Ensuring Seniors' Access to COVID Treatments Act
This bill requires prescription drug plans under Medicare and Medicare Advantage to cover drugs that are approved to treat COVID-19 (i.e., coronavirus disease 2019) without cost-sharing during the public health emergency.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 975 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 975
To amend title XVIII of the Social Security Act to require coverage
under Medicare PDPs and MA-PD plans, without the imposition of cost
sharing or utilization management requirements, of drugs intended to
treat COVID-19 during certain emergencies.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 11, 2021
Mr. Casten introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Foreign Affairs, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to require coverage
under Medicare PDPs and MA-PD plans, without the imposition of cost
sharing or utilization management requirements, of drugs intended to
treat COVID-19 during certain emergencies.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Ensuring Seniors' Access to COVID
Treatments Act''.
SEC. 2. REQUIRING COVERAGE UNDER MEDICARE PDPS AND MA-PD PLANS, WITHOUT
THE IMPOSITION OF COST SHARING OR UTILIZATION MANAGEMENT
REQUIREMENTS, OF DRUGS INTENDED TO TREAT COVID-19 DURING
CERTAIN EMERGENCIES.
(a) Coverage Requirement.--
(1) In general.--Section 1860D-4(b)(3) of the Social
Security Act (42 U.S.C. 1395w-104(b)(3)) is amended by adding
at the end the following new subparagraph:
``(I) Required inclusion of drugs intended to treat
covid-19.--
``(i) In general.--Notwithstanding any
other provision of law, a PDP sponsor offering
a prescription drug plan shall, with respect to
a plan year, any portion of which occurs during
the period described in clause (ii), be
required to--
``(I) include in any formulary--
``(aa) all covered part D
drugs with a medically accepted
indication (as defined in
section 1860D-2(e)(4)) to treat
COVID-19 that are marketed in
the United States; and
``(bb) all drugs authorized
under section 564 or 564A of
the Federal Food Drug and
Cosmetic Act to treat COVID-19;
and
``(II) not impose any prior
authorization or other utilization
management requirement with respect to
such drugs described in item (aa) or
(bb) of subclause (I) (other than such
a requirement that limits the quantity
of drugs due to safety).
``(ii) Period described.--For purposes of
clause (i), the period described in this clause
is the period during which there exists the
public health emergency declared by the
Secretary pursuant to section 319 of the Public
Health Service Act on January 31, 2020,
entitled `Determination that a Public Health
Emergency Exists Nationwide as the Result of
the 2019 Novel Coronavirus' (including any
renewal of such declaration pursuant to such
section).''.
(b) Elimination of Cost Sharing.--
(1) Elimination of cost sharing for drugs intended to treat
covid-19 under standard and alternative prescription drug
coverage.--Section 1860D-2 of the Social Security Act (42
U.S.C. 1395w-102) is amended--
(A) in subsection (b)--
(i) in paragraph (1)(A), by striking ``The
coverage'' and inserting ``Subject to paragraph
(8), the coverage'';
(ii) in paragraph (2)--
(I) in subparagraph (A), by
inserting after ``Subject to
subparagraphs (C) and (D)'' the
following: ``and paragraph (8)'';
(II) in subparagraph (C)(i), by
striking ``paragraph (4)'' and
inserting ``paragraphs (4) and (8)'';
and
(III) in subparagraph (D)(i), by
striking ``paragraph (4)'' and
inserting ``paragraphs (4) and (8)'';
(iii) in paragraph (4)(A)(i), by striking
``The coverage'' and inserting ``Subject to
paragraph (8), the coverage''; and
(iv) by adding at the end the following new
paragraph:
``(8) Elimination of cost-sharing for drugs intended to
treat covid-19.--The coverage does not impose any deductible,
copayment, coinsurance, or other cost-sharing requirement for
drugs described in section 1860D-4(b)(3)(I)(i)(I) with respect
to a plan year, any portion of which occurs during the period
during which there exists the public health emergency declared
by the Secretary pursuant to section 319 of the Public Health
Service Act on January 31, 2020, entitled `Determination that a
Public Health Emergency Exists Nationwide as the Result of the
2019 Novel Coronavirus' (including any renewal of such
declaration pursuant to such section).''; and
(B) in subsection (c), by adding at the end the
following new paragraph:
``(4) Same elimination of cost-sharing for drugs intended
to treat covid-19.--The coverage is in accordance with
subsection (b)(8).''.
(2) Elimination of cost sharing for drugs intended to treat
covid-19 dispensed to individuals who are subsidy eligible
individuals.--Section 1860D-14(a) of the Social Security Act
(42 U.S.C. 1395w-114(a)) is amended--
(A) in paragraph (1)--
(i) in subparagraph (D)--
(I) in clause (ii), by striking
``In the case of'' and inserting
``Subject to subparagraph (F), in the
case of''; and
(II) in clause (iii), by striking
``In the case of'' and inserting
``Subject to subparagraph (F), in the
case of''; and
(ii) by adding at the end the following new
subparagraph:
``(F) Elimination of cost-sharing for drugs
intended to treat covid-19.--Coverage that is in
accordance with section 1860D-2(b)(8).''; and
(B) in paragraph (2)--
(i) in subparagraph (B), by striking ``A
reduction'' and inserting ``Subject to
subparagraph (F), a reduction'';
(ii) in subparagraph (D), by striking ``The
substitution'' and inserting ``Subject to
subparagraph (F), the substitution'';
(iii) in subparagraph (E), by inserting
after ``Subject to'' the following:
``subparagraph (F) and''; and
(iv) by adding at the end the following new
subparagraph:
``(F) Elimination of cost-sharing for drugs
intended to treat covid-19.--Coverage that is in
accordance with section 1860D-2(b)(8).''.
(c) Implementation.--Notwithstanding any other provision of law,
the Secretary of Health and Human Services may implement the amendments
made by this section by program instruction or otherwise.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Foreign Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Foreign Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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