Sec. 401. Adjustments to Medicare part D cost-sharing reductions for low-income individuals

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Section 1860D–14(a) of the Social Security Act ( 42 U.S.C. 1395w–114(a) ), as amended by section 301(d), is further amended— in paragraph (1)— in subparagraph (D)— in clause (ii)— by striking that does not exceed $1 for and all that follows through the period at the end and inserting that does not exceed— for plan years before plan year 2021— for a generic drug or a preferred drug that is a multiple source drug (as defined in section 1927(k)(7)(A)(i)), $1 or, if less, the copayment amount applicable to an individual under clause (iii); and for any other drug, $3 or, if less, the copayment amount applicable to an individual under clause (iii); and ; and by adding at the end the following new subclauses: for plan year 2021— for a generic drug, $0; and for any other drug, the dollar amount applied under this clause (after application of paragraph (4)(A)) for plan year 2020 for a drug described in subclause (I)(bb); and for a subsequent year, the dollar amount applied under this clause for the previous year for the drug, increased by the annual percentage increase in the consumer price index (all items;

U.S. city average) as of September of such previous year. ; and in clause (iii)— by striking does not exceed the copayment amount specified under and inserting does not exceed— for plan years beginning before plan year 2021, the copayment amount specified under ; by striking the period at the end and inserting ; and ; and by adding at the end the following new subclause: for plan year 2021 and each subsequent plan year, the copayment amount applied under clause

(ii)for the drug and year involved. ; and by adding at the end the following new subparagraph: Any amount established under clause

(ii)of subparagraph (D), including as applied under clause

(iii)of such subparagraph or paragraph (2)(D), that is based on an increase of $3, that is not a multiple of 5 cents or 10 cents, respectively, shall be rounded to the nearest multiple of 5 cents or 10 cents, respectively. ; in paragraph (2)— in subparagraph (D)— by striking of coinsurance of and inserting of— for plan years before plan year 2021, coinsurance of ; by striking the period at the end and inserting ; and ; and by adding at the end the following new clause: for plan year 2021 and each subsequent plan year, a copayment amount that does not exceed the copayment amount applied under paragraph (1)(D)(ii) for the drug and year involved. ; and in subparagraph (E)— by striking subsection (c), the substitution for and inserting subsection (c)— for plan years before plan year 2021, the substitution for ; by striking the period at the end and inserting ; and ; and by adding at the end the following new clause: for plan year 2021, the elimination of any cost-sharing imposed under section 1860D–2(b)(4)(A). ; and in paragraph (4)(A)(ii), by inserting (before 2021) after subsequent year .

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42 USC 1395w–114(a)

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Sec. 401

Adjustments to Medicare part D cost-sharing reductions for low-income individuals

Cite42 USC 1395w–114(a)

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