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H.R. 4139IntroducedHouse · nowSenatePresidentLawIn committee
Sec. 2 · H.R. 4139

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)) is amended in paragraph (1)(D)(ii)— (1) by striking that does not exceed $1 for and all that follows through the period at the end and inserting that does not exceed— (I) for plan years before plan year 2026— (aa) 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 (bb) for any other drug, $3 or, if less, the copayment amount applicable to an individual under clause (iii); and; and (2) by adding at the end the following new subclauses: (II) for plan year 2026— (aa) for a generic drug, $0; and (bb) for any other drug, the dollar amount applied under this clause (after application of paragraph (4)(A)) for plan year 2023 for a drug described in subclause (I)(bb); and (III) 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..