II 

Calendar No. 283 

118TH CONGRESS 

1ST SESSION S. 127 

To prevent unfair and deceptive acts or practices and the dissemination 

of false information related to pharmacy benefit management services 

for prescription drugs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 26, 2023 

Ms. CANTWELL (for herself, Mr. GRASSLEY, Mrs. HYDE-SMITH, Mr. BRAUN, 

Mr. MORAN, Mr. TILLIS, Mr. TESTER, Mrs. CAPITO, Mr. BOOZMAN, Mr. 

WELCH, Mr. MARSHALL, Mr. HEINRICH, Ms. ERNST, Mr. ROUNDS, and 

Mrs. SHAHEEN) introduced the following bill; which was read twice and 

referred to the Committee on Commerce, Science, and Transportation 

DECEMBER 13, 2023 

Reported by Ms. CANTWELL, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To prevent unfair and deceptive acts or practices and the 

dissemination of false information related to pharmacy 

benefit management services for prescription drugs, 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 ‘‘Pharmacy Benefit 

3 Manager Transparency Act of 2023’’. 

4 SEC. 2. PROHIBITION ON UNFAIR OR DECEPTIVE PRE5 SCRIPTION DRUG PRICING PRACTICES. 

6 (a) CONDUCT PROHIBITED.—Except as provided in 

7 subsection (b), it shall be unlawful for any pharmacy ben8 efit manager (or affiliate, subsidiary, or agent of a phar9 macy benefit manager), directly or indirectly, to engage 

10 in any of the following activities related to pharmacy ben11 efit management services: 

12 (1) Charge a health plan or payer a different 

13 amount for a prescription drug’s ingredient cost or 

14 dispensing fee than the amount the pharmacy ben15 efit manager reimburses a pharmacy for the pre16 scription drug’s ingredient cost or dispensing fee 

17 where the pharmacy benefit manager retains the 

18 amount of any such difference. 

19 (2) Arbitrarily, unfairly, or deceptively, by con20 tract or any other means, reduce, rescind, or other21 wise claw back any reimbursement payment, in 

22 whole or in part, to a pharmacist or pharmacy for 

23 a prescription drug’s ingredient cost or dispensing 

24 fee. 

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1 imbursement to a pharmacy in order to offset reim2 bursement changes instructed by the Federal Gov3 ernment under any health plan funded by the Fed4 eral Government. 

5 (b) EXCEPTIONS.—A pharmacy benefit manager 

6 shall not be in violation of subsection (a) if the pharmacy 

7 benefit manager meets the following conditions: 

8 (1) The pharmacy benefit manager, affiliate, 

9 subsidiary, or agent passes along or returns 100 per10 cent of any price concession to a health plan or 

11 payer, including any rebate, discount, or other price 

12 concession. 

13 (2) The pharmacy benefit manager, affiliate, 

14 subsidiary, or agent provides full and complete dis15 closure of— 

16 (A) the cost, price, and reimbursement of 

17 the prescription drug to each health plan, 

18 payer, and pharmacy with which the pharmacy 

19 benefit manager, affiliate, subsidiary, or agent 

20 has a contract or agreement to provide phar21 macy benefit management services; 

22 (B) each fee, markup, and discount 

23 charged or imposed by the pharmacy benefit 

24 manager, affiliate, subsidiary, or agent to each 

25 health plan, payer, and pharmacy with which 


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1 the pharmacy benefit manager, affiliate, sub2 sidiary, or agent has a contract or agreement 

3 for pharmacy benefit management services; or 

4 (C) the aggregate amount of all remunera5 tion the pharmacy benefit manager receives 

6 from a prescription drug manufacturer for a 

7 prescription drug, including any rebate, dis8 count, administration fee, and any other pay9 ment or credit obtained or retained by the phar10 macy benefit manager, or affiliate, subsidiary, 

11 or agent of the pharmacy benefit manager, pur12 suant to a contract or agreement for pharmacy 

13 benefit management services to a health plan, 

14 payer, or any Federal agency (upon the request 

15 of the agency). 

