Section 1 Short title
This Act may be cited as the “Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2016 ” or the “RxCAP Act of 2016”.
Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2016
A BILL
To amend title XVIII of the Social Security Act to prevent catastrophic out-of-pocket spending on prescription drugs for seniors and individuals with disabilities.
Sec. 2 Elimination of cost-sharing above the Medicare part D annual out-of-pocket threshold
In general— Section 1860D–2(b)(4)(A) of the Social Security Act (42 U.S.C. 1395w–102(b)(4)(A)) is amended—
in clause (i)—
by redesignating subclauses (I) and (II) as items (aa) and (bb), respectively;
by striking “subparagraph (B), with cost-sharing” and inserting the following: “subparagraph (B)—
“(I) for plan years 2006 through 2017, with cost-sharing”
in item (bb), as redesignated by subparagraph (A), by striking the period at the end and inserting “; and”; and
by adding at the end the following new subclause:
“(II) for plan year 2018 and subsequent plan years, without any cost-sharing.”
in clause (ii)—
by striking “clause (i)(I)” and inserting “clause (i)(I)(aa)”; and
by adding at the end the following new sentence: “The Secretary shall continue to calculate the dollar amounts specified in clause (i)(I)(aa), including with the adjustment under this clause, after plan year 2017 for purposes of 1860D–14(a)(1)(D)(iii).”.
Conforming amendments to low-Income subsidy— Section 1860D–14(a) of the Social Security Act (42 U.S.C. 1395w–114(a)) is amended—
in paragraph (1)—
in subparagraph (D)(iii), by striking “1860D–2(b)(4)(A)(i)(I)” and inserting “1860D–2(b)(4)(A)(i)(I)(aa)”; and
in subparagraph (E)—
in the heading, by inserting “prior to the elimination of such cost-sharing for all individuals” after “threshold”; and
by striking “The elimination” and inserting “For plan years 2006 through 2017, the elimination”; and
in paragraph (2)(E)—
in the heading, by inserting “prior to the elimination of such cost-sharing for all individuals” after “threshold”;
by striking “Subject to” and inserting “For plan years 2006 through 2017, subject to”; and
by striking “1860D–2(b)(4)(A)(i)(I)” and inserting “1860D–2(b)(4)(A)(i)(I)(aa)”.