; (2) in paragraph (3)(A), in the matter preceding clause (i), by inserting and paragraph (5) after subparagraph (C) ; and (3) by adding at the end the following new paragraph: (5) Special rule for determining minimum basic rebates for insulin (A) In general In determining the amount of the rebate specified in this subsection for a dosage form and strength of a covered outpatient drug described in subparagraph (B) for any rebate period occurring after April 30, 2020, paragraph (1)(A)(ii)(II) or paragraph (3)(A)(i) (as applicable) shall be applied by substituting— (i) the pre-reduction average manufacturer price (as defined in subparagraph (C)) for the dosage form and strength of the drug for the rebate period; for (ii) the average manufacturer price for the dosage form and strength of the drug for the rebate period. (B) Drugs described A covered outpatient drug is described in this subparagraph for a rebate period if the drug is insulin for which, throughout such rebate period, the manufacturer has certified the list price for each dosage form and strength of such drug in accordance with section 5(b) of the Insulin Price Reduction Act . (C) Pre-reduction average manufacturer price For purposes of this paragraph, the term pre-reduction average manufacturer price means, with respect to each dosage form and strength of a covered outpatient drug described in subparagraph (B) and a rebate period— (i) the average manufacturer price for such drug for the calendar quarter beginning July 1, 2019