Read twice and referred to the Committee on Finance.
Congressional Research Service
Official summary
Version 00 · Introduced in Senate · Jul 25, 2013
Part D Beneficiary Appeals Fairness Act - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act, with respect to a prescription drug plan (PDP) that provides for any tiered cost-sharing within a formulary (including a structure that provides for different co-payment or coinsurance amounts for drugs in different tiers included within the formulary), to authorize a Medicare part D eligible individual enrolled in the plan to request an exception to the tiered cost-sharing structure.
States that in no case may the Secretary of Health and Human Services (HHS) allow a PDP sponsor to make any formulary tier of the tiered cost-sharing structure (including a formulary tier used for very high cost or unique items) ineligible for lower-cost sharing through an exception.
Source last updated: Dec 5, 2025. Consult Congress.gov for the current record.
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