Bill > HR6101

This bill, the Drug Price Transparency in Medicaid Act of 2021, 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" in contracts between states and pharmacy benefit managers (PBMs) or managed care entities, where any payment made by the entity or PBM for a covered outpatient drug must be passed through in its entirety to the dispensing pharmacy or provider. This prevents PBMs from engaging in "spread pricing" where they charge more than the amount paid to the pharmacy. 2. It prohibits states, Medicaid managed care organizations, or PBMs from requiring covered entities under the 340B drug discount program to dispense 340B drugs to Medicaid beneficiaries or from restricting such entities from receiving payment for 340B drugs dispensed to Medicaid beneficiaries. 3. It requires the Secretary of Health and Human Services to conduct a survey of retail community pharmacy drug prices to determine the national average drug acquisition cost, and requires pharmacies receiving Medicaid payments to respond to these surveys.