Most Favored Patient Act of 2026

#7837 | HR Congress #119

Policy Area: Health
Subjects:

Last Action: 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. (3/5/2026)

Bill Text Source: Congress.gov

Summary and Impacts
Original Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7837 Introduced in House (IH)]

<DOC>






119th CONGRESS
  2d Session
                                H. R. 7837

To amend title XI of the Social Security Act to require the Center for 
  Medicare and Medicaid Innovation to test a model implementing most-
                      favored-nation drug pricing.


_______________________________________________________________________




                             March 5, 2026

  Mr. Meuser 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 XI of the Social Security Act to require the Center for 
  Medicare and Medicaid Innovation to test a model implementing most-
                      favored-nation drug pricing.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Most Favored Patient Act of 2026''.

SEC. 2. REQUIRING THE CENTER FOR MEDICARE AND MEDICAID INNOVATION TO 
              TEST A MODEL IMPLEMENTING MOST FAVORED NATION DRUG 
              PRICING.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a) is 
amended--
            (1) in subsection (b)(2)(A), by inserting ``, and, 
        beginning January 1, 2029, shall include the Most Favored 
        Nations Pricing Model described in subsection (h)'' before the 
        period at the end; and
            (2) by adding at the end the following new subsection:
    ``(h) Most Favored Nations Pricing Model.--
            ``(1) In general.--For purposes of subsection (b)(2)(A), 
        the Most Favored Nations Pricing Model described in this 
        subsection is a model under which, subject to paragraph (2), 
        each specified manufacturer--
                    ``(A) provides access to the most-favored-nation 
                price of each covered drug of such manufacturer--
                            ``(i) to most-favored-nation price eligible 
                        individuals who with respect to such drug are 
                        described in clause (i) of paragraph (5)(D) and 
                        are dispensed such drug (and to pharmacies, 
                        mail order services, and other dispensers, with 
                        respect to such individuals who are dispensed 
                        such drugs); and
                            ``(ii) to hospitals, physicians, and other 
                        providers of services and suppliers with 
                        respect to most-favored-nation price eligible 
                        individuals who with respect to such drug are 
                        described in clause (ii) of such paragraph 
                        furnished or administered such drug; and
                    ``(B) reports to the Secretary, at such time and in 
                such manner as the Secretary shall specify, such 
                information as the Secretary determines necessary for 
                purposes of calculating the most-favored-nation price 
                with respect to each such covered drug.
            ``(2) Exception.--The Secretary may suspend the 
        requirements under paragraph (1) with respect to a covered drug 
        of a specified manufacturer until April 1, 2029, if the 
        Secretary reasonably believes that such manufacturer is likely 
        to enter into a covered agreement with the Secretary before 
        such date.
            ``(3) Duration.--The model described in paragraph (1) shall 
        be carried out for a period of 5 years.
            ``(4) Definitions.--In this subsection:
                    ``(A) Applicable net price.--The term `applicable 
                net price' means, with respect to a covered drug and a 
                reference country in which such drug was sold during a 
                year, the average price paid to the manufacturer for 
                the drug across package sizes and package types of the 
                drug in such reference country during such year across 
                all purchasers, taking into account all manufacturer 
                rebates, discounts, and price concessions, and adjusted 
                to take into account differences in purchasing power in 
                such country compared to the United States in a manner 
                specified by the Secretary.
                    ``(B) Appropriate congressional committees.--The 
                term `appropriate congressional committees' means--
                            ``(i) the Committee on Energy and Commerce 
                        and the Committee on Ways and Means of the 
                        House of Representatives; and
                            ``(ii) the Committee on Finance and the 
                        Committee on Health, Education, Labor, and 
                        Pensions of the Senate.
                    ``(C) Covered agreement.--The term `covered 
                agreement' means an agreement between a manufacturer of 
                a covered drug and the Secretary that--
                            ``(i) provides that such manufacturer--
                                    ``(I) will provide access to the 
                                most-favored-nation price of 1 or more 
                                covered drugs of such manufacturer in 
                                the same manner as described in 
                                paragraph (1)(A);
                                    ``(II) will report to the Secretary 
                                the information described in paragraph 
                                (1)(B) with respect to each such drug; 
                                and
                                    ``(III) commits, to the 
                                satisfaction of the Secretary, to 
                                increasing manufacturing operations in 
                                the United States; and
                            ``(ii) is--
                                    ``(I) entered into not later than 
                                December 31, 2028; and
                                    ``(II) reported by the Secretary to 
                                the appropriate congressional 
                                committees--
                                            ``(aa) not later than April 
                                        1, 2029; or
                                            ``(bb) in the case that 
                                        such agreement was entered into 
                                        before the date of the 
                                        enactment of the Most Favored 
                                        Patient Act of 2026, not later 
                                        than the date that is 30 days 
                                        after such date of enactment.
                    ``(D) Covered drug.--The term `covered drug' means, 
                with respect to a year, a specified drug that was sold 
                in 2 or more reference countries during such year.
                    ``(E) Manufacturer.--The term `manufacturer' has 
                the meaning given such term in section 1847A(c)(6)(A).
                    ``(F) Most-favored-nation price.--The term `most-
                favored-nation price' means, with respect to a covered 
                drug and a year, the second-lowest applicable net price 
                for such drug.
                    ``(G) Most-favored-nation price eligible 
                individual.--The term `most-favored-nation price 
                eligible individual' means, with respect to a covered 
                drug--
                            ``(i) in the case such drug is dispensed to 
                        the individual at a pharmacy, by a mail order 
                        service, or by another dispenser, an 
                        individual--
                                    ``(I) who is eligible for medical 
                                assistance under a State plan (or a 
                                waiver of such plan) under title XIX if 
                                coverage is provided under such plan 
                                (or waiver) for such covered drug; or
                                    ``(II) who is enrolled in a 
                                prescription drug plan under part D of 
                                title XVIII or an MA-PD plan under part 
                                C of such title if coverage is provided 
                                under such plan for such covered drug; 
                                and
                            ``(ii) in the case such drug is furnished 
                        or administered to the individual by a 
                        hospital, physician, or other provider of 
                        services or supplier, an individual who is 
                        enrolled under part B of title XVIII, including 
                        an individual who is enrolled in an MA plan 
                        under part C of such title, if payment may be 
                        made under part B for such selected drug.
                    ``(H) Reference country.--The term `reference 
                country' means any of the following countries:
                            ``(i) Canada.
                            ``(ii) Denmark.
                            ``(iii) France.
                            ``(iv) Germany.
                            ``(v) Italy.
                            ``(vi) Japan.
                            ``(vii) Switzerland.
                            ``(viii) The United Kingdom.
                    ``(I) Specified drug.--The term `specified drug' 
                means--
                            ``(i) a covered outpatient drug (as defined 
                        in section 1927(k));
                            ``(ii) a drug or biological product for 
                        which payment may be made under part B of title 
                        XVIII; or
                            ``(iii) a covered part D drug (as defined 
                        in section 1860D-2(e)).
                    ``(J) Specified manufacturer.--The term `specified 
                manufacturer' means a manufacturer of a covered drug 
                that does not have a covered agreement with the 
                Secretary.''.
                                 <all>

AI processing bill