16 SEC. 3. PROHIBITION ON FALSE INFORMATION. 

17 It shall be unlawful for any person to report informa18 tion related to pharmacy benefit management services to 

19 a Federal department or agency if— 

20 (1) the person knew, or reasonably should have 

21 known, the information to be false or misleading; 

22 (2) the information was required by law to be 

23 reported; and 

24 (3) the false or misleading information reported 

25 by the person would affect analysis or information 


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1 compiled by the Federal department or agency for 

2 statistical or analytical purposes with respect to the 

3 market for pharmacy benefit management services. 

4 SEC. 4. TRANSPARENCY. 

5 (a) REPORTING BY PHARMACY BENEFIT MAN6 AGERS.—Not later than 1 year after the date of enactment 

7 of this Act, and annually thereafter, each pharmacy ben8 efit manager (or affiliate, subsidiary, or agent of a phar9 macy benefit manager) shall report to the Commission the 

10 following information: 

11 (1) The aggregate amount of the difference be12 tween the amount the pharmacy benefit manager 

13 was paid by each health plan and the amount that 

14 the pharmacy benefit manager paid each pharmacy 

15 on behalf of the health plan for prescription drugs. 

16 (2) The aggregate amount of any— 

17 (A) generic effective rate fee charged to 

18 each pharmacy; 

19 (B) direct and indirect remuneration fee 

20 charged or other price concession to each phar21 macy; and 

22 (C) payment rescinded or otherwise clawed 

23 back from a reimbursement made to each phar24 macy. 


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1 (3) If, during the reporting year, the pharmacy 

2 benefit manager moved or reassigned a prescription 

3 drug to a formulary tier that has a higher cost, 

4 higher copayment, higher coinsurance, or higher de5 ductible to a consumer, or a lower reimbursement to 

6 a pharmacy, an explanation of the reason why the 

7 drug was moved or reassigned from 1 tier to an8 other, including whether the move or reassignment 

9 was determined or requested by a prescription drug 

10 manufacturer or other entity. 

11 (4) With respect to any pharmacy benefit man12 ager that owns, controls, or is affiliated with a phar13 macy, a report regarding any difference in reim14 bursement rates or practices, direct and indirect re15 muneration fees or other price concessions, and 

16 clawbacks between a pharmacy that is owned, con17 trolled, or affiliated with the pharmacy benefit man18 ager and any other pharmacy. 

19 (b) REPORT TO CONGRESS.— 

20 (1) IN GENERAL.—Not later than 1 year after 

21 the date of enactment of this Act, and annually 

22 thereafter, the Commission shall submit to the Com23 mittee on Commerce, Science, and Transportation of 

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1 merce of the House of Representatives a report that 

2 addresses, at a minimum— 

3 (A) the number of actions brought by the 

4 Commission during the reporting year to en5 force this Act and the outcome of each such en6 forcement action; 

7 (B) the number of open investigations or 

8 inquiries into potential violations of this Act as 

9 of the time the report is submitted; 

10 (C) the number and nature of complaints 

11 received by the Commission relating to an alle12 gation of a violation of this Act during the re13 porting year; 

14 (D) an anonymized summary of the re15 ports filed with the Commission pursuant to 

16 subsection (a) for the reporting year; and 

17 (E) policy or legislative recommendations 

18 to strengthen any enforcement action relating 

19 to a violation of this Act, including rec20 ommendations to include additional prohibited 

21 conduct in section 2(a). 

