Section 1 Short title
This Act may be cited as the “Increasing Medication Access for Seniors Act of 2025”.
Increasing Medication Access for Seniors Act of 2025
A BILL
To require the Secretary of Health and Human Services to submit to Congress a report on the option to elect to pay cost-sharing under a prescription drug plan or MA-PD plan in monthly capped amounts.
Sec. 2 Reports on Medicare part D monthly capped cost-sharing option
Reports— Not later than the date that is 3 months after the date of the enactment of this section, not less frequently than every 3 months thereafter until the date that is 1 year after the date of the enactment of this section, and not less frequently than annually thereafter until March 31, 2031, the Secretary of Health and Human Services (in this section referred to as the “Secretary”) shall submit to Congress a report on the option to elect to pay cost-sharing under a prescription drug plan or MA–PD plan in monthly capped amounts under section 1860D–2(b)(2)(E)(i) of the Social Security Act (42 U.S.C. 1395w–102(b)(2)(E)(i)), including, with respect to the 1-year period ending on the date that is 1 year before the date on which the report is required to be submitted—
the number of Medicare part D enrollees who made such an election during such period, including—
the number of such enrollees residing in each census region (as designated by the Bureau of the Census);
the number of such enrollees who are enrolled in a prescription drug plan; and
the number of such enrollees who are enrolled in an MA–PD plan;
an estimate of the number of Medicare part D enrollees who did not make such an election and incurred out-of-pocket costs with respect to covered part D drugs during such period that make it likely such enrollees may benefit from making such an election, as determined by the Secretary;
a description of any steps taken by the Secretary during such period to implement a mechanism to allow a Medicare part D enrollee to make such election at the point-of-sale of a covered part D drug, including information on how such a mechanism may be made available for every Medicare part D enrollee;
a description of each method used by the Secretary during such period to facilitate making such an election, including—
the Medicare.gov website;
the notice distributed pursuant to section 1804(a) of the Social Security Act (42 U.S.C. 1395b–2(a)) (commonly known as the Medicare & You handbook);
the toll-free telephone number 1–800–MEDICARE; and
resources for health care providers; and
a description of any other outreach efforts the Secretary conducted with respect to such option during such period, including outreach to—
health care provider associations and societies;
patient and consumer advocacy groups that represent Medicare part D enrollees;
pharmacy benefit managers;
pharmacies; and
health insurance providers.
Definitions— In this section:
Medicare part D enrollee— The term Medicare part D enrollee means an individual enrolled in a prescription drug plan or MA–PD plan under part D of title XVIII of the Social Security Act (42 U.S.C. 1395w–101 et seq.).
Medicare part D terms— The terms covered part D drug, prescription drug plan, and MA–PD plan have the meanings given each such term in part D of title XVIII of the Social Security Act (42 U.S.C. 1395w–101 et seq.).