Sec. 804. Temporary increase in Medicare part B payment for certain biosimilar biological products

301 words·~1 min read·/bill/116/hr/3/eh/section-804

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Section 1847A(b)(8) of the Social Security Act (42 U.S.C. 1395w–3a(b)(8)) is amended— by redesignating subparagraphs

(A)and

(B)as clauses

(i)and (ii), respectively, and moving the margin of each such redesignated clause 2 ems to the right; by striking and inserting the following: “ product .—The amount product .— Subject to subparagraph (B), the amount ; and by adding at the end the following new subparagraph: In the case of a qualifying biosimilar biological product that is furnished during the applicable 5-year period for such product, the amount specified in this paragraph for such product with respect to such period is the sum determined under subparagraph (A), except that clause

(ii)of such subparagraph shall be applied by substituting 8 percent for 6 percent . For purposes of clause (i), the applicable 5-year period for a biosimilar biological product is— in the case of such a product for which payment was made under this paragraph as of December 31, 2019, the 5-year period beginning on January 1, 2020; and in the case of such a product for which payment is first made under this paragraph during a calendar quarter during the period beginning January 1, 2020, and ending December 31, 2024, the 5-year period beginning on the first day of such calendar quarter during which such payment is first made. For purposes of this subparagraph, the term qualifying biosimilar biological product means a biosimilar biological product described in paragraph (1)(C) with respect to which— in the case of a product described in clause (ii)(I), the average sales price is not more than the average sales price for the reference biological product; and in the case of a product described in clause (ii)(II), the wholesale acquisition cost is not more than the wholesale acquisition cost for the reference biological product. .

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42 USC 1395w–3a(b)(8)

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Sec. 804

Temporary increase in Medicare part B payment for certain biosimilar biological products

Cite42 USC 1395w–3a(b)(8)

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