Protecting Patient Access to Cancer and Complex Therapies Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
This bill, the Protecting Patient Access to Cancer and Complex Therapies Act, aims to lower the cost of certain expensive drugs and biological products for Medicare beneficiaries. It establishes a system where manufacturers of selected drugs must provide rebates to the government based on the difference between the manufacturer’s price (ASP+6) and a maximum fair price negotiated by the Secretary. This rebate system is designed to ensure that Medicare payments reflect a more reasonable cost for these medications, particularly those used to treat cancer and other complex conditions.
Key provisions
- Manufacturers of selected drugs must provide rebates to Medicare based on the difference between the manufacturer's price and a maximum fair price.
- The Secretary will negotiate maximum fair prices for selected drugs.
- Manufacturers will be required to report detailed information to the Secretary about drug sales and payments.
- Medicare payments will be calculated using a ‘MFP+6’ payment amount, which is 106 percent of the maximum fair price.
- Beneficiaries’ coinsurance will be based on the MFP+6 coinsurance amount.
- Rebates will be deposited into the Federal Supplementary Medical Insurance Trust Fund.
- Civil money penalties will be applied for non-compliance.
- The bill includes conforming amendments to existing Social Security Act sections related to cost-sharing and payment calculations.
Who is affected
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