Us Congress 2025-2026 Regular Session

Us Congress Senate Bill SB694 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	II
2	2	119THCONGRESS
3	3	1
4	4	STSESSION S. 694
5	5	To amend title XVIII of the Social Security Act to provide a phase-in
6	6	for plasma-derived products under the manufacturer discount program.
7	7	IN THE SENATE OF THE UNITED STATES
8	8	FEBRUARY24, 2025
9	9	Mr. T
10	10	ILLIS(for himself and Mr. KELLY) introduced the following bill; which
11	11	was read twice and referred to the Committee on Finance
12	12	A BILL
13	13	To amend title XVIII of the Social Security Act to provide
14	14	a phase-in for plasma-derived products under the manu-
15	15	facturer discount program.
16	16	Be it enacted by the Senate and House of Representa-1
17	17	tives of the United States of America in Congress assembled, 2
18	18	SECTION 1. SHORT TITLE. 3
19	19	This Act may be cited as the ‘‘Preserving Life-saving 4
20	20	Access to Specialty Medicines in America Act’’ or the 5
21	21	‘‘PLASMA Act’’. 6
22	22	SEC. 2. PHASE-IN FOR PLASMA-DERIVED PRODUCTS UNDER 7
23	23	MANUFACTURER DISCOUNT PROGRAM. 8
24	24	Section 1860D–14C(g)(4) of the Social Security Act 9
25	25	(42 U.S.C. 1395w–114c(g)(4)) is amended— 10
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28	28	•S 694 IS
29	29	(1) in subparagraph (A), in the matter pre-1
30	30	ceding clause (i), by striking ‘‘and (C)’’ and insert-2
31	31	ing ‘‘, (C), and (D)’’; 3
32	32	(2) by redesignating subparagraphs (D) and 4
33	33	(E) as subparagraphs (E) and (F), respectively; and 5
34	34	(3) by inserting after subparagraph (C) the fol-6
35	35	lowing: 7
36	36	‘‘(D) P
37	37	HASE-IN FOR PLASMA -DERIVED 8
38	38	PRODUCTS.— 9
39	39	‘‘(i) I
40	40	N GENERAL.—For 2026 and 10
41	41	subsequent years, subject to clause (iv), in 11
42	42	the case of an applicable drug of a manu-12
43	43	facturer that is a plasma-derived product 13
44	44	(as defined in clause (ii)), and that is mar-14
45	45	keted as of August 16, 2022, and dis-15
46	46	pensed for an applicable beneficiary, the 16
47	47	term ‘discounted price’ means the specified 17
48	48	plasma-derived product percent (as defined 18
49	49	in clause (iii)) of the negotiated price of 19
50	50	the applicable drug of the manufacturer. 20
51	51	‘‘(ii) P
52	52	LASMA-DERIVED PRODUCT.—In 21
53	53	this subparagraph, the term ‘plasma-de-22
54	54	rived product’ means an applicable drug 23
55	55	that is a biological product that is derived 24
56	56	from human whole blood or plasma. 25
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59	59	•S 694 IS
60	60	‘‘(iii) SPECIFIED PLASMA -DERIVED 1
61	61	PRODUCT PERCENT .—In this subpara-2
62	62	graph, the term ‘specified plasma-derived 3
63	63	product percent’ means, with respect to a 4
64	64	year— 5
65	65	‘‘(I) for an applicable drug that 6
66	66	is a plasma-derived product dispensed 7
67	67	for an applicable beneficiary who has 8
68	68	not incurred costs, as determined in 9
69	69	accordance with section 1860D– 10
70	70	2(b)(4)(C), for covered part D drugs 11
71	71	in the year that are equal to or exceed 12
72	72	the annual out-of-pocket threshold 13
73	73	specified in section 1860D– 14
74	74	2(b)(4)(B)(i) for the year— 15
75	75	‘‘(aa) for 2026, 99 percent; 16
76	76	‘‘(bb) for 2027, 98 percent; 17
77	77	‘‘(cc) for 2028, 95 percent; 18
78	78	‘‘(dd) for 2029, 92 percent; 19
79	79	and 20
80	80	‘‘(ee) for 2030 and each 21
81	81	subsequent year, 90 percent; and 22
82	82	‘‘(II) for an applicable drug that 23
83	83	is a plasma-derived product dispensed 24
84	84	for an applicable beneficiary who has 25
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87	87	•S 694 IS
88	88	incurred costs, as determined in ac-1
89	89	cordance with section 1860D– 2
90	90	2(b)(4)(C), for covered part D drugs 3
91	91	in the year that are equal to or exceed 4
92	92	the annual out-of-pocket threshold 5
93	93	specified in section 1860D– 6
94	94	2(b)(4)(B)(i) for the year— 7
95	95	‘‘(aa) for 2026, 99 percent; 8
96	96	‘‘(bb) for 2027, 98 percent; 9
97	97	‘‘(cc) for 2028, 95 percent; 10
98	98	‘‘(dd) for 2029, 92 percent; 11
99	99	‘‘(ee) for 2030, 90 percent; 12
100	100	‘‘(ff) for 2031, 85 percent; 13
101	101	and 14
102	102	‘‘(gg) for 2032 and each 15
103	103	subsequent year, 80 percent. 16
104	104	‘‘(iv) L
105	105	IMITATIONS.—This subpara-17
106	106	graph shall not apply with respect to the 18
107	107	following: 19
108	108	‘‘(I) C
109	109	ERTAIN DRUGS DISPENSED 20
110	110	TO LIS BENEFICIARIES.—An applica-21
111	111	ble drug described in subparagraph 22
112	112	(B)(i). 23
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115	115	•S 694 IS
116	116	‘‘(II) SPECIFIED SMALL MANU -1
117	117	FACTURERS.—An applicable drug de-2
118	118	scribed in subparagraph (C)(i).’’. 3
119	119	Æ
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