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HR 1244119th CongressIntroduced
Reducing Drug Prices for Seniors Act
Introduced: Oct 18, 2025
Standard Summary
Comprehensive overview in 1-2 paragraphs
The Reducing Drug Prices for Seniors Act requires Medicare Part D coinsurance to be based on actual acquisition cost rather than wholesale acquisition cost.
Key Points
- 1Mandates coinsurance calculations use actual acquisition cost when lower than WAC
- 2Applies to costs above deductible and below out-of-pocket threshold
- 3Defines actual acquisition cost as negotiated price net of manufacturer concessions
- 4Uses Detailed DIR Report data for cost determination
- 5Applies to plan years beginning January 1, 2026
- 6Excludes certain protected drugs (catastrophic coverage, protected classes)
Impact Areas
Medicare Part D beneficiariesPrescription drug costs and affordabilityPharmaceutical pricing and negotiationsMedicare Advantage plans with drug coverageFederal health care spending
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