parkland, Florida, and offers condolences to the families, loved ones, and friends of the victims. The resolution (1) honors the survivors and pledges continued support for their recovery, (2) recognizes the strength and resilience of the Marjory Stoneman Douglas High School community, and (3) expresses gratitude to the emergency medical and health care professionals of the Parkland community for their efforts in responding to the attack and caring for the victims and survivors.
United States · United States Congress · 14 February 2019
Student Job Protection Act of 201 9 This bill excludes certain student workers from being taken into account to determine an institution of higher education's employer health care shared responsibility under the Patient Protection and Affordable Care Act. Specifically, the bill excludes individuals who are employed by the institution of higher education and carrying a full-time academic workload at the institution.
United States · United States Congress · 14 February 2019
Public Buildings Renewal Act of 201 9 This bill allows tax-exempt financing of certain government-owned buildings by expanding the definition of "exempt facility bond" to include bonds used for qualified government buildings. A qualified government building is a government-owned building or facility that consists of one or more of the following an elementary or secondary school; facilities of a state college or university used for educational purposes; a public library; a court; hospital, health care, laboratory, or research facilities; public safety facilities; or offices for government employees. The bill excludes buildings or facilities that include specified recreational equipment or are used for the primary purpose of providing retail food and beverage services, recreation, or entertainment. The bill establishes (1) a $5 billion limit on the amount of tax-exempt financing which may be provided for government buildings, and (2) procedures for allocating and applying for the financing. The bill exempts the bonds for government buildings from the volume cap on private activity bonds.
United States · United States Congress · 14 February 2019
Cardiac Arrest Survival Act of 2019 This bill expands immunity from civil liability related to emergency use of automated external defibrillator devices (AEDs). Among other things, the bill specifies that immunity applies regardless of whether the person who used the AED complied with signage, received training, or was assisted or supervised by another person, such as a licensed physician.
United States · United States Congress · 14 February 2019
Advancing Care for Exceptional Kids Act of 2019 or the ACE Kids Act of 2019 This bill establishes a state Medicaid option to provide for medical assistance with respect to coordinated care provided through a health home (i.e., a designated provider or team of health-care professionals) for children with medically complex conditions. States must determine payment methodologies in accordance with specified requirements; payments also temporarily qualify for an enhanced federal matching rate.
United States · United States Congress · 14 February 2019
Living Donor Protection Act of 2019 This bill prohibits discrimination based on an individual's status as a living organ donor in the offering, issuance, cancellation, coverage, price, or any other condition of a life-insurance policy, disability-insurance policy, or long-term-care insurance policy. The bill also specifically includes recovery from organ-donation surgery as a serious health condition that entitles covered private-sector and federal civil-service employees to medical leave. The Department of Health and Human Services must update public-service announcements, websites, and other media regarding live organ donation to educate the public on the benefits of live organ donation and on access to insurance for living organ donors.
United States · United States House of Representatives · 13 February 2019
United States · United States Senate · 13 February 2019
United States · United States Congress · 13 February 2019
This joint resolution declares that the government has a duty to create a Green New Deal with the goals of achieving net-zero greenhouse gas emissions; establishing millions of high-wage jobs and ensuring economic security for all; investing in infrastructure and industry; securing clean air and water, climate and community resiliency, healthy food, access to nature, and a sustainable environment for all; and promoting justice and equality. The joint resolution calls for accomplishment of these goals through a 10-year national mobilization effort. The resolution also enumerates the goals and projects of the mobilization effort, including building smart power grids (i.e., power grids that enable customers to reduce their power use during peak demand periods); upgrading all existing buildings and constructing new buildings to achieve maximum energy and water efficiency; removing pollution and greenhouse gas emissions from the transportation and agricultural sectors; cleaning up existing hazardous waste and abandoned sites; ensuring businesspersons are free from unfair competition; and providing higher education, high-quality health care, and affordable, safe, and adequate housing to all.
United States · United States Congress · 13 February 2019
Acupuncture for Heroes and Seniors Act of 2019 This bill expands access to acupuncturist services, particularly for veterans and seniors. Specifically, the bill requires the provision of qualified acupuncturist services for veterans enrolled in the Department of Veterans Affairs (VA) health care system and military members and their dependents under the TRICARE program. A qualified acupuncturist is an individual who is licensed, certified, or otherwise accredited to perform acupuncture services. The bill also entitles military members and their dependents to qualified acupuncturist services under the TRICARE program without a referral, even if such services are not medically or psychologically necessary to prevent, diagnose, or treat an issue. The VA must implement a program to provide acupuncturist services in at least one VA facility in each Veterans Integrated Service Network in both urban and rural areas. Such services must be available to veterans enrolled in the VA health care system without the requirement of a referral. The VA must also establish the Advisory Committee on Acupuncturist Services to assist with the implementation of the VA acupuncturist program. The VA must pay acupuncturists equivalently with how it pays physicians. The bill provides for coverage for qualified acupuncturist services under the Medicare program and prescribes benefit amounts and payment rules depending on the circumstances of the service. The bill also makes acupuncturists eligible for appointment as (1) commissioned officers in the Armed Forces, and (2) officers in the commissioned Regular Corps and the Ready Reserve Corps of the Public Health Service.
