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Senate Bill 475
116th Congress(2019-2020)
RxCAP Act of 2019
Introduced
Introduced
Introduced in Senate on Feb 13, 2019
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Introduced in Senate 
Feb 13, 2019
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Introduced in Senate(Feb 13, 2019)
Feb 13, 2019
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S. 475 (Introduced-in-Senate)


116th CONGRESS
1st Session
S. 475


To amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities.

IN THE SENATE OF THE UNITED STATES

February 13, 2019

Mr. Wyden (for himself, Mr. Bennet, Mr. Cardin, Ms. Klobuchar, Mr. Merkley, and Mr. Whitehouse) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities.

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 “Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019” or the “RxCAP Act of 2019”.

SEC. 2. Elimination of cost-sharing above the Medicare part D annual out-of-pocket threshold.

(a) In general.—Section 1860D–2(b)(4)(A) of the Social Security Act (42 U.S.C. 1395w–102(b)(4)(A)) is amended—

(1) in clause (i)—

(A) by redesignating subclauses (I) and (II) as items (aa) and (bb), respectively, and indenting appropriately;

(B) by striking “subparagraph (B), with cost-sharing” and inserting the following: “subparagraph (B)—

“(I) for plan years 2006 through 2019, with cost-sharing”;

(C) in item (bb), as redesignated by subparagraph (A), by striking the period at the end and inserting “; and”; and

(D) by adding at the end the following new subclause:

“(II) for plan year 2020 and subsequent plan years, without any cost-sharing.”; and

(2) in clause (ii)—

(A) by striking “clause (i)(I)” and inserting “clause (i)(I)(aa)”; and

(B) by adding at the end the following new sentence: “The Secretary shall continue to calculate the dollar amounts specified in clause (i)(I)(aa), including with the adjustment under this clause, after plan year 2019 for purposes of 1860D–14(a)(1)(D)(iii).”.

(b) Conforming amendments to low-Income subsidy.—Section 1860D–14(a) of the Social Security Act (42 U.S.C. 1395w–114(a)) is amended—

(1) in paragraph (1)—

(A) in subparagraph (D)(iii), by striking “1860D–2(b)(4)(A)(i)(I)” and inserting “1860D–2(b)(4)(A)(i)(I)(aa)”; and

(B) in subparagraph (E)—

(i) in the heading, by inserting “prior to the elimination of such cost-sharing for all individuals” after “threshold”; and

(ii) by striking “The elimination” and inserting “For plan years 2006 through 2019, the elimination”; and

(2) in paragraph (2)(E)—

(A) in the heading, by inserting “prior to the elimination of such cost-sharing for all individuals” after “threshold”;

(B) by striking “Subject to” and inserting “For plan years 2006 through 2019, subject to”; and

(C) by striking “1860D–2(b)(4)(A)(i)(I)” and inserting “1860D–2(b)(4)(A)(i)(I)(aa)”.