Page:United States Statutes at Large Volume 124.djvu/1064

 124 STAT. 1038 PUBLIC LAW 111–152—MAR. 30, 2010 (ii) by adding ‘‘and’’ at the end of subparagraph (C); (iii) by striking subparagraph (D); and (iv) by redesignating subparagraph (E) as subpara- graph (D); and (3) in section 1860D–2(b)— (A) in paragraph (2)(A), by striking ‘‘The coverage’’ and inserting ‘‘Subject to subparagraphs (C) and (D), the coverage’’; (B) in paragraph (2)(B), by striking ‘‘subparagraph (A)(ii)’’ and inserting ‘‘subparagraphs (A)(ii), (C), and (D)’’; (C) by adding at the end of paragraph (2) the following new subparagraphs: ‘‘(C) COVERAGE FOR GENERIC DRUGS IN COVERAGE GAP.— ‘‘(i) IN GENERAL.—Except as provided in paragraph (4), the coverage for an applicable beneficiary (as defined in section 1860D–14A(g)(1)) has coinsurance (for costs above the initial coverage limit under para- graph (3) and below the out-of-pocket threshold) for covered part D drugs that are not applicable drugs under section 1860D–14A(g)(2) that is— ‘‘(I) equal to the generic-gap coinsurance percentage (specified in clause (ii)) for the year; or ‘‘(II) actuarially equivalent (using processes and methods established under section 1860D– 11(c)) to an average expected payment of such percentage of such costs for covered part D drugs that are not applicable drugs under section 1860D– 14A(g)(2). ‘‘(ii) GENERIC-GAP COINSURANCE PERCENTAGE.— The generic-gap coinsurance percentage specified in this clause for— ‘‘(I) 2011 is 93 percent; ‘‘(II) 2012 and each succeeding year before 2020 is the generic-gap coinsurance percentage under this clause for the previous year decreased by 7 percentage points; and ‘‘(III) 2020 and each subsequent year is 25 percent. ‘‘(D) COVERAGE FOR APPLICABLE DRUGS IN COVERAGE GAP.— ‘‘(i) IN GENERAL.—Except as provided in paragraph (4), the coverage for an applicable beneficiary (as defined in section 1860D–14A(g)(1)) has coinsurance (for costs above the initial coverage limit under para- graph (3) and below the out-of-pocket threshold) for the negotiated price (as defined in section 1860D– 14A(g)(6)) of covered part D drugs that are applicable drugs under section 1860D–14A(g)(2) that is— ‘‘(I) equal to the difference between the applicable gap percentage (specified in clause (ii) for the year) and the discount percentage specified in section 1860D–14A(g)(4)(A) for such applicable drugs; or 42 USC 1395w–102.