Bill > S4011

This bill proposes to amend Medicare Part D to provide a cap on beneficiary liability, with key provisions including: - Redesigning the Part D benefit structure by setting the annual out-of-pocket threshold at $2,000 for 2025 and increasing it annually thereafter, and adjusting the reinsurance payment amount to be 20-40% of costs above the out-of-pocket threshold depending on whether the drugs are "applicable drugs" subject to the new manufacturer discount program. - Establishing a new "Manufacturer Discount Program" starting in 2025 that requires drug manufacturers to provide discounts of 80-90% on applicable drugs for beneficiaries who have not yet reached the out-of-pocket threshold. - Phasing out the existing Medicare Coverage Gap Discount Program after 2024. - Making various conforming amendments to other Medicare Part D provisions to align with the new benefit structure and manufacturer discount program. The overall goal of the bill is to provide financial relief for Medicare Part D beneficiaries, particularly seniors, by capping their out-of-pocket drug costs and requiring deeper discounts from manufacturers.

Budget and Finance

https://www.congress.gov/bill/117th-congress/senate-bill/4011/all-info