Part D Beneficiary Appeals Fairness Act
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Part D Beneficiary Appeals Fairness Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to a prescription drug plan (PDP) that provides for any tiered cost-sharing within a formulary (including a structure that provides for different co-payment or coinsurance amounts for drugs in different tiers included within the formulary), to authorize a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure.
States that in no case may the Secretary of Health and Human Services (HHS) allow a PDP sponsor to make any formulary tier of the tiered cost-sharing structure (including a formulary tier used for very high cost or unique items) ineligible for lower-cost sharing through an exception.
Read twice and referred to the Committee on Finance.
- Introduced in Senate Formatted Text PDF Formatted XML
Cite this page
U.S. Congress. (2026). S. 1365: Part D Beneficiary Appeals Fairness Act. 113th Congress. Open America. https://openamerica.io/bill/113-S-1365/
"S. 1365: Part D Beneficiary Appeals Fairness Act." 113th Congress, 2026, Open America, https://openamerica.io/bill/113-S-1365/.
S. 1365, 113th Cong. (2026), https://openamerica.io/bill/113-S-1365/.
[S. 1365: Part D Beneficiary Appeals Fairness Act](https://openamerica.io/bill/113-S-1365/)