Protect Patients from Costly Care Act
The Protect Patients from Costly Care Act would roll back two policy changes enacted in Public Law 119-21. First, it repeals Section 71120, effectively undoing changes to Medicaid cost-sharing requirements and applying Title XIX of the Social Security Act as if those changes had not been enacted. It also rescinds the corresponding funding set aside under Section 71120(c). Second, it repeals Section 71203, undoing the exclusion that kept orphan drugs out of the Medicare Drug Price Negotiation Program and applying Title XI of the Social Security Act as if that section had not been enacted. In short, the bill seeks to restore the pre-119-21 rules for Medicaid cost sharing and to allow orphan drugs to participate in Medicare drug price negotiations, with the overall effect of returning to the prior policy landscape on these two issues.
Key Points
- 1Repeal of Medicaid cost-sharing changes: Section 71120 of Public Law 119-21 is repealed; Medicaid cost-sharing requirements return to the pre-change framework under Title XIX of the Social Security Act.
- 2Rescission of funding: The amounts appropriated under 71120(c) are rescinded, removing new funding tied to those changes.
- 3Repeal of orphan-drug exclusion from Medicare price negotiations: Section 71203 is repealed, so orphan drugs would be subject to Medicare drug price negotiations, as if the exclusion had not been enacted.
- 4Reapplication of pre-119-21 provisions: Title XI of the Social Security Act would be applied as if Section 71203 had not been enacted, restoring the prior negotiation regime for orphan drugs.
- 5Overall effect: Return to the policy and funding posture that existed before Public Law 119-21 for Medicaid cost sharing and orphan-drug price negotiations, with potential changes in out-of-pocket costs for beneficiaries and drug prices under Medicare.