Bill > S694

This bill, known as the "Preserving Life-saving Access to Specialty Medicines in America Act" or the "PLASMA Act", amends the Social Security Act to create a phased approach for calculating discounted prices of plasma-derived products under Medicare Part D's manufacturer discount program. Specifically, the bill introduces a graduated percentage reduction for these specialized biological products derived from human whole blood or plasma, with different discount rates depending on whether a beneficiary has reached Medicare's annual out-of-pocket spending threshold. For beneficiaries who have not yet reached this threshold, the discount percentage will start at 99% in 2026 and gradually decrease to 90% by 2030. For beneficiaries who have exceeded the out-of-pocket threshold, the discounts will follow a similar pattern but with additional reductions, reaching 80% by 2032. The bill does not apply to certain drugs dispensed to low-income subsidy beneficiaries or drugs from specified small manufacturers. This approach aims to provide a predictable and gradual transition for plasma-derived product manufacturers while potentially reducing out-of-pocket costs for Medicare beneficiaries.

Budget and Finance

https://www.congress.gov/bill/119th-congress/senate-bill/694/all-info