A bill to amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information.

II 116TH CONGRESS 1ST SESSION S. 801 To amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission with access to certain drug payment information, including certain rebate information. IN THE SENATE OF THE UNITED STATES MARCH 14, 2019 Ms. CORTEZ MASTO (for herself, Mr. CORNYN, Mr. CARPER, and Mr. CAS- SIDY) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend titles XVIII and XIX of the Social Security Act to provide the Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Com- mission with access to certain drug payment information, including certain rebate information. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 03:13 Mar 27, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S801.IS S801 kjohnson on DSK79L0C42 with BILLS 2 •S 801 IS SECTION 1. PROVIDING THE MEDICARE PAYMENT ADVI- 1 SORY COMMISSION AND MEDICAID AND CHIP 2 PAYMENT AND ACCESS COMMISSION WITH 3 ACCESS TO CERTAIN DRUG PAYMENT INFOR- 4 MATION, INCLUDING CERTAIN REBATE IN- 5 FORMATION. 6 (a) ACCESS TO CERTAIN PART D PAYMENT DATA.— 7 Section 1860D–15(f) of the Social Security Act (42 8 U.S.C. 1395w–115(f)) is amended— 9 (1) in paragraph (2)— 10 (A) in subparagraph (A)(ii), by striking 11 ‘‘and’’ at the end; 12 (B) in subparagraph (B), by striking the 13 period at the end and inserting ‘‘; and’’; and 14 (C) by inserting at the end the following 15 new subparagraph: 16 ‘‘(C) by the Executive Director of the 17 Medicare Payment Advisory Commission for 18 purposes of monitoring, making recommenda- 19 tions, and analysis of the program under this 20 title and by the Executive Director of the Med- 21 icaid and CHIP Payment and Access Commis- 22 sion for purposes of monitoring, making rec- 23 ommendations, and analysis of the Medicaid 24 program established under title XIX and the 25 VerDate Sep 11 2014 03:13 Mar 27, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S801.IS S801 kjohnson on DSK79L0C42 with BILLS 3 •S 801 IS Children’s Health Insurance Program under 1 title XXI.’’; and 2 (2) by adding at the end the following new 3 paragraph: 4 ‘‘(3) ADDITIONAL RESTRICTIONS ON DISCLO- 5 SURE OF INFORMATION.—The Executive Directors 6 described in paragraph (2)(C) shall not disclose any 7 of the following information disclosed to such Execu- 8 tive Directors or obtained by such Executive Direc- 9 tors pursuant to such paragraph, with respect to a 10 prescription drug plan offered by a PDP sponsor: 11 ‘‘(A) The specific amounts or the identity 12 of the source of any rebates, price concessions, 13 or other forms of direct or indirect remunera- 14 tion under such prescription drug plan. 15 ‘‘(B) Information submitted with the bid 16 submitted under section 1860D–11 by such 17 PDP sponsor. 18 ‘‘(C) In the case of such information from 19 prescription drug event records, in a form that 20 would not be permitted under section 21 423.505(m) of title 42, Code of Federal Regula- 22 tions, or any successor regulation, if made by 23 the Centers for Medicare & Medicaid Services.’’. 24 VerDate Sep 11 2014 03:13 Mar 27, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S801.IS S801 kjohnson on DSK79L0C42 with BILLS 4 •S 801 IS (b) ACCESS TO CERTAIN REBATE AND PAYMENT 1 DATA UNDER MEDICARE AND MEDICAID.—Section 2 1927(b)(3)(D) of the Social Security Act (42 U.S.C. 3 1396r–8(b)(3)(D)) is amended— 4 (1) in the matter before clause (i), by striking 5 ‘‘subsection (a)(6)(A)(ii)’’ and inserting ‘‘subsection 6 (a)(6)(A)’’; 7 (2) in clause (iv), by striking ‘‘and’’ at the end; 8 (3) in clause (v), by striking the period at the 9 end and inserting ‘‘, and’’; 10 (4) by inserting after clause (v) the following 11 new clause: 12 ‘‘(vi) to permit the Executive Director 13 of the Medicare Payment Advisory Com- 14 mission and the Executive Director of the 15 Medicaid and CHIP Payment and Access 16 Commission to review the information pro- 17 vided.’’; 18 (5) in the matter at the end, by striking 19 ‘‘1860D–4(c)(2)(E)’’ and inserting ‘‘1860D– 20 4(c)(2)(G)’’; and 21 (6) by adding at the end the following new sen- 22 tence: ‘‘Any information disclosed to the Executive 23 Director of the Medicare Payment Advisory Commis- 24 sion or the Executive Director of the Medicaid and 25 VerDate Sep 11 2014 03:13 Mar 27, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S801.IS S801 kjohnson on DSK79L0C42 with BILLS 5 •S 801 IS CHIP Payment and Access Commission pursuant to 1 this subparagraph shall not be disclosed by either 2 such Executive Director in a form which discloses 3 the identity of a specific manufacturer or wholesaler 4 or prices charged for drugs by such manufacturer or 5 wholesaler.’’. 6 Æ VerDate Sep 11 2014 03:13 Mar 27, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S801.IS S801 kjohnson on DSK79L0C42 with BILLS