; (ii) is not passed on, in whole or in part, to a client or customer of the entity, whether or not the entity takes title to the drug or biological; (iii) is a fixed payment and not based on a percentage of sales; and (iv) is not determined in a manner that takes into account the volume or value of any referrals or business otherwise generated between the parties. . (b) Effective date The amendments made by subsection (a) shall apply to drugs and biologicals furnished on or after the first day of the first calendar quarter that begins on or after the date that is 180 days after the date of the enactment of this Act. 109. Establishment of maximum add-on payment for drugs and biologicals (a) In general Section 1847A of the Social Security Act ( 42 U.S.C. 1395w–3a ) is amended— (1) in subsection (b)— (A) in paragraph (1), in the matter preceding subparagraph (A), by striking paragraph (7) and inserting paragraphs (7) and (9) ; and (B) by adding at the end the following new paragraph: (9) Maximum add-on payment amount (A) In general In determining the payment amount under the provisions of subparagraph (A), (B), or (C) of paragraph (1) of this subsection, subsection (c)(4)(A)(ii), or subsection (d)(3)(C) for a drug or biological furnished on or after January 1, 2021, if the applicable add-on payment (as defined in subparagraph (B)) for each drug or biological on a claim for a date of service exceeds the maximum add-on payment amount specified under subparagraph (C) for the drug or biological, then the payment amount otherwise determined for the drug or biological under those provisions, as applicable, shall be reduced by the amount of such excess. (B) Applicable add-on payment defined In this paragraph, the term applicable add-on payment means the following amounts, determined without regard to the application of subparagraph (A): (i) In the case of a multiple source drug, an amount equal to the difference between— (I) the amount that would otherwise be applied under paragraph (1)(A)