22 (2) FORMULARY DESIGN OR PLACEMENT PRAC23 TICES.—Not later than 1 year after the date of en24 actment of this Act, the Commission shall submit to 

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1 portation of the Senate and the Committee on En2 ergy and Commerce of the House of Representatives 

3 a report that addresses the policies, practices, and 

4 role of pharmacy benefit managers (including their 

5 affiliates, subsidiaries, and agents) regarding for6 mulary design or placement, including whether— 

7 (A) pharmacy benefit managers (including 

8 their affiliates, subsidiaries, and agents) use 

9 formulary design or placement to increase their 

10 gross revenue without an accompanying in11 crease in patient access or decrease in patient 

12 cost; or 

13 (B) such policies or practices of pharmacy 

14 benefit managers regarding formulary design or 

15 placement violate section 5(a) of the Federal 

16 Trade Commission Act (15 U.S.C. 45(a)). 

17 (3) CONSTRUCTION.—Nothing in this section 

18 shall be construed as authorizing the Commission to 

19 disclose any information that is a trade secret or 

20 confidential information described in section 

21 552(b)(4) of title 5, United States Code. 

22 (c) GAO STUDY.—Not later than 1 year after the 

23 date of enactment of this Act, the Comptroller General 

24 of the United States shall submit to the Committee on 

25 Commerce, Science, and Transportation, the Committee 


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1 on Finance, and the Committee on Health, Education, 

2 Labor, and Pensions of the Senate and to the Committee 

3 on Ways and Means and the Committee on Energy and 

4 Commerce of the House of Representatives a report 

5 that— 

6 (1) addresses, at minimum— 

7 (A) the role that pharmacy benefit man8 agers play in the pharmaceutical supply chain; 

9 (B) the state of competition among phar10 macy benefit managers, including the market 

11 share for the Nation’s 10 largest pharmacy 

12 benefit managers; 

13 (C) the use of rebates and fees by phar14 macy benefit managers, including data for each 

15 of the 10 largest pharmacy benefit managers 

16 that reflects, for each drug in the formulary of 

17 each such pharmacy benefit manager— 

18 (i) the amount of the rebate passed on 

19 to patients; 

20 (ii) the amount of the rebate passed 

21 on to payors; 

22 (iii) the amount of the rebate kept by 

23 the pharmacy benefit manager; and 

24 (iv) the role of fees charged by the 

25 pharmacy benefit manager; 


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1 (D) whether pharmacy benefit managers 

2 structure their formularies in favor of high-re3 bate prescription drugs over lower-cost, lower4 rebate alternatives; 

5 (E) the average prior authorization ap6 proval time for each of the 10 largest pharmacy 

7 benefit managers; 

8 (F) factors affecting the use of step ther9 apy in each of the 10 largest pharmacy benefit 

10 managers; and 

11 (G) the extent to which the price that 

12 pharmacy benefit managers charge payors, such 

13 as the Medicare program under title XXVIII of 

14 the Social Security Act (42 U.S.C. 1395 et 

15 seq.), State Medicaid programs under title XIX 

16 of the Social Security Act (42 U.S.C. 1396 et 

17 seq.), the Federal Employees Health Benefits 

18 Program under chapter 89 of title 5, United 

19 States Code, or private payors, for a drug is 

20 more than such pharmacy benefit managers pay 

21 the pharmacy for the drug; and 

22 (2) provides recommendations for legislative ac23 tion to lower the cost of prescription drugs for con24 sumers and payors, improve the efficiency of the 

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1 mediary costs, improve competition in pharmacy 

2 benefit management, and provide transparency in 

3 pharmacy benefit management. 

4 SEC. 5. WHISTLEBLOWER PROTECTIONS. 

5 (a) IN GENERAL.—A pharmacy benefit manager, 

6 health plan, pharmaceutical manufacturer, pharmacy, or 

7 any affiliate, subsidiary, or agent thereof shall not, directly 

8 or indirectly, discharge, demote, suspend, diminish, or 

9 withdraw benefits from, threaten, harass, or in any other 

10 manner discriminate against or adversely impact a covered 

11 individual because— 

12 (1) the covered individual, or anyone perceived 

13 as assisting the covered individual, takes (or is sus14 pected to have taken or will take) a lawful action in 

15 providing to Congress, an agency of the Federal 

16 Government, the attorney general of a State, a State 

17 regulator with authority over the distribution or in18 surance coverage of prescription drugs, or a law en19 forcement agency relating to any act or omission 

