PLASMA Act
Sponsored By: Representative Hudson
Introduced
Summary
Phased reduction of manufacturer discounts for plasma-derived drugs in Medicare Part D. This bill would create a year-by-year phase-in that changes how the Part D manufacturer discount is calculated for plasma-derived products, with separate schedules for beneficiaries who have already spent on Part D drugs and those who have not, and exclusions for certain low-income subsidy beneficiaries and small manufacturers.
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- Medicare beneficiaries who have not incurred Part D drug costs would see the applicable manufacturer discount set at 99% in 2026, then step down to 98% in 2027, 95% in 2028, 92% in 2029, and 90% in 2030 and later.
- Beneficiaries who have already incurred Part D costs face a longer phase-down that reaches 90% in 2030, 85% in 2031, and 80% in 2032 and later, creating different out-of-pocket dynamics by enrollee history.
- Manufacturers of plasma-derived products marketed as of August 16, 2022 would have their discounted price calculated as a year-specific percent of the negotiated price, gradually reducing the required discount over time; the phase-in does not apply to certain drugs dispensed to low-income subsidy (LIS) beneficiaries and to specified small manufacturers.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
Phase-in for Medicare plasma drug prices
If enacted, this would change how Medicare Part D counts prices for certain plasma-derived drugs. It would apply to drugs made from human plasma that were marketed by August 16, 2022. Starting in 2026, the counted price would be a set percent of the negotiated price for each fill. If you have hit the Part D out-of-pocket threshold: 2026 99%; 2027 98%; 2028 95%; 2029 92%; 2030 90%; 2031 85%; 2032+ 80%. If you have not hit it: 2026 99%; 2027 98%; 2028 95%; 2029 92%; 2030+ 90%. The phase-in would not apply to some Low-Income Subsidy fills or to drugs from specified small manufacturers. Your costs could vary by plan stage and year.
Sponsors & CoSponsors
Sponsor
Hudson
NC • R
Cosponsors
Davis (NC)
NC • D
Sponsored 2/21/2025
Murphy
NC • R
Sponsored 2/21/2025
Peters
CA • D
Sponsored 2/21/2025
Rouzer
NC • R
Sponsored 5/5/2025
Knott
NC • R
Sponsored 6/3/2025
Roll Call Votes
No roll call votes available for this bill.
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