H.R. 4299 — Protecting Patient Access to Cancer and Complex Therapies Act

This section (1) maintains Medicare Part B payment rates for selected drugs (as defined under the Medicare Drug Price Negotiation Program) at average sales price plus 6% (ASP+6) by striking prior exceptions in SSA §1847A(b)(1)(B); (2) requires manufacturers of such drugs to pay quarterly rebates, due within 30 days of the Secretary's report (issued no later than 6 months after quarter-end), equal to the excess of ASP+6 payments and coinsurance over maximum fair price plus 6% (MFP+6) payments and coinsurance, with beneficiary coinsurance based on MFP+6 (the lesser of which applies if an inflation rebate is also due); and (3) deposits rebates into the Federal Supplementary Medical Insurance Trust Fund, applies civil money penalties for noncompliance, and conforms Part B payment provisions under SSA §1833(a)(1). (As background, the Medicare Drug Price Negotiation Program selects high-cost, single-source Part D drugs without price competition or generic/biosimilar equivalents for negotiation of an MFP, initially applicable in 2026. Thus, manufacturer rebates effectively reduce net Part B payments for physician-administered selected drugs to MFP+6.)