United States · United States Congress · 13 February 2019
Native American Suicide Prevention Act of 2019 This bill requires a state or state-designated entity that receives support from the Substance Abuse and Mental Health Services Administration for development and implementation of a statewide youth suicide early intervention and prevention strategy to agree to collaborate with each of the state's federally recognized Indian tribes, tribal organizations, urban Indian organizations, and Native Hawaiian health care systems regarding the strategy.
United States · United States Congress · 13 February 2019
Forcing Limits on Abusive and Tumultuous Prices or the FLAT Prices Act This bill directs the Food and Drug Administration to reduce the market exclusivity of an approved prescription drug if the drug manufacturer increases the drug's price by more than a specified percentage. This reduction may be waived under specified circumstances.
United States · United States Congress · 13 February 2019
Expanding Transparency of Information and Safeguarding Toxics Act of 2019 or the ETO is Toxic Act This bill updates requirements for chemicals that pose an adverse public health risk. Specifically, the bill requires the Environmental Protection Agency (EPA) to publish an updated National Air Toxics Assessment once every two years. The assessment uses emissions data to estimate health risks from toxic air pollutants. The bill also requires the EPA to use data from its Integrated Risk Information System when conducting rulemaking with respect to chemicals that have been assessed in the system. For chemicals that are found to pose an adverse health risk, the EPA shall identify and do additional review on facilities that are significant sources of the chemical to determine whether the facility poses an adverse public health risk. Under the bill, chemicals identified as carcinogenic in the system must have a toxic chemical release form completed by the owner or operator of a facility. The bill requires the Department of Health and Human Services (HHS) to consult with appropriate EPA offices regarding the future schedule of assessments of chemicals to be conducted under the system, the results or existing assessments, and concerns that may merit additional review. HHS must also administer personal exposure tests for chemicals that pose a new adverse public health risk to vulnerable populations, such as children. HHS must establish a Community Outreach Division to communicate risk assessments to affected communities.
United States · United States Congress · 13 February 2019
Social Security and Medicare Lock-Box Act This bill establishes (1) in the Federal Old-Age and Survivors Insurance Trust Fund, a Social Security Surplus Protection Account; and (2) in the Federal Hospital Insurance Trust Fund, a Medicare Surplus Protection Account. The Managing Trustee of each trust fund (in both cases, the Secretary of the Treasury) (1) must transfer the annual surplus of the trust fund to its respective account; and (2) may not invest the balance in the account until a law takes effect that authorizes, for amounts in the trust fund, an investment vehicle other than U.S. obligations. The bill establishes in the executive branch a commission to study the most effective vehicles for investment of the trust funds, other than investments in the form of U.S. obligations.
United States · United States Congress · 13 February 2019
Acupuncture for Our Heroes Act This bill requires the Department of Veterans Affairs (VA) to provide qualified acupuncturist services to veterans enrolled in the VA health care system. A qualified acupuncturist is an individual who is licensed, certified, or otherwise accredited and may be appointed as an employee of the VA or as a contractor. The VA shall carry out such program in at least one VA facility in each Veterans Integrated Service Network (regional VA health care administrative areas) in both urban and rural areas. The bill requires the VA to establish the Advisory Committee on Acupuncturist Services, which must advise the VA on governing protocols and review and evaluate the ability of a veteran to access an acupuncturist at VA facilities.
United States · United States Congress · 13 February 2019
Creating Transparency to Have Drug Rebates Unlocked (C-THRU) Act of 2019 This bill establishes a series of requirements relating to drug rebates and discounts under Medicare and Medicare Advantage (MA). Specifically, for each pharmacy benefits manager (PBM) that contracts with a prescription drug plan (PDP) under Medicare or MA, or with a qualified health benefits plan offered through a health insurance exchange, HHS must publish on its website (1) the amount and type of rebates and discounts negotiated by the PBM and the extent to which these rebates and discounts are passed on to the plan sponsor, and (2) the difference between the amount paid by the plan sponsor to the PBM and the amount paid by the PBM to pharmacies. As a condition of participation as a contractor under Medicare or MA, a PBM must pass on to a PDP sponsor a minimum percentage, as established by HHS, of the amount of rebates and discounts negotiated by the PBM that are attributable to patient utilization under the plan. The bill also modifies requirements regarding Medicare enrollees' access to negotiated drug prices. Current law requires a PDP sponsor to provide enrollees in Medicare or MA with access to negotiated drug prices that account for rebates and discounts. The bill requires that, with respect to a covered drug, a negotiated price (or, if necessary, an approximate negotiated price) be provided at the point of sale.
United States · United States Congress · 13 February 2019
Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 or the RxCAP Act of 2019 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.
United States · United States Congress · 13 February 2019
Stopping the Pharmaceutical Industry from Keeping Drugs Expensive (SPIKE) Act of 2019 This bill requires manufacturers of drugs with specified percentage increases in their wholesale costs to submit to the Centers for Medicare & Medicaid Services (CMS) written justification for certain increases in drug prices. The CMS shall publish each submission, together with an easily understandable summary, on its website. Certain proprietary information may be excluded from publication, as specified by the bill. A manufacturer that does not comply with the bill's requirements shall be subject to civil monetary penalties.