S. 1339 · 118th Congress
Pharmacy Benefit Manager Reform Act
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Never voted on. It didn't reach a floor vote before the 118th Congress ended, so it expired. A bill has to be introduced again to be considered in a new Congress.
I
SandersSponsor4 cosponsors · 1 D, 3 R
3 signed on when it was introduced; the rest joined later. Cosponsors who withdrew aren't shown.
This bill establishes various requirements for pharmacy benefit managers (PBMs) with respect to services provided to health insurance plans.
What it does: CRS summary · Introduced in Senate · Apr 27, 2023
Pharmacy Benefit Manager Reform Act
This bill establishes various requirements for pharmacy benefit managers (PBMs) with respect to services provided to health insurance plans.
First, PBMs must report annually to the plan sponsor certain information about the PBM's services, including the amount of prescription drug copayment assistance funded by drug manufacturers, a list of covered drugs billed under the plan during the reporting period, and the total net spending by the health plan on prescription drugs. PBMs also must provide plan sponsors with a supplementary report every six months with specified information about drugs that were dispensed under the plan by pharmacies that are wholly or partially owned by the PBM.
Second, the bill prohibits spread pricing. Under the bill, spread pricing occurs when a PBM charges an insurance plan (or an insurance plan charges plan participants) a price for a prescription drug that exceeds the price paid to the pharmacy for the drug.
Finally, PBMs must remit to the plan sponsor all rebates, fees, alternative discounts, and other remuneration received from a drug manufacturer.
The bill establishes civil penalties for violations of these requirements and provides funding for the Centers for Medicare & Medicaid Services and the Department of Labor to implement the provisions of this bill.
Written by the nonpartisan Congressional Research Service. All summary versions on Congress.gov
About this bill and sources
Official title: Pharmacy Benefit Manager Reform Act
Latest action (Jun 22, 2023): Placed on Senate Legislative Calendar under General Orders. Calendar No. 113.
Policy area: Health · Origin: Senate · Introduced: Apr 27, 2023
Official page on Congress.gov · Bill text (GovInfo) · Status record (XML)
No recorded floor vote found.