Medicare patients would pay less for certain drugs, and drug makers would pay rebates.
This bill would change how Medicare Part B pays for certain expensive drugs. It would mean Medicare patients pay less out-of-pocket for these drugs, while drug manufacturers would pay rebates back to the government. These changes would take effect on the first day of the initial price applicability period for each selected drug.
Today, Medicare Part B payments to providers for selected drugs are based on 106 percent of the average sales price (ASP+6). Patient coinsurance is also calculated from this ASP+6 amount. If this bill passes, Medicare Part B payments to providers for selected drugs would continue to be based on 106 percent of the average sales price (ASP+6). However, manufacturers of these drugs would pay a quarterly rebate to the government, and patient coinsurance would be calculated based on 20 percent of the maximum fair price plus 6 percent (MFP+6).
HR 4299 · 119th Congress · July 7, 2025 · AI Summary by gemini-2.5-flash · 8/10
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