COVERAGE OF ADULT VACCINES RECOMMENDED BY THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES UNDER MEDICARE PART D.

SEC. 11401. COVERAGE OF ADULT VACCINES RECOMMENDED BY THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES UNDER MEDICARE PART D.(a) Ensuring Treatment of Cost-sharing and Deductible Is Consistent With Treatment of Vaccines Under Medicare Part B.—Section 1860D–2 of the Social Security Act (42 U.S.C. 1395w–102), as amended by sections 11201 and 11202, is amended—(1) in subsection (b)—(A) in paragraph (1)(A), by striking “The coverage” and inserting “Subject to paragraph (8), the coverage”; (B) in paragraph (2)—(i) in subparagraph (A), by inserting “and paragraph (8)” after “and (E)”; (ii) in subparagraph (C)(i), in the matter preceding subclause (I), by striking “paragraph (4)” and inserting “paragraphs (4) and (8)”; and (iii) in subparagraph (D)(i), in the matter preceding subclause (I), by striking “paragraph (4)” and inserting “paragraphs (4) and (8)”; (C) in paragraph (3)(A), in the matter preceding clause (i), by striking “and (4)” and inserting “(4), and (8)”; (D) in paragraph (4)(A)(i), by striking “The coverage” and inserting “Subject to paragraph (8), the coverage”; and (E) by adding at the end the following new paragraph:“(8) Treatment of cost-sharing for adult vaccines recommended by the advisory committee on immunization practices consistent with treatment of vaccines under part b.—“(A) In general.—For plan years beginning on or after January 1, 2023, with respect to an adult vaccine recommended by the Advisory Committee on Immunization Practices (as defined in subparagraph (B))—“(i) the deductible under paragraph (1) shall not apply; and136 STAT. 1897 “(ii) there shall be no coinsurance or other cost-sharing under this part with respect to such vaccine. “(B) Adult vaccines recommended by the advisory committee on immunization practices.—For purposes of this paragraph, the term ‘adult vaccine recommended by the Advisory Committee on Immunization Practices’ means a covered part D drug that is a vaccine licensed under section 351 of the Public Health Service Act for use by adult populations and administered in accordance with recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.” ; and (2) in subsection (c), by adding at the end the following new paragraph:“(5) Treatment of cost-sharing for adult vaccines recommended by the advisory committee on immunization practices.—The coverage is in accordance with subsection (b)(8).” . (b) Conforming Amendments to Cost-sharing for Low-income Individuals.—Section 1860D–14(a) of the Social Security Act (42 U.S.C. 1395w–114(a)), as amended by section 11201, is amended—(1) in paragraph (1)(D), in each of clauses (ii) and (iii), by striking “In the case” and inserting “Subject to paragraph (6), in the case”; (2) in paragraph (2)—(A) in subparagraph (B), by striking “A reduction” and inserting “Subject to section 1860D–2(b)(8), a reduction”; (B) in subparagraph (D), by striking “The substitution” and inserting “Subject to paragraph (6), the substitution”; and (C) in subparagraph (E), by striking “subsection (c)” and inserting “paragraph (6) of this subsection and subsection (c)”; and (3) by adding at the end the following new paragraph:“(6) No application of cost-sharing or deductible for adult vaccines recommended by the advisory committee on immunization practices.—For plan years beginning on or after January 1, 2023, with respect to an adult vaccine recommended by the Advisory Committee on Immunization Practices (as defined in section 1860D–2(b)(8)(B))—“(A) the deductible under section 1860D–2(b)(1) shall not apply; and “(B) there shall be no cost-sharing under this section with respect to such vaccine.” . (c) Temporary Retrospective Subsidy.—(1) In general.—Section 1860D–15 of the Social Security Act (42 U.S.C. 1395w–115) is amended by adding at the end the following new subsection:“(h) Temporary Retrospective Subsidy for Reduction in Cost-sharing and Deductible for Adult Vaccines Recommended by the Advisory Committee on Immunization Practices During 2023.—“(1) In general.—In addition to amounts otherwise payable under this section to a PDP sponsor of a prescription drug plan or an MA organization offering an MA–PD plan, for plan year 2023, the Secretary shall provide the PDP sponsor 136 STAT. 1898 or MA organization offering the plan subsidies in an amount equal to the aggregate reduction in cost-sharing and deductible by reason of the application of section 1860D–2(b)(8) for individuals under the plan during the year. “(2) Timing.—The Secretary shall provide a subsidy under paragraph (1), as applicable, not later than 18 months following the end of the applicable plan year.” . (2) Treatment as incurred costs.—Section 1860D–2(b)(4)(C)(iii)(I) of the Social Security Act (42 U.S.C. 1395w–102(b)(4)(C)(iii)(I)), as amended by section 11201(a)(3)(C), is amended—(A) in item (cc), by striking “or” at the end; and (B) by adding at the end the following new item:“(dd) under section 1860D–15(h); or” . (d) Rule of Construction.—Nothing in this section shall be construed as limiting coverage under part D of title XVIII of the Social Security Act for vaccines that are not recommended by the Advisory Committee on Immunization Practices. (e) Implementation for 2023 Through 2025.—The Secretary shall implement this section, including the amendments made by this section, for 2023, 2024, and 2025, by program instruction or other forms of program guidance.