Title 42, The Public Health and WelfareRelease 119-102

§1395w–114d Selected Drug Subsidy Program

Title 42 › CHAPTER 7 — SOCIAL SECURITY › SUBCHAPTER XVIII — HEALTH INSURANCE FOR AGED AND DISABLED › Part D — Voluntary Prescription Drug Benefit Program › subpart 2 — prescription drug plans; pdp sponsors; financing › § 1395w–114d

Last updated Aug 21, 2026|Official source

Summary

The Secretary must set up a way to pay drug plans a subsidy equal to 10 percent of the negotiated price when an applicable beneficiary who has not reached the year’s out-of-pocket threshold is given an applicable Part D drug. Definitions: applicable beneficiary — a qualifying person; applicable drug — the covered Part D medicine at issue; negotiated price — the plan’s agreed price.

Full Legal Text

Title 42, §1395w–114d

The Public Health and Welfare, Source: USLM XML via OLRC

With respect to covered part D drugs that would be applicable drugs (as defined in section 1395w–114c(g)(2) of this title) but for the application of subparagraph (B) of such section, the Secretary shall provide a process whereby, in the case of an applicable beneficiary (as defined in section 1395w–114c(g)(1) of this title) who, with respect to a year, is enrolled in a prescription drug plan or is enrolled in an MA–PD plan, has not incurred costs that are equal to or exceed the annual out-of-pocket threshold specified in section 1395w–102(b)(4)(B)(i) of this title, and is dispensed such a drug, the Secretary (periodically and on a timely basis) provides the PDP sponsor or the MA organization offering the plan, a subsidy with respect to such drug that is equal to 10 percent of the negotiated price (as defined in section 1395w–114c(g)(6) of this title) of such drug.

Reference

Citations & Metadata

Citation

42 U.S.C. § 1395w–114d

Title 42, The Public Health and Welfare

Last Updated

Aug 21, 2026

Release point: 119-102