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H.R. 2851

To prohibit application of a payment limit to a drug or biological under part B of the Medicare Program based on a less costly alternative for courses of treatment begun before the change in payment.

Provides that, if the Secretary of Health and Human Services or a carrier reduces a recognized rate for a drug or biological under part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act based solely on the identification of an alternative drug or biological that is less costly for treatment of the same condition, the Secretary shall provide that such reduction shall not apply during a course of treatment to an individual who, as of the effective date of the payment rate reduction, was entitled to benefits under such part and was in a course of treatment with such drug or biological for which such benefits are available. States that this requirement shall not apply in the case of substitution of a generic drug for another.

Directs the Secretary to report to the Congress on: (1) the types of coverage decisions being made by carriers under Medicare part B as well as their legal authority to make them; and (2) whether further Federal guidance is needed to prevent regional disparities in coverage under Medicare part B.

Referred to the Subcommittee on Health and Environment.

Rep. Kennelly, Barbara B. [D-CT-1](D-CT)Sponsor
2committees7actions
  1. CommitteeH11000

    Referred to the Subcommittee on Health and Environment.

    Health and Environment Subcommittee
  2. CommitteeH11000

    Referred to the Subcommittee on Health.

    Health Subcommittee
  3. IntroReferralH11100

    Referred to House Ways and Means

    Ways and Means Committee
  4. IntroReferralH11100-A

    Referred to the Committee on 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.

  5. IntroReferralH11100

    Referred to House Commerce

    Energy and Commerce Committee
  6. IntroReferralIntro-H

    Introduced in House

  7. IntroReferral1000

    Introduced in House