Bill > HR1035

Introduced Session

To amend title XVIII of the Social Security Act to provide for pharmacy benefits manager standards under the Medicare prescription drug program and Medicare Advantage program to further transparency of payment methodologies to pharmacies, and for other purposes. This bill establishes additional requirements for prescription drug plan sponsors (PDPs) under Medicare and Medicare Advantage, as well as health insurance carriers under the Federal Employees Health Benefits Program, relating to the methodology of payments to pharmacies and the use of pharmacy benefits managers (PBMs). Specifically, such PDPs and carriers must disclose specified information to pharmacies regarding applicable standards for reimbursement that are based on drug costs, including the sources used to update such standards. Additionally, such PDPs and carriers may not contract with PBMs that require, or that provide an incentive for, plan enrollees to use pharmacies that have a shared ownership interest with the PBM.

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Doug Collins (R)*,  Mo Brooks (R),  Ted Budd (R),  Bradley Byrne (R),  Buddy Carter (R),  Yvette Clarke (D),  Ben Cline (R),  Rick Crawford (R),  Sharice Davids (D),  Lloyd Doggett (D),  Tulsi Gabbard (D),  Vicente Gonzalez (D),  Jaime Herrera Beutler (R),  Jody Hice (R),  French Hill (R),  Fred Keller (R),  Steve King (R),  Debbie Lesko (R),  David Loebsack (D),  Barry Loudermilk (R),  Roger Marshall (R),  Cathy McMorris Rodgers (R),  Dan Meuser (R),  Dan Newhouse (R),  Steven Palazzo (R),  Collin Peterson (D),  Bill Posey (R),  Jamie Raskin (D),  Kathleen Rice (D),  Martha Roby (R),  David Roe (R),  Mike Rogers (R),  John Sarbanes (D),  Austin Scott (R),  G.T. Thompson (R),  Filemón Vela (D),  Peter Visclosky (D),  Peter Welch (D),  Bruce Westerman (R), 

Referred to the Subcommittee on Health. (on 02/07/2019)

Official Document