HR 5467 Re-checks Congress.gov for new actions and updates the bill's status, and fills in any sponsors, committees, or related bills that are missing. It does not re-pull sponsors/cosponsors/committees/related — those rarely change — and it skips all work if nothing has changed upstream, so it's cheap to click.
To amend title XVIII of the Social Security Act to require coverage of drugs for autoimmune diseases and certain blood disorders under Medicare part D.
Summary
The bill requires Medicare Part D drug plans to include medications for treating autoimmune diseases, hemophilia, and Von Willebrand disease starting in 2027. It limits prior authorization restrictions for these drugs, allowing plans to require approval no more than once per 12-month period, with exceptions for short-term medications and drugs with special safety requirements. Prior authorization is a process where insurers require doctor approval before patients can access certain medications.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
5 cosponsors
Actions (2)
- Sep 18, 2025 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. · house
- Sep 18, 2025 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Text versions (1)
Bills are re-published as they move (Introduced → Reported → Engrossed → Enrolled …). Each stage below is a separate text; pick two to see what changed. Data from Congress.gov.
Full text
IN THE HOUSE OF REPRESENTATIVES
September 18, 2025
Ms. Johnson of Texas (for herself and Mr. Kennedy of Utah) 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 XVIII of the Social Security Act to require coverage of drugs for autoimmune diseases and certain blood disorders under Medicare part D.
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 “Patient Access to Autoimmune Treatments Act” or the “PAAT Act”.
SEC. 2. REQUIRING COVERAGE OF DRUGS FOR AUTOIMMUNE DISEASES AND CERTAIN BLOOD DISORDERS UNDER MEDICARE PART D.
Section 1860D-4 of the Social Security Act (42 U.S.C. 1395w-104) is amended—
(1) in subsection (b)(3), by adding at the end the following new subparagraph:
“(J) Required inclusion of certain drugs for autoimmune diseases and blood disorders.—
“(i) In general.—For 2027 and each subsequent year, a PDP sponsor offering a prescription drug plan shall include each covered part D drug that is an autoimmune or blood disorder drug described in clause (ii).
“(ii) Autoimmune or blood disorder drug.— For purposes of clause (i), a drug described in this clause is a covered part D drug indicated and prescribed for the treatment of an autoimmune disease, hemophilia, or Von Willebrand disease.”; and
(2) in subsection (c)—
(A) by redesignating paragraph (6), as added by section 50354 of division E of the Bipartisan Budget Act of 2018 (Public Law 115-123), as paragraph (7); and
(B) by adding at the end the following new paragraph:
“(8) Prohibition on use of prior authorization for certain autoimmune or blood disorder drugs.—For plan years beginning on or after January 1, 2027, a PDP sponsor offering a prescription drug plan (and an MA organization offering an MA- PD plan) may not require, with respect to an individual enrolled under such plan, that prior authorization for an autoimmune or blood disorder drug (as described in subsection
(b)(3)(J)(ii)) be obtained more than once during any 12-month period unless such drug is—
“(A) typically used for a period of 12 months or less;
“(B) an opioid, a benzodiazepine, a barbiturate, or carisoprodol; or
“(C) a drug with respect to which a risk evaluation and mitigation strategy is required under Section 505-1 of the Federal Food, Drug, and Cosmetic Act.”. <all>
Comments