PBM Price Transparency and Accountability Act
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
The PBM Price Transparency and Accountability Act aims to increase transparency and accountability in how prescription drugs are priced and paid for under Medicaid and Medicare. It requires the Department of Health and Human Services to determine national average drug acquisition costs, prevent abusive spread pricing practices, and ensure pharmacies receive accurate payments. The bill also seeks to improve pharmacy access and choice for Medicare beneficiaries and modernize PBM accountability under Medicare, including establishing standards for pharmacy contracts and reporting requirements.
Key provisions
- Requires the Department of Health and Human Services to survey pharmacies to determine national average drug acquisition costs.
- Prohibits abusive spread pricing practices in Medicaid by requiring transparent prescription drug pass-through pricing.
- Establishes standards for reasonable and relevant contract terms and conditions between prescription drug plans and pharmacies.
- Mandates that pharmacy benefit managers (PBMs) provide information on their pricing practices to PDP sponsors.
- Ensures pharmacy access and choice for Medicare beneficiaries by requiring PDP sponsors to allow any willing pharmacy to participate in their networks.
- Creates a process for pharmacies to report violations of contract terms and conditions with PBMs.
- Requires PBMs to disclose information on rebates, discounts, and other price concessions.
- Establishes reporting requirements for PDP sponsors regarding drug costs and utilization.
Bill text
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Sponsors
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28 on record
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