I
119THCONGRESS
1
STSESSION H. R. 2554
To amend title XVIII of the Social Security Act to apply prescription drug
inflation rebates to drugs furnished in the commercial market and to
change the base year for rebate calculations.
IN THE HOUSE OF REPRESENTATIVES
APRIL1, 2025
Mr. H
ORSFORD(for himself, Mrs. CHERFILUS-MCCORMICK, and Mr. JOHN-
SONof Georgia) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee
on Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall within
the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to apply
prescription drug inflation rebates to drugs furnished
in the commercial market and to change the base year
for rebate calculations.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Lower Drug Costs for 4
Families Act’’. 5
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SEC. 2. APPLICATION OF PRESCRIPTION DRUG INFLATION 1
REBATES TO DRUGS FURNISHED IN THE 2
COMMERCIAL MARKET. 3
(a) P
ARTB DRUGS.— 4
(1) A
PPLICATION OF PRESCRIPTION DRUG IN -5
FLATION REBATES TO DRUGS FURNISHED IN THE 6
COMMERCIAL MARKET .—Section 1847A(i) of the So-7
cial Security Act (42 U.S.C. 1395w–3a(i)) is amend-8
ed— 9
(A) in paragraph (1)(A)(i), by striking 10
‘‘units’’ and inserting ‘‘billing units’’; 11
(B) in paragraph (2)(A), by striking ‘‘for 12
which payment is made under this part’’ and 13
inserting ‘‘that would be payable under this 14
part if such drug were furnished to an indi-15
vidual enrolled under this part’’; 16
(C) in paragraph (3)— 17
(i) in subparagraph (A)(i), by striking 18
‘‘units’’ and inserting ‘‘billing units’’; and 19
(ii) by striking subparagraph (B) and 20
inserting the following: 21
‘‘(B) T
OTAL NUMBER OF BILLING 22
UNITS.—For purposes of subparagraph (A)(i), 23
the total number of billing units with respect to 24
a part B rebatable drug is determined as fol-25
lows: 26
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‘‘(i) Determine the total number of 1
units equal to— 2
‘‘(I) the total number of units, as 3
reported under subsection (c)(1)(B) 4
for each National Drug Code of such 5
drug during the calendar quarter that 6
is two calendar quarters prior to the 7
calendar quarter as described in sub-8
paragraph (A), minus 9
‘‘(II) the total number of units 10
with respect to each National Drug 11
Code of such drug for which payment 12
was made under a State plan under 13
title XIX (or waiver of such plan), as 14
reported by States under section 15
1927(b)(2)(A) for the rebate period 16
that is the same calendar quarter as 17
described in subclause (I). 18
‘‘(ii) Convert the units determined 19
under clause (i) to billing units for the bill-20
ing and payment code of such drug, using 21
a methodology similar to the methodology 22
used under this section, by dividing the 23
units determined under clause (i) for each 24
National Drug Code of such drug by the 25
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billing unit for the billing and payment 1
code of such drug. 2
‘‘(iii) Compute the sum of the billing 3
units for each National Drug Code of such 4
drug in clause (ii).’’. 5
(2) C
HANGE OF BASE YEAR FOR REBATE CAL -6
CULATION.—Section 1847A(i) of the Social Security 7
Act (42 U.S.C. 1395w–3a(i)) is amended— 8
(A) in paragraph (3)— 9
(i) in subparagraph (D), by striking 10
‘‘July 1, 2021’’ and inserting ‘‘July 1, 11
2016’’; and 12
(ii) in subparagraph (E), by striking 13
‘‘January 2021’’ and inserting ‘‘January 14
2016’’; and 15
(B) in paragraph (4)— 16
(i) in subparagraph (A)— 17
(I) by striking ‘‘December 1, 18
2020’’ and inserting ‘‘December 31, 19
2015’’; and 20
(II) by striking ‘‘January 2021’’ 21
and inserting ‘‘January 2016’’; 22
(ii) in subparagraph (B), by striking 23
‘‘December 1, 2020’’ and inserting ‘‘De-24
cember 31, 2015’’; and 25
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(iii) in subparagraph (C), by striking 1
