H.R. 5467 — PAAT Act

This section requires prescription drug plan (PDP) sponsors under Medicare Part D to include on their formularies, for 2027 and subsequent years, each covered Part D drug indicated and prescribed for the treatment of an autoimmune disease, hemophilia, or Von Willebrand disease. The section further prohibits PDP sponsors and Medicare Advantage prescription drug (MA-PD) plan organizations, for plan years beginning on or after January 1, 2027, from requiring prior authorization for such drugs more than once during any 12-month period, unless the drug is typically used for 12 months or less, is an opioid, benzodiazepine, barbiturate, or carisoprodol, or is subject to a risk evaluation and mitigation strategy under FDA requirements.