Bill > S146

This bill, the Cap Insulin Prices Act, aims to reduce the price of insulin for patients. The key provisions are: 1. For Medicare Part D plans, it caps the out-of-pocket cost for covered insulin products at $25 per 30-day supply in 2024 and 2025, down from $35 previously. 2. For group and individual health plans, it requires coverage of selected insulin products with no deductible and a cost-sharing limit of the lesser of $25 or 25% of the negotiated price per 30-day supply, starting in 2024. It also prohibits utilization management practices on these insulin products, except when clinically justified. 3. It mandates that health plans cover selected insulin products, even before the enrollee has met their annual deductible, for catastrophic plans under the Affordable Care Act. 4. It applies similar cost-sharing requirements and coverage provisions for selected insulin products to group health plans under ERISA and self-insured group health plans under the Internal Revenue Code.

Health and Social Services

https://www.congress.gov/bill/118th-congress/senate-bill/146/all-info