H.R. 8143

119 HR 8143 IH: Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026.
 U.S. House of Representatives
 2026-03-27
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 I
 119th CONGRESS  2d Session
 H. R. 8143
 IN THE HOUSE OF REPRESENTATIVES
 March 27, 2026
  Ms. Matsui  (for herself,  Mrs. Miller-Meeks , and  Mr. Auchincloss ) introduced the following bill; which was referred to the  Committee on Energy and Commerce , and in addition to the Committee on  Ways and Means , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
 A BILL
To amend title XVIII of the Social Security Act to require PDP sponsors of a prescription drug plan under part D of the Medicare program that use a formulary to include certain generic drugs and biosimilar biological products on such formulary, and for other purposes.
1.
Short title
This Act may be cited as the   Ensuring Access to Lower-Cost Medicines for Seniors Act of 2026.
2.
Requirements for pdp sponsors of prescription drug plans under part d of the medicare program that use formularies
Section 1860D–4(b)(3) of the Social Security Act ( 42 U.S.C. 1395w–104(b)(3) ) is amended by adding at the end the following new subparagraph:
(J)
Required inclusion of certain generic drugs and biosimilar biological
  products
(i)
In general
With respect to a plan year beginning on or after January 1, 2027, the formulary shall include in a preferred position relative to the reference drug—
(I)
each covered generic drug for which the wholesale acquisition cost is less than the wholesale acquisition cost of the reference drug of such covered generic drug; and
(II)
at least two covered bio-similar biological products for which the wholesale acquisition cost is less than the wholesale acquisition cost of the reference biological product of such covered biosimilar biological product.
(ii)
Prohibition on certain lim-its on access
The PDP sponsor offering the prescription drug plan may not impose limits on access to a covered generic drug required to be included on the formulary under clause (i)(I) or a covered biosimilar biological product required to be included on the formulary under clause (i)(II), including through utilization management techniques such as prior authorization, or step therapy, that are more restrictive than any such limits imposed on access to the reference drug of such covered generic drug or reference biological product of such covered biosimilar biological product, respectively, or that otherwise have the effect of limiting the availability to enrollees of such covered generic drug or covered biosimilar biological product relative to such reference drug or reference biological product over such covered generic drug or covered biosimilar biological product, respectively.
(iii)
Definitions
In this subparagraph and subparagraph (J):
(I)
Covered biosimilar biological product
The term  covered biosimilar biological product  means a covered part D drug that is a biosimilar biological product (as defined in section 1847A(c)(6)(H)).
(II)
Covered generic drug
The term  covered generic drug  means a covered part D drug that is a drug described in section 1860D–2(e)(1)(A) and approved under section 505(j) of the Federal Food, Drug, and Cosmetic Act.
(III)
Preferred position
The term  preferred position  means a product is placed on a more favorable formulary tier and has lower patient out-of-pocket costs than the corresponding reference drug or reference biological product.
(IV)
Reference biological product
The term  reference biological product  has the meaning given such term in section 1847A(c)(6)(I).
(V)
Reference drug
The term  reference drug  means, with respect to a covered generic drug, the listed drug (as described in clause (i) of section 505(j)(2)(A) of the Federal Food, Drug, and Cosmetic Act) that is referred to in the abbreviated application for such covered generic drug under such section.
(VI)
Wholesale acquisition cost
The term  wholesale acquisition cost  has the meaning given such term in section 1847A(c)(6)(B).
 .