I 

118TH CONGRESS 

1ST SESSION H. R. 6844 

To amend title XVIII of the Social Security Act to prohibit the Secretary 

of Health and Human Services from entering into contracts with PDP 

sponsors of prescription drug plans that have a contract with certain 

pharmacy benefits managers. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 15, 2023 

Ms. TENNEY 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 XVIII of the Social Security Act to prohibit 

the Secretary of Health and Human Services from entering into contracts with PDP sponsors of prescription 

drug plans that have a contract with certain pharmacy 

benefits managers. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Ensuring PBM Com5 petition Act’’. 


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1 SEC. 2. PROHIBITING THE SECRETARY OF HEALTH AND 

2 HUMAN SERVICES FROM ENTERING INTO 

3 CONTRACTS WITH PDP SPONSORS OF PRE4 SCRIPTION DRUG PLANS THAT HAVE A CON5 TRACT WITH CERTAIN PHARMACY BENEFITS 

6 MANAGERS. 

7 Section 1860D–12(b) of the Social Security Act (42 

8 U.S.C. 1395w–112(b)) is amended by adding at the end 

9 the following new paragraph: 

10 ‘‘(9) PROHIBITION ON ENTERING INTO CON11 TRACTS WITH PDP SPONSORS THAT HAVE A CON12 TRACT WITH A CERTAIN PHARMACY BENEFITS MAN13 AGERS.— 

14 ‘‘(A) IN GENERAL.—Subject to subpara15 graph (B), beginning on the date that is 5 

16 years after the date of enactment of this para17 graph, the Secretary shall not enter into, or 

18 renew, a contract with a PDP sponsor for the 

19 offering of a prescription drug plan in a PDP 

20 region for a year if such sponsor has a contract 

21 for such year with a pharmacy benefits man22 ager that, directly or indirectly, or through one 

23 or more intermediaries, owns, controls, or oth24 erwise has a financial interest in, a pharmacy. 

25 ‘‘(B) AUTHORITY TO DELAY REQUIRE26 MENT.—The Secretary may delay the requireVerDate Sep 11 2014 19:57 Jan 05, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6844.IH H6844

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1 ment in subparagraph (A) by not more than 2 

2 years. 

3 ‘‘(C) PHARMACY BENEFITS MANAGER DE4 FINED.—For purposes of this paragraph, the 

5 term ‘pharmacy benefits manager’ means any 

6 entity (or any affiliate, subsidiary, or agent of 

7 such entity) that, pursuant to an agreement 

8 with a PDP sponsor, either directly or through 

9 an intermediary acts as a price negotiator or 

10 group purchaser on behalf of such sponsor, or 

11 manages the prescription drug benefits provided 

12 by such sponsor, including the processing and 

13 paying claims for covered part D drugs, per14 forming drug utilization review, processing drug 

15 prior authorization requests, adjudicating ap16 peals or grievances related to covered part D 

17 drugs, contracting with network pharmacies, 

18 controlling the cost of such drugs, or providing 

19 any services related to managing such drug 

20 benefits.’’. 

Æ 


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