Summary#
This bill would create a Hepatitis C Elimination Program at the Department of Health and Human Services. The Secretary must issue a national strategy and implementation plan, set performance metrics, form an advisory committee and an interagency working group, and publish a public dashboard to track progress. The bill establishes a subscription purchasing program where HHS would sign 5-year agreements with drug manufacturers to buy direct acting antivirals (DAAs) for hepatitis C and distribute them to registered pharmacies, participating State and local correctional systems, the Bureau of Prisons, and Indian Health Service facilities. Individuals in specified "covered populations" who are diagnosed with hepatitis C would be entitled to receive treatments bought under the program without cost-sharing. Covered populations include people enrolled in participating State Medicaid or CHIP programs, people in Bureau of Prisons facilities, people in participating state or local correctional facilities (including those who started treatment in custody but were released before finishing), people without minimum essential coverage, and those served by Indian health programs. The bill also directs grants and contracts to states, community organizations, health centers, opioid treatment programs, tribal health programs, and correctional systems to boost testing, diagnosis, treatment, outreach, and continuity of care. It allows HHS to buy and distribute point-of-care diagnostic tests and to fund training and technical assistance. The bill amends Medicaid drug pricing rules to exclude prices charged under the subscription program from certain Medicaid best-price and average manufacturer price calculations. It further removes Medicare Part D cost-sharing for DAAs for plan years 2028 through 2032 (with authority to delay to 2029 if not feasible). The bill includes specific program rules, reporting requirements, and rulemaking authority for the Secretary.
What it means for you#
- If you are diagnosed with hepatitis C and are in a covered group defined by the bill, you would be eligible to get hepatitis C treatments purchased under the program without cost-sharing.
- Medicare Part D enrollees would have the deductible and cost-sharing for hepatitis C DAAs eliminated for plan years 2028–2032 (or starting 2029 if implementation is delayed).
- People incarcerated in participating state or local correctional facilities, and people in Bureau of Prisons facilities, would be eligible for treatment under the program. Correctional systems that join must provide the remainder of a course of treatment and a referral to care when someone is released.
- People without minimum essential coverage and people served by Indian health programs can be eligible under the program; the Secretary will designate providers to verify eligibility.
- Registered pharmacies and sites of dispensing that join the program would dispense the purchased drugs and may receive reasonable dispensing fees. Participating State Medicaid and CHIP programs must not require prior authorization for screening and treatment provided through the program.
- The Secretary will publish a dashboard and annual reports on program progress.
Expenses#
- Section 4 (subscription drug purchases): $5,500,000,000 is authorized and appropriated for fiscal year 2027, to remain available through fiscal year 2033.
- Section 6 (program operations and public health activities): $4,283,000,000 is authorized and appropriated for fiscal year 2027, to remain available through fiscal year 2033.
- Of amounts for program operations, not more than 5 percent may be used for administrative expenses of the Hepatitis C Elimination Program.
- The Secretary shall transfer $25,000,000 of the Section 6 appropriation to the Federal Bureau of Prisons for expenses to carry out the program.
- Up to $20,000,000 of funds for the public health activities may be used to support development of point-of-care diagnostic tests.
- The Secretary will pay customary and usual dispensing fees to registered pharmacies that dispense treatments to covered individuals.
- Agreements with drug manufacturers under the subscription model will run for 5 years; the Secretary must specify the covered population and estimated size to support bidding.
Proponents' View#
No publicly available information.
Opponents' View#
No publicly available information.