H.R.4209 - Patients' Access to Treatments Act of 2012

To amend title XXVII of the Public Health Service Act to limit co-payment, coinsurance, or other cost-sharing requirements applicable to prescription drugs in a specialty drug tier to the dollar amount (or its equivalent) of such requirements applicable to prescription drugs in a non-preferred brand drug tier, and for other purposes. view all titles (2)

All Bill Titles

  • Official: To amend title XXVII of the Public Health Service Act to limit co-payment, coinsurance, or other cost-sharing requirements applicable to prescription drugs in a specialty drug tier to the dollar amount (or its equivalent) of such requirements applicable to prescription drugs in a non-preferred brand drug tier, and for other purposes. as introduced.
  • Short: Patients' Access to Treatments Act of 2012 as introduced.

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Introduced
 
House
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Senate
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President
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03/19/12
 
 
 
 
 
 
 

Sponsor

M001180

Representative

David McKinley

R-WV

View Co-Sponsors (43)

Official Summary

Patients' Access to Treatments Act of 2012 - Amends the Public Health Service Act to prohibit a health plan offering group or individual health insurance that provides coverage for prescription drugs and uses a formulary or other tiered cost-sharing structure from imposing co-payment,

Official Summary

Patients' Access to Treatments Act of 2012 - Amends the Public Health Service Act to prohibit a health plan offering group or individual health insurance that provides coverage for prescription drugs and uses a formulary or other tiered cost-sharing structure from imposing co-payment, coinsurance, or other cost-sharing requirements applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of such requirements applicable to prescription drugs in a non-preferred brand drug tier. Provides that if a formulary used by such a health plan contains more than one non-preferred brand drug tier, such prohibition shall be applied with respect to the non-preferred brand drug tier for which beneficiary cost-sharing is lowest. Defines:
(1) \"non-preferred brand drug tier\" as a category of drugs within a tier in such formulary for which beneficiary cost-sharing is greater than tiers for generic drugs or preferred brand drugs in the plan's formulary, that are prescription drugs, and that are not included within a specialty drug tier; and
(2) \"specialty drug tier\" as a category of drugs within a tier in such formulary for which beneficiary cost-sharing is greater than tiers for generic drugs, preferred brand drugs, or non-preferred drugs in the plan's formulary and that are prescription drugs.

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