S 694
PLASMA Act
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Sign in to take action- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Bill overview
This bill, the PLASMA Act, gradually increases the discount manufacturers must provide for plasma-derived products under Medicare’s prescription drug benefit. Starting in 2026, the discounts will begin at 1% and increase over time, reaching 10% for initial coverage and 20% for catastrophic coverage by 2030 and 2032, respectively. This aims to improve access to these life-saving medicines for Medicare beneficiaries.
Key provisions
- Establishes a phased-in discount program for plasma-derived products under Medicare.
- Initial discount of 1% in 2026.
- Increases discounts annually until reaching 10% for initial coverage in 2030 and 20% for catastrophic coverage in 2032.
- Defines ‘plasma-derived product’ as a biological drug derived from human whole blood or plasma.
- The discount percentages are tied to the beneficiary’s out-of-pocket spending.
- Excludes certain drugs dispensed to Long-Term Skilled Nursing Facility (LIS) beneficiaries.
- Excludes certain small manufacturers' drugs.
- Amends Section 1860D-14C of the Social Security Act.
Who is affected
- Medicare beneficiaries
- Pharmaceutical manufacturers of plasma-derived products
- Healthcare providers administering plasma-derived products
Notable changes
- Introduces a specific discount schedule for plasma-derived products, distinct from the standard discount program.
Sponsors
Official sponsors from legislative records.
Primary sponsor
Thomas Tillis
Cosponsors
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119th CONGRESS — 1st Session
S. 694
IN THE SENATE OF THE UNITED STATES
A BILL
To amend title XVIII of the Social Security Act to provide a phase-in for plasma-derived products under the manufacturer discount program.
This Act may be cited as the Preserving Life-saving Access to Specialty Medicines in America Act PLASMA Act
or the
.
Section 1860D–14C(g)(4) of the Social Security Act (42 U.S.C. 1395w–114c(g)(4)) is amended—
in subparagraph (A), in the matter preceding clause (i), by striking and (C)
and inserting , (C), and (D)
;
by redesignating subparagraphs (D) and (E) as subparagraphs (E) and (F), respectively; and
by inserting after subparagraph (C) the following:
In this subparagraph, the term plasma-derived product means an applicable drug that is a biological product that is derived from human whole blood or plasma.
In this subparagraph, the term specified plasma-derived product percent means, with respect to a year—
for an applicable drug that is a plasma-derived product dispensed for an applicable beneficiary who has not incurred costs, as determined in accordance with section 1860D–2(b)(4)(C), for covered part D drugs in the year that are equal to or exceed the annual out-of-pocket threshold specified in section 1860D–2(b)(4)(B)(i) for the year—
for 2026, 99 percent;
for an applicable drug that is a plasma-derived product dispensed for an applicable beneficiary who has incurred costs, as determined in accordance with section 1860D–2(b)(4)(C), for covered part D drugs in the year that are equal to or exceed the annual out-of-pocket threshold specified in section 1860D–2(b)(4)(B)(i) for the year—
for 2026, 99 percent;
This subparagraph shall not apply with respect to the following:
An applicable drug described in subparagraph (B)(i).
An applicable drug described in subparagraph (C)(i).