Lowering Medicare Patient Costs for Negotiated Cancer and Complex Drugs.
This bill introduces a rebate system to lower out-of-pocket costs for Medicare Part B patients receiving certain expensive, negotiated drugs, often used for cancer and complex therapies. While Medicare initially pays the standard market rate, the patient's cost-sharing (coinsurance) is calculated based on the lower, negotiated maximum fair price, resulting in direct savings for beneficiaries. Drug manufacturers are required to rebate the price difference back to Medicare.
Key points
Reduces patient out-of-pocket costs (coinsurance) for selected high-cost drugs covered under Medicare Part B price negotiations.
Patient coinsurance is calculated using the lower, negotiated maximum price, rather than the higher average sales price.
Drug manufacturers must pay a rebate to Medicare equal to the difference between the standard payment rate and the negotiated rate.
Expired
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