S.Amdt. 2581

1. Adds SEC. __. INCLUDING COSTS INCURRED BY THE INDIAN HEALTH SERVICE, A FEDERALLY QUALIFIED HEALTH CENTER, AN AIDS DRUG ASSISTANCE PROGRAM, CERTAIN HOSPITALS, OR A PHARMACEUTICAL MANUFACTURER PATIENT ASSISTANCE PROGRAM IN PROVIDING PRESCRIPTION DRUGS TOWARD THE ANNUAL OUT OF POCKET THRESHOLD UNDER PART D wherever appropriate

   Adds a section

   Inserted: SEC. __. INCLUDING COSTS INCURRED BY THE INDIAN HEALTH SERVICE, A FEDERALLY QUALIFIED HEALTH CENTER, AN AIDS DRUG ASSISTANCE PROGRAM, CERTAIN HOSPITALS, OR A PHARMACEUTICAL MANUFACTURER PATIENT ASSISTANCE PROGRAM IN PROVIDING PRESCRIPTION DRUGS TOWARD THE ANNUAL OUT OF POCKET THRESHOLD UNDER PART D.

   Inserted: (a) Including Costs Incurred.--

   Inserted: (1) In general.--Section 1860D-2(b)(4)(C) (42 U.S.C. 1395w-102(b)(4)(C)) is amended--

   Inserted: (A) in clause (i), by striking "and" at the end;

   Inserted: (B) in clause (ii)--

   Inserted: (i) by striking "such costs shall be treated as incurred only if" and inserting "subject to clause (iii), such costs shall be treated as incurred if";

   Inserted: (ii) by striking ", under section 1860D-14, or under a State Pharmaceutical Assistance Program";

   Inserted: (iii) by striking "(other than under such section or such a Program)"; and

   Inserted: (iv) by striking the period at the end and inserting "; and"; and

   Inserted: (C) by inserting after clause (ii) the following new clause:

   Inserted: "(iii) such costs shall be treated as incurred and shall not be considered to be reimbursed under clause (ii) if such costs are borne or paid--

   Inserted: "(I) under section 1860D-14;

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   Inserted: "(II) under a State Pharmaceutical Assistance Program;

   Inserted: "(III) by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act);

   Inserted: "(IV) by a Federally qualified health center (as defined in section 1861(aa)(4));

   Inserted: "(V) under an AIDS Drug Assistance Program under part B of title XXVI of the Public Health Service Act;

   Inserted: "(VI) by a subsection (d) hospital (as defined in section 1886(d)(1)(B)) that meets the requirements of clauses (i) and (ii) of section 340B(a)(4)(L) of the Public Health Service Act; or

   Inserted: "(VII) by a pharmaceutical manufacturer patient assistance program, either directly or through the distribution or donation of covered part D drugs, which shall be valued at the negotiated price of such covered part D drug under the enrollee's prescription drug plan or MA-PD plan as of the date that the drug was distributed or donated.".

   Inserted: (2) Effective date.--The amendments made by paragraph (1) shall apply to costs incurred on or after January 1, 2008.

   Inserted: (b) Increase in Basic Rebate for Single Source Drugs and Innovator Multiple Source Drugs.--

   Inserted: (1) In general.--Section 1927(c) (42 U.S.C. 1396r-8(c)) is amended--

   Inserted: (A) in paragraph (1)(B)(i)--

   Inserted: (i) in subclause (IV), by striking "and" after the semicolon;

   Inserted: (ii) in subclause (V)--

   Inserted: (I) by inserting "and before January 1, 2008," after "1995,"; and

   Inserted: (II) by striking the period and inserting "; and"; and

   Inserted: (iii) by adding at the end the following:

   Inserted: "(VI) after December 31, 2007, is 20.1 percent."; and

   Inserted: (B) in paragraph (3)(B)--

   Inserted: (i) in clause (i), by striking "and" at the end;

   Inserted: (ii) in clause (ii)--

   Inserted: (I) by inserting "and before January 1, 2008," after "1993,"; and

   Inserted: (II) by striking the period and inserting "; and"; and

   Inserted: (III) by adding at the end the following new clause:

   Inserted: "(iii) after December 31, 2007, is 16 percent.".

   Inserted: (2) Effective date.--The amendments made by this subsection take effect on the date of enactment of this Act and apply to rebate agreements entered into or renewed under section 1927 of the Social Security Act (42 U.S.C. 1396r-8) on or after such date.

   The amendment doesn't say where this goes; the clerk decides.

   Original wording

   At the appropriate place, insert the following:

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As printed