H.R.3613 - Part D Beneficiary Appeals Fairness Act112th Congress (2011-2012)
Summary: H.R.3613 — 112th Congress (2011-2012)
Introduced in House (12/08/2011)
Part D Beneficiary Appeals Fairness Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to a prescription drug plan (PDP) that provides for any tiered cost-sharing within a formulary (including a structure that provides for different co-payment or coinsurance amounts for drugs in different tiers included within the formulary), to authorize a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure.
States that in no case may the Secretary of Health and Human Services (HHS) allow a PDP sponsor to make any element of the tiered cost-sharing structure (including a tier used for very high cost or unique items) ineligible for lower-cost sharing through an exception.