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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6844 Introduced in House (IH)]

<DOC>

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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring PBM Competition Act''.

SEC. 2. PROHIBITING 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.

    Section 1860D-12(b) of the Social Security Act (42 U.S.C. 1395w-
112(b)) is amended by adding at the end the following new paragraph:
            ``(9) Prohibition on entering into contracts with pdp 
        sponsors that have a contract with a certain pharmacy benefits 
        managers.--
                    ``(A) In general.--Subject to subparagraph (B), 
                beginning on the date that is 5 years after the date of 
                enactment of this paragraph, the Secretary shall not 
                enter into, or renew, a contract with a PDP sponsor for 
                the offering of a prescription drug plan in a PDP 
                region for a year if such sponsor has a contract for 
                such year with a pharmacy benefits manager that, 
                directly or indirectly, or through one or more 
                intermediaries, owns, controls, or otherwise has a 
                financial interest in, a pharmacy.
                    ``(B) Authority to delay requirement.--The 
                Secretary may delay the requirement in subparagraph (A) 
                by not more than 2 years.
                    ``(C) Pharmacy benefits manager defined.--For 
                purposes of this paragraph, the term `pharmacy benefits 
                manager' means any entity (or any affiliate, 
                subsidiary, or agent of such entity) that, pursuant to 
                an agreement with a PDP sponsor, either directly or 
                through an intermediary acts as a price negotiator or 
                group purchaser on behalf of such sponsor, or manages 
                the prescription drug benefits provided by such 
                sponsor, including the processing and paying claims for 
                covered part D drugs, performing drug utilization 
                review, processing drug prior authorization requests, 
                adjudicating appeals or grievances related to covered 
                part D drugs, contracting with network pharmacies, 
                controlling the cost of such drugs, or providing any 
                services related to managing such drug benefits.''.
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