PAAT Act

This legislation amends the Social Security Act to significantly expand coverage for specific conditions under Medicare Part D. Beginning in 2027, it mandates that all Prescription Drug Plan (PDP) sponsors must include every covered Part D drug indicated for the treatment of autoimmune diseases , hemophilia , or Von Willebrand disease . Furthermore, the bill introduces new restrictions on prior authorization for these critical medications. For plan years starting on or after January 1, 2027, PDP sponsors and MA organizations are prohibited from requiring prior authorization for these autoimmune or blood disorder drugs more than once during any 12-month period. Exceptions apply to drugs typically used for shorter durations, certain controlled substances like opioids, or those requiring a risk evaluation and mitigation strategy (REMS).