I 

116TH CONGRESS 

1ST SESSION H. R. 5442 

To amend title XXVII of the Public Health Service Act and title XVIII 

of the Social Security Act to require pharmacies to disclose any differential between the cost of a prescription drug based on whether certain 

individuals use prescription drug coverage to acquire such drug, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 16, 2019 

Ms. PORTER (for herself and Ms. DELAURO) introduced the following bill; 

which was referred to the Committee on Energy and Commerce, and in 

addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XXVII of the Public Health Service Act 

and title XVIII of the Social Security Act to require 

pharmacies to disclose any differential between the cost 

of a prescription drug based on whether certain individuals use prescription drug coverage to acquire such drug, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Lowest Price for Pa3 tients Act’’. 

4 SEC. 2. REQUIREMENT FOR PHARMACIES TO DISCLOSE 

5 ANY DIFFERENTIAL BETWEEN THE COST OF 

6 A PRESCRIPTION DRUG BASED ON WHETHER 

7 CERTAIN INDIVIDUALS USE PRESCRIPTION 

8 DRUG COVERAGE TO ACQUIRE SUCH DRUG. 

9 (a) ENROLLEES OF PRESCRIPTION DRUG COVERAGE

10 UNDER A GROUP HEALTH PLAN OR A HEALTH INSUR11 ANCE ISSUER OFFERING GROUP OR INDIVIDUAL HEALTH

12 INSURANCE COVERAGE.—Section 2729(a) of the Public 

13 Health Service Act (42 U.S.C. 300gg–29(a)) is amend14 ed— 

15 (1) in paragraph (1)— 

16 (A) by striking ‘‘not restrict, directly or in17 directly,’’ and inserting ‘‘provide that’’; and 

18 (B) by striking ‘‘from informing (or penal19 ize such pharmacy for informing)’’ and insert20 ing ‘‘inform’’; and 

21 (2) in paragraph (2)— 

22 (A) by striking ‘‘ensure’’ and inserting 

23 ‘‘provide’’; 

24 (B) by striking ‘‘does not, with respect to 

25 such plan or coverage, restrict, directly or indiVerDate Sep 11 2014 01:44 Dec 27, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5442.IH H5442

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1 rectly,’’ and inserting ‘‘requires under such con2 tract that’’; and 

3 (C) by striking ‘‘from informing (or penal4 ize such pharmacy for informing)’’ and insert5 ing ‘‘inform’’. 

6 (b) ENROLLEES OF PRESCRIPTION DRUG COVERAGE

7 UNDER A PRESCRIPTION DRUG PLAN OR MA–PD 

8 PLAN.—Section 1860D–4 of the Social Security Act (42 

9 U.S.C. 1395w–104) is amended— 

10 (1) by redesignating the subsection (m) as in11 serted by section 6063(c) of the SUPPORT for Pa12 tients and Communities Act as subsection (n); and 

13 (2) by adding at the end the following new sub14 section: 

15 ‘‘(o) PHARMACY DISCLOSURE OF THE PRICE OF A

16 DRUG FOR AN ENROLLEE USING AND NOT USING PRE17 SCRIPTION DRUG COVERAGE.—For plan year 2020 and 

18 each subsequent plan year, a PDP sponsor and a Medicare 

19 Advantage organization offering a prescription drug plan 

20 or MA–PD plan under a contract with an entity that pro21 vides pharmacy benefits management services on behalf 

22 of such MA–PD plan shall provide that each pharmacy 

23 that dispenses a coverage part D drug shall inform an en24 rollee of any differential between— 


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1 ‘‘(1) the price of the drug for an individual that 

2 is an enrollee under such prescription drug plan or 

3 MA–PD plan (as the case may be) using such plan; 

4 and 

5 ‘‘(2) the price of the drug for such individual 

6 described in paragraph (1) without using such 

7 plan.’’. 

Æ 


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