The plan that House Speaker Nancy Pelosi (D-Calif.) has been quietly working on for months.

The Pelosi plan would have Medicare negotiate prices of the top 250 drugs with the greatest total cost to Medicare (and the entire U.S. health system) without competition from at least two generic, biosimilar or interchangeable biologics on the market.

The law would also set a maximum price for any negotiated drug with an International Price Index. The upper limit for the price reached in any negotiation can be no more than 1.2 times ( or 120 percent) of the volume-weighted average of price of six countries (Australia, Canada, France, Germany, Japan, and the United Kingdom). 

All +8,000 drugs in Medicare Part B and D would also face a new inflation rebate - if a drug company has raised the price of a drug in Part B or D above the rate of inflation since 2016, they can either lower the price or be required to pay the entire price above inflation in a rebate back to the U.S. Treasury. 

The document was first obtained by Bloomberg Government. 

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