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Bill > HR2115


US HR2115

Public Disclosure of Drug Discounts and Real-Time Beneficiary Drug Cost Act


summary

Introduced
04/08/2019
In Committee
04/09/2019
Crossed Over
10/29/2019
Passed
Dead
12/31/2020

Introduced Session

116th Congress

Bill Summary

Public Disclosure of Drug Discounts and Real-Time Beneficiary Drug Cost Act Public Disclosure of Drug Discounts and Real-Time Beneficiary Drug Cost Act This bill requires the Centers for Medicare & Medicaid Services (CMS) to publish certain payment information regarding pharmacy benefit managers (PBMs) and prescription drugs. Specifically, the CMS must publish certain information, as reported by PBMs, relating to generic dispensing rates, drug discounts and rebates, and payments between PBMs, health plans, and pharmacies, in accordance with specified confidentiality requirements. The bill also provides statutory authority for certain provisions of the CMS rule titled "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses," published on May 23, 2019. The rule requires, in part, Medicare prescription drug plan sponsors to implement an electronic, real-time benefit tool that is capable of integrating with at least one prescriber's electronic prescribing system or electronic health record. The tool must provide prescribers with patient-specific, real-time formulary and benefit information, including information regarding cost-sharing, formulary alternatives, and utilization management requirements. The rule takes effect January 1, 2021.

AI Summary

This bill requires the Centers for Medicare & Medicaid Services (CMS) to publicly disclose certain payment information reported by pharmacy benefit managers (PBMs), including generic dispensing rates, drug discounts and rebates, and payments between PBMs, health plans, and pharmacies, while protecting confidentiality requirements. The bill also provides statutory authority for a CMS rule that requires Medicare prescription drug plan sponsors to implement an electronic, real-time benefit tool capable of integrating with prescribers' electronic systems to provide patient-specific information on formulary alternatives, cost-sharing, and utilization management requirements.

Committee Categories

Budget and Finance, Business and Industry, Health and Social Services

Sponsors (6)

Last Action

Received in the Senate and Read twice and referred to the Committee on Finance. (on 10/29/2019)

bill text


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