Bill > HR5281

This bill, the Drug Price Transparency in Medicaid Act of 2019, aims to improve transparency and prevent the use of abusive spread pricing and related practices in the Medicaid program. The key provisions of the bill are: 1. It requires pass-through pricing models and prohibits spread-pricing for payment arrangements with pharmacy benefit managers (PBMs) under Medicaid. This means that any payments made by the Medicaid managed care entity or PBM to pharmacies must be passed through in full, with a limit on the administrative fees that can be charged. 2. It extends funding for retail pharmacy surveys and requires additional information, such as price concessions, dispensing fees, and survey participation, to be made publicly available. This is intended to improve the accuracy of the national average drug acquisition cost data used in Medicaid. 3. It includes a requirement for retail community pharmacies that receive any Medicaid-related payments, fees, discounts, or rebates to respond to the retail price surveys conducted by the Secretary. The bill aims to increase transparency and prevent the use of practices that may lead to higher drug prices for the Medicaid program.

Business and Industry, Health and Social Services

https://www.congress.gov/bill/116th-congress/house-bill/5281/all-info