‘‘January 2021’’ and inserting ‘‘January 2
2016’’. 3
(3) E
FFECTIVE DATE.—The amendments made 4
by this subsection shall apply with respect to cal-5
endar quarters beginning on or after January 1, 6
2026. 7
(b) C
OVEREDPARTD DRUGS.— 8
(1) A
PPLICATION OF PRESCRIPTION DRUG IN -9
FLATION REBATES TO DRUGS FURNISHED IN THE 10
COMMERCIAL MARKET .—Section 1860D–14B of the 11
Social Security Act (42 U.S.C. 1395w–114b) is 12
amended— 13
(A) in subsection (b)— 14
(i) in paragraph (1)— 15
(I) in subparagraph (A)(i), by 16
striking ‘‘the total number of units’’ 17
and all that follows through the semi-18
colon and inserting the following: ‘‘the 19
total number of units that are used to 20
calculate the average manufacturer 21
price of such dosage form and 22
strength with respect to such part D 23
rebatable drug, as reported by the 24
manufacturer of such drug under sec-25
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tion 1927 for each month, with re-1
spect to such period;’’; and 2
(II) by striking subparagraph (B) 3
and inserting the following: 4
‘‘(B) E
XCLUDED UNITS.—For purposes of 5
subparagraph (A)(i), the Secretary shall exclude 6
from the total number of units for a dosage 7
form and strength with respect to a part D 8
rebatable drug, with respect to an applicable pe-9
riod, the following: 10
‘‘(i) Units of each dosage form and 11
strength of such part D rebatable drug for 12
which payment was made under a State 13
plan under title XIX (or waiver of such 14
plan), as reported by States under section 15
1927(b)(2)(A). 16
‘‘(ii) Units of each dosage form and 17
strength of such part D rebatable drug for 18
which a rebate is paid under section 19
1847A(i). 20
‘‘(iii) Beginning with plan year 2026, 21
units of each dosage form and strength of 22
such part D rebatable drug for which the 23
manufacturer provides a discount under 24
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the program under section 340B of the 1
Public Health Service Act.’’; and 2
(ii) in paragraph (6), by striking ‘‘
IN-3
FORMATION.—The Secretary’’ and all that 4
follows through ‘‘rebatable covered part D 5
drug dispensed’’ and inserting the fol-6
lowing: ‘‘AMP
REPORTS.—The Secretary 7
shall provide for a method and process 8
under which, in the case of a manufacturer 9
of a part D rebatable drug that submits 10
revisions to information submitted under 11
section 1927 by the manufacturer with re-12
spect to such drug’’; and 13
(B) by striking subsection (d) and insert-14
ing the following: 15
‘‘(d) I
NFORMATION.—For purposes of carrying out 16
this section, the Secretary shall use information submitted 17
by manufacturers under section 1927(b)(3) and informa-18
tion submitted by States under section 1927(b)(2)(A).’’. 19
(2) C
HANGE OF BASE YEAR FOR REBATE CAL -20
CULATION.—Section 1860D–14B of the Social Secu-21
rity Act (42 U.S.C. 1395w–114b) is amended— 22
(A) in subsection (b)(5)— 23
(i) in subparagraph (A)— 24
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(I) by striking ‘‘October 1, 2021’’ 1
and inserting ‘‘October 1, 2016’’; and 2
(II) by striking ‘‘January 2021’’ 3
and inserting ‘‘January 2016’’; and 4
(ii) in subparagraph (C), by striking 5
‘‘January 2021’’ and inserting ‘‘January 6
2016’’; and 7
(B) in subsection (g)— 8
(i) in paragraph (3)— 9
(I) by striking ‘‘January 1, 10
2021’’ and inserting ‘‘January 1, 11
2016’’; and 12
(II) by striking ‘‘October 1, 13
2021’’ and inserting ‘‘October 1, 14
2016’’; and 15
(ii) in paragraph (4), by striking 16
‘‘January 2021’’ and inserting ‘‘January 17
2016’’. 18
(3) E
FFECTIVE DATE.—The amendments made 19
by this subsection shall take apply with respect to 20
applicable periods (as defined in section 1860D– 21
14B(g)(7) of the Social Security Act (42 U.S.C. 22
1395w–114b(g)(7))) beginning on or after October 23
1, 2025. 24
Æ
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