Ways and Means Committee, Energy and Commerce Committee, Education and Workforce Committee
Introduced
In Committee
On Floor
Passed Chamber
Enacted
This legislation amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code of 1986. Its central purpose is to establish new requirements for cost-sharing for epinephrine delivery systems under group health plans and both group and individual health insurance coverage. The bill mandates that health plans and issuers must cover epinephrine delivery systems without applying any deductible . It further limits patient cost-sharing to a maximum of $60 per package of two delivery systems or their equivalent. Importantly, these cost-sharing payments will be counted towards any applicable deductible or out-of-pocket maximums under the plan or coverage. An epinephrine delivery system is defined as any FDA-approved system for administering epinephrine, including auto-injectors, nasal sprays, or sublingual systems. The bill clarifies that plans are not required to provide benefits for out-of-network providers for these systems and may impose higher cost-sharing for such services. These new requirements will apply to plan years beginning on or after January 1, 2026 .
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, 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.
Health
EPIPEN Act
USA119th CongressHR-5139| House
| Updated: 9/4/2025
This legislation amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code of 1986. Its central purpose is to establish new requirements for cost-sharing for epinephrine delivery systems under group health plans and both group and individual health insurance coverage. The bill mandates that health plans and issuers must cover epinephrine delivery systems without applying any deductible . It further limits patient cost-sharing to a maximum of $60 per package of two delivery systems or their equivalent. Importantly, these cost-sharing payments will be counted towards any applicable deductible or out-of-pocket maximums under the plan or coverage. An epinephrine delivery system is defined as any FDA-approved system for administering epinephrine, including auto-injectors, nasal sprays, or sublingual systems. The bill clarifies that plans are not required to provide benefits for out-of-network providers for these systems and may impose higher cost-sharing for such services. These new requirements will apply to plan years beginning on or after January 1, 2026 .
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, 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.