; and (B) by inserting (except for an insulin drug) after section 1860D–14A(g) . (b) Exclusion of insulin payments from MLR Not later than 90 days after the date of the enactment of this Act, the Secretary of Health and Human Services shall exclude, beginning with plan years beginning on or after January 1, 2021, from the denominator (as defined in section 158.221(c) of title 45, Code of Federal Regulations) section of a medical loss ratio (as calculated under section 158.221(a) of such title) of a health insurance issuer (as defined in section 144.103 of such title) the amount of payments that such issuer paid during a MLR reporting year (as defined in section 144.103 of such title) for insulin drugs through the promulgation of a regulation. (c) Maximum cost sharing and coinsurance for insulin drugs in certain private plans and Medicare (1) PHSA amendment Subpart II of part A of title XXVII of the Public Health Service Act ( 42 U.S.C. 300gg–11 et seq.) is amended by inserting after section 2713 the following new section: 2713A. Coverage of insulin drugs (a) In general Beginning with plan years beginning 90 days after the date of the enactment of this section, a group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage and may impose cost sharing for an insulin drug in accordance with subsection (b) for an individual that is provided a prescription for such drug. (b) Cost sharing Beginning with plan years beginning 90 days after the date of the enactment of this section, the cost sharing incurred under a plan or coverage described in subsection (a) for an insulin drug may not exceed $10 for each 1-month period of coverage. (c) Insulin drug defined In this section, the term insulin drug has the meaning given such term in section 1150C(f)(3) of the Social Security Act. . (2) Medicare amendments (A) Coinsurance limitation Section 1860D–2(b)(2) of the Social Security Act ( 42 U.S.C. 1395w–102(b)(2) ) is amended— (i) in subparagraph (A),