summary
Introduced
12/04/2019
12/04/2019
In Committee
12/05/2019
12/05/2019
Crossed Over
Passed
Dead
12/31/2020
12/31/2020
Introduced Session
116th Congress
Bill Summary
A BILL To amend title XXVII of the Public Health Service Act to require health plan oversight of pharmacy benefit manager services, and for other purposes. 1
AI Summary
This bill, the PBM Transparency in Prescription Drug Costs Act, aims to amend the Public Health Service Act to require health plans to oversee pharmacy benefit manager (PBM) services. The key provisions include: 1) prohibiting contracts that limit disclosure of information to plan sponsors, 2) requiring PBMs to submit periodic reports to plan sponsors on drug costs, rebates, and utilization, 3) limiting "spread pricing" where PBMs charge plans more than the amount paid to pharmacies, 4) requiring 100% pass-through of rebates and other remuneration received by PBMs to the health plan, and 5) establishing penalties for non-compliance. The bill also clarifies that these obligations apply to third-party administrators of group health plans.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (2)
Last Action
Referred to the Subcommittee on Health. (on 12/05/2019)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.congress.gov/bill/116th-congress/house-bill/5304/all-info |
| BillText | https://www.congress.gov/116/bills/hr5304/BILLS-116hr5304ih.pdf |
| Bill | https://www.congress.gov/116/bills/hr5304/BILLS-116hr5304ih.pdf.pdf |
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