Section 1 Short title
This Act may be cited as the “Maximizing Individual Savings for Servicemembers In Obtaining Negotiated Rx Act” or the “MISSION Rx Act”.
Maximizing Individual Savings for Servicemembers In Obtaining Negotiated Rx Act
A BILL
To amend titles 10 and 38, United States Code, to set the maximum cost-sharing amount paid by an eligible covered beneficiary under the TRICARE program and a veteran for such selected drug, as established under the Social Security Act, and the maximum price of a selected drug procured by Federal agencies, and for other purposes.
Sec. 2 Maximum price for a selected drug for the cost-sharing amount paid by an eligible covered beneficiary under TRICARE and a veteran and for Federal procurement
in subsection (a)(6), by adding at the end the following new subparagraphs:
“(F) Notwithstanding subparagraphs (A), (B), and (C), during any year a selected drug is covered under the Drug Price Negotiation Program established under section 1191 of the Social Security Act (42 U.S.C. 1320f), the cost-sharing amount under this subsection during a year for such selected drug for an eligible covered beneficiary may not exceed the cost-sharing amount paid by a Medicare beneficiary for such selected drug in that year under part D of title XVIII of that Act (42 U.S.C. 1395w–101 et seq.) pursuant to such Drug Price Negotiation Program.”
in subsection (i), by adding at the end the following new paragraph:
“(5) The term “selected drug” has the meaning given such term in section 1192(c) of the Social Security Act (42 U.S.C. 1320f–1(c)).”
Copayment for medications— Section 1722A of title 38, United States Code, is amended by adding at the end the following new subsections:
“(d) Notwithstanding subsections (a) and (b), during any year a selected drug is covered under the Drug Price Negotiation Program established under section 1191 of the Social Security Act (42 U.S.C. 1320f), the copayment amount determined under this section during a year for such selected drug for a veteran may not exceed the copayment amount paid by a Medicare beneficiary for such selected drug in that year under part D of title XVIII of that Act (42 U.S.C. 1395w–101 et seq.) pursuant to such Drug Price Negotiation Program.
“(e) In this section, the term “selected drug” has the meaning given such term in section 1192(c) of the Social Security Act (42 U.S.C. 1320f–1(c)).”
Limitation on prices of drugs procured by Department and certain other Federal agencies— Section 8126 of title 38, United States Code, is amended—
in subsection (a)—
in paragraph (3), by striking “; and” and inserting a semicolon;
in paragraph (4)(C), by striking the period and inserting “; and”; and
by adding at the end the following new paragraph:
“(5) with respect to each selected drug of the manufacturer procured by a Federal agency, as described in subsection (b), such master agreement shall be subject to the requirements in subsection (j).”
in subsection (g)(1), by striking “1992” and inserting “1992, except with respect to any reference to a provision of such Act in paragraphs (7) and (8) of subsection (h) and in subsection (j)”;
in subsection (h)—
by redesignating paragraphs (5) and (6) as paragraphs (6) and (8), respectively;
by inserting after paragraph (4) the following new paragraph:
“(5) The term “maximum fair price” has the meaning given such term in section 1191(c)(3) of the Social Security Act (42 U.S.C. 1320f(c)(3)).”
by inserting after paragraph (6), as redesignated by subparagraph (A), the following new paragraph:
“(7) The term “selected drug” has the meaning given such term in section 1192(c) of the Social Security Act (42 U.S.C. 1320f–1(c)).”
by adding at the end the following new subsections:
“(j) During any year a selected drug is covered under the Drug Price Negotiation Program established under section 1191 of the Social Security Act (42 U.S.C. 1320f), each manufacturer entering into a master agreement may not set the maximum price for such selected drug included in such master agreement at the time such master agreement is executed at a price exceeding the maximum fair price for such drug as set by such Drug Price Negotiation Program for the duration of such master agreement.”
Application—
In general— The amendments made in subsection (c) shall apply with respect to each master agreement under section 8126 of title 38, United States Code, covering a selected drug, as defined by such section, that is in effect on the date of the enactment of this Act or enters into force on or after such date.
Termination of the Drug Price Negotiation Program— Upon termination of the Drug Price Negotiation Program established under section 1191 of the Social Security Act (42 U.S.C. 1320f), each master agreement described in paragraph (1) shall be modified to reflect the drug price maximums as of the date of such modification under existing law for each selected drug, as defined in section 8126 of title 38, United States Code, as amended by subsection (c).
in section 1193(a)(4)(A), by striking “8126(h)(5)” and inserting “8126(h)”; and
in section 1194(c)(6), by striking “8126(h)(5)” and inserting “8126(h)”.