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Protecting Patient Access to Cancer and Complex Therapies Act

USA119th CongressHR-4299| House 
| Updated: 7/7/2025
Gregory F. Murphy

Gregory F. Murphy

Republican Representative

North Carolina

Cosponsors (19)
David Kustoff (Republican)Andy Harris (Republican)Neal P. Dunn (Republican)Mariannette Miller-Meeks (Republican)Donald G. Davis (Democratic)Thomas R. Suozzi (Democratic)Earl L. "Buddy" Carter (Republican)Vicente Gonzalez (Democratic)Thomas H. Kean (Republican)Carol D. Miller (Republican)Mike Kelly (Republican)Mike Kennedy (Republican)John Joyce (Republican)Blake D. Moore (Republican)August Pfluger (Republican)Brian K. Fitzpatrick (Republican)Adam Gray (Democratic)Max L. Miller (Republican)Troy Balderson (Republican)

Ways and Means Committee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This bill amends Title XVIII of the Social Security Act, which governs Medicare, to establish a new rebate system for manufacturers of certain drugs and biological products. The core purpose is to ensure that the benefits of maximum fair price negotiation for these drugs are realized through a manufacturer rebate mechanism. This rebate is designed to bridge the gap between the higher average sales price (ASP) and the lower negotiated maximum fair price (MFP) for selected drugs. Under this new system, manufacturers of selected drugs subject to a maximum fair price negotiation agreement will be required to pay a quarterly rebate to the Secretary of Health and Human Services. The rebate amount is calculated by taking the difference between the ASP+6 payment amount and the MFP+6 payment amount , then multiplying this difference by the total units of the drug furnished under Medicare Part B. These collected rebates will be deposited into the Federal Supplementary Medical Insurance Trust Fund. A significant provision of the bill is its impact on beneficiary cost-sharing. For selected drugs for which a rebate is paid, the amount of beneficiary coinsurance will be based on the lower MFP+6 coinsurance amount , which is 20 percent of the MFP+6 payment amount, aiming to reduce out-of-pocket costs for Medicare beneficiaries. The bill also includes provisions for civil money penalties for manufacturers who fail to comply with these new rebate requirements and clarifies that manufacturers are not required to provide drugs at maximum fair prices except through this rebate system.
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Timeline

Bill from Previous Congress

HR 118-5391
Protecting Patient Access to Cancer and Complex Therapies Act
Jul 7, 2025
Introduced in House
Jul 7, 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committee on 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.
  • Bill from Previous Congress

    HR 118-5391
    Protecting Patient Access to Cancer and Complex Therapies Act


  • July 7, 2025
    Introduced in House


  • July 7, 2025
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on 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.

Health

Protecting Patient Access to Cancer and Complex Therapies Act

USA119th CongressHR-4299| House 
| Updated: 7/7/2025
This bill amends Title XVIII of the Social Security Act, which governs Medicare, to establish a new rebate system for manufacturers of certain drugs and biological products. The core purpose is to ensure that the benefits of maximum fair price negotiation for these drugs are realized through a manufacturer rebate mechanism. This rebate is designed to bridge the gap between the higher average sales price (ASP) and the lower negotiated maximum fair price (MFP) for selected drugs. Under this new system, manufacturers of selected drugs subject to a maximum fair price negotiation agreement will be required to pay a quarterly rebate to the Secretary of Health and Human Services. The rebate amount is calculated by taking the difference between the ASP+6 payment amount and the MFP+6 payment amount , then multiplying this difference by the total units of the drug furnished under Medicare Part B. These collected rebates will be deposited into the Federal Supplementary Medical Insurance Trust Fund. A significant provision of the bill is its impact on beneficiary cost-sharing. For selected drugs for which a rebate is paid, the amount of beneficiary coinsurance will be based on the lower MFP+6 coinsurance amount , which is 20 percent of the MFP+6 payment amount, aiming to reduce out-of-pocket costs for Medicare beneficiaries. The bill also includes provisions for civil money penalties for manufacturers who fail to comply with these new rebate requirements and clarifies that manufacturers are not required to provide drugs at maximum fair prices except through this rebate system.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline

Bill from Previous Congress

HR 118-5391
Protecting Patient Access to Cancer and Complex Therapies Act
Jul 7, 2025
Introduced in House
Jul 7, 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committee on 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.
  • Bill from Previous Congress

    HR 118-5391
    Protecting Patient Access to Cancer and Complex Therapies Act


  • July 7, 2025
    Introduced in House


  • July 7, 2025
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on 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.
Gregory F. Murphy

Gregory F. Murphy

Republican Representative

North Carolina

Cosponsors (19)
David Kustoff (Republican)Andy Harris (Republican)Neal P. Dunn (Republican)Mariannette Miller-Meeks (Republican)Donald G. Davis (Democratic)Thomas R. Suozzi (Democratic)Earl L. "Buddy" Carter (Republican)Vicente Gonzalez (Democratic)Thomas H. Kean (Republican)Carol D. Miller (Republican)Mike Kelly (Republican)Mike Kennedy (Republican)John Joyce (Republican)Blake D. Moore (Republican)August Pfluger (Republican)Brian K. Fitzpatrick (Republican)Adam Gray (Democratic)Max L. Miller (Republican)Troy Balderson (Republican)

Ways and Means Committee, Energy and Commerce Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted