To amend title XVIII of the Social Security Act to permit coverage of certain covered part D drugs for uses that are determined to be for medically accepted indications based upon clinical evidence in peer reviewed medical literature.
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 ``Part D Off-Label Prescription Parity Act''.
SEC. 2. REVISED DEFINITION OF MEDICALLY ACCEPTED INDICATION FOR MEDICARE COVERED PART D DRUGS.
(a) In General.--Section 1860D-2(e)(4) of the Social Security Act (42 U.S.C. 1395w-102(e)(4)) is amended by adding at the end the following new subparagraph: ``(D) Clarification.--Notwithstanding subparagraph (A)(ii), none of the provisions of this subsection shall prevent a PDP sponsor offering a prescription drug plan or an MA organization offering an MA-PD plan from determining (whether through a determination, reconsideration of such a determination, or an appeal of such a determination under section 1852(g) or subsection (g) or (h) of section 1860D-4, as applicable) that a use of a covered part D drug is for a medically accepted indication for purposes of coverage of such drug under such plan if such determination is based upon guidance provided by the Secretary for determining accepted uses of covered part D drugs and on supportive clinical evidence in peer reviewed medical literature.''. (b) Effective Date.--The amendment made by this section shall apply to plan years beginning on or after January 1, 2012. <all>