S.3551

The bill provides coverage for certain drugs used in treating rare diseases and conditions.

The bill amends titles XVIII and XIX of the Social Security Act and title XXVII of the Public Health Service Act to provide coverage for certain drugs used in the treatment or management of a rare disease or condition. It defines a "rare disease or condition" as one affecting 200,000 or fewer individuals in the United States. The bill also establishes an expedited process for appealing denials of coverage for these drugs. The changes apply to Medicare, Medicaid, and private health insurance, effective from January 1, 2027.