To provide for a COVID-19-related delay regarding annual limitation on cost-sharing for group health plans and individual and small group health insurance coverage.
This bill delays until the first calendar year that is 12 months after the end of the COVID-19 (i.e., coronavirus disease 2019) public health emergency the application of the Centers for Medicare & Medicaid Services (CMS) rule dated May 14, 2020. That rule allows private health insurance plans to decide whether support provided by a prescription drug manufacturer to cover a patient's costs for a drug counts toward the patient's annual out-of-pocket limit. The bill requires enforcement of the previous rule, which allows plans to exclude drug manufacturer support from a patient's annual out-of-pocket limit only if a generic version of the drug is available.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.