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42 U.S.C. § 1320f–5Administrative duties and compliance monitoring

submitted 91 years ago by Pub. L. 117-169 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 480 words · no verdicts yet

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The Secretary must establish procedures for applying maximum fair prices across drug forms and Medicare coverage arrangements. The Secretary must also establish the negotiation, submission, tax-information, and related procedures and monitor manufacturer compliance.

(a) Administrative duties. For section 1320f(a)(4), the Secretary's administrative duties are: (1) establishing procedures to ensure that a selected drug's maximum fair price is applied before (A) any coverage or financial assistance under another health-benefit plan or program that helps maximum-fair-price-eligible people buy or receive prescription drug coverage, and (B) any other discounts; (2) establishing procedures to compute and apply the maximum fair price across different strengths and dosage forms, without basing it on the drug's specific formulation, package size, or package type; (3) establishing procedures to carry out this part, as applicable, for maximum-fair-price-eligible people enrolled (A) in a Part D prescription drug plan or a Part C MA–PD plan, and (B) under Part B, including people enrolled in a Part C MA plan; (4) establishing a negotiation and renegotiation process under section 1320f–3; (5) establishing a process for manufacturers to submit the information described in section 1320f–3(b)(2)(A); (6) sharing with the Treasury Secretary the information needed to determine the tax imposed by section 5000D of the Internal Revenue Code of 1986, including applying that tax to a manufacturer, producer, or importer and determining dates described in section 5000D(c)(1). This information must include: (A) the date the Secretary receives notice that an agreement under the Medicare coverage gap discount program ended and the date a later agreement under that program begins; (B) the corresponding dates for an agreement under the manufacturer discount program; and (C) the corresponding dates for a rebate agreement under section 1396r–8(b); and (7) establishing procedures for applying subsections (d)(2)(B) and (f)(1)(C) of section 1320f–1. (b) Compliance monitoring. The Secretary must monitor whether a manufacturer complies with the terms of its agreement under section 1320f–2 and establish a way to report violations of those terms.
the actual law source: uscode.house.gov ↗public domain
(a) Administrative duties

For purposes of section 1320f(a)(4) of this title, the administrative duties described in this section are the following:

(1)

The establishment of procedures to ensure that the maximum fair price for a selected drug is applied before—

(A)

any coverage or financial assistance under other health benefit plans or programs that provide coverage or financial assistance for the purchase or provision of prescription drug coverage on behalf of maximum fair price eligible individuals; and

(B)

any other discounts.

(2)

The establishment of procedures to compute and apply the maximum fair price across different strengths and dosage forms of a selected drug and not based on the specific formulation or package size or package type of such drug.

(3)

The establishment of procedures to carry out the provisions of this part, as applicable, with respect to—

(A)

maximum fair price eligible individuals who are enrolled in a prescription drug plan under part D of subchapter XVIII or an MA–PD plan under part C of such subchapter; and

(B)

maximum fair price eligible individuals who are enrolled under part B of such subchapter, including who are enrolled in an MA plan under part C of such subchapter.

(4)

The establishment of a negotiation process and renegotiation process in accordance with section 1320f–3 of this title.

(5)

The establishment of a process for manufacturers to submit information described in section 1320f–3(b)(2)(A) of this title.

(6)

The sharing with the Secretary of the Treasury of such information as is necessary to determine the tax imposed by section 5000D of the Internal Revenue Code of 1986, including the application of such tax to a manufacturer, producer, or importer or the determination of any date described in section 5000D(c)(1) of such Code. For purposes of the preceding sentence, such information shall include—

(A)

the date on which the Secretary receives notification of any termination of an agreement under the Medicare coverage gap discount program under section 1395w–114a of this title and the date on which any subsequent agreement under such program is entered into;

(B)

the date on which the Secretary receives notification of any termination of an agreement under the manufacturer discount program under section 1395w–114c of this title and the date on which any subsequent agreement under such program is entered into; and

(C)

the date on which the Secretary receives notification of any termination of a rebate agreement described in section 1396r–8(b) of this title and the date on which any subsequent rebate agreement described in such section is entered into.

(7)

The establishment of procedures for purposes of applying subsections (d)(2)(B) and (f)(1)(C) of section 1320f–1 of this title.

(b) Compliance monitoring

The Secretary shall monitor compliance by a manufacturer with the terms of an agreement under section 1320f–2 of this title and establish a mechanism through which violations of such terms shall be reported.

Source credit: (Aug. 14, 1935, ch. 531, title XI, § 1196, as added and amended Pub. L. 117–169, title I, §§ 11001(a), 11002(a)(3), Aug. 16, 2022, 136 Stat. 1849, 1861.)

history & why it existsrecord from the source credit
  • 1935Enacted · Pub. L. 117-169 · 136 Stat. 1849, 1861

A history note hasn’t been published yet. The record shows enactment by Pub. L. 117-169 on 1935-08-14.

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