20 that the covered individual reasonably believes to be 

21 a violation of this Act; 

22 (2) the covered individual provides information 

23 that the covered individual reasonably believes evi24 dences such a violation to— 


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1 (A) a person with supervisory authority 

2 over the covered individual at the pharmacy 

3 benefit manager, health plan, pharmaceutical 

4 manufacturer, pharmacy, or any affiliate, sub5 sidiary, or agent thereof; or 

6 (B) another individual working for the 

7 pharmacy benefit manager, health plan, phar8 maceutical manufacturer, pharmacy, or any af9 filiate, subsidiary, or agent thereof who the cov10 ered individual reasonably believes has the au11 thority to investigate, discover, or terminate the 

12 violation or to take any other action to address 

13 the violation; 

14 (3) the covered individual testifies (or it is sus15 pected that the covered individual will testify) in an 

16 investigation or judicial or administrative proceeding 

17 concerning such a violation; 

18 (4) the covered individual assists or participates 

19 (or it is expected that the covered individual will as20 sist or participate) in such an investigation or judi21 cial or administrative proceeding; or 

22 (5) the covered individual takes any other ac23 tion to assist in carrying out the purposes of this 

24 Act. 


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1 (b) ENFORCEMENT.—An individual who alleges any 

2 adverse action in violation of subsection (a) may bring an 

3 action for a jury trial in the appropriate district court of 

4 the United States for the following relief: 

5 (1) Temporary relief while the case is pending. 

6 (2) Reinstatement with the same seniority sta7 tus that the individual would have had, but for the 

8 discharge or discrimination. 

9 (3) Twice the amount of back pay otherwise 

10 owed to the individual, with interest. 

11 (4) Consequential and compensatory damages, 

12 and compensation for litigation costs, expert witness 

13 fees, and reasonable attorneys’ fees. 

14 (c) WAIVER OF RIGHTS AND REMEDIES.—The rights 

15 and remedies provided for in this section shall not be 

16 waived by any policy form or condition of employment, in17 cluding by a predispute arbitration agreement. 

18 (d) PREDISPUTE ARBITRATION AGREEMENTS.—No 

19 predispute arbitration agreement shall be valid or enforce20 able if the agreement requires arbitration of a dispute 

21 arising under this section. 

22 SEC. 6. ENFORCEMENT. 

23 (a) ENFORCEMENT BY THE COMMISSION.— 

24 (1) UNFAIR AND DECEPTIVE ACTS OR PRAC25 TICES.—A violation of this Act shall be treated as 


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1 a violation of a rule defining an unfair or deceptive 

2 act or practice under section 18(a)(1)(B) of the Fed3 eral Trade Commission Act (15 U.S.C. 

4 57a(a)(1)(B)). 

5 (2) POWERS OF THE COMMISSION.— 

6 (A) IN GENERAL.—Except as provided in 

7 subparagraph (C), the Commission shall enforce 

8 this Act in the same manner, by the same 

9 means, and with the same jurisdiction, powers, 

10 and duties as though all applicable terms and 

11 provisions of the Federal Trade Commission 

12 Act (15 U.S.C. 41 et seq.) were incorporated 

13 into and made a part of this Act. 

14 (B) PRIVILEGES AND IMMUNITIES.—Sub15 ject to paragraph (3), any person who violates 

16 this Act shall be subject to the penalties and 

17 entitled to the privileges and immunities pro18 vided in the Federal Trade Commission Act (15 

19 U.S.C. 41 et seq.). 

20 (C) NONPROFIT ORGANIZATIONS AND IN21 SURANCE.—Notwithstanding section 4 or 6 of 

22 the Federal Trade Commission Act (15 U.S.C. 

23 44, 46), section 2 of McCarran-Ferguson Act 

24 (15 U.S.C. 1012), or any other jurisdictional 

25 limitation of the Commission, the Commission 


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1 shall also enforce this Act, in the same manner 

2 provided in subparagraphs (A) and (B) of this 

3 paragraph, with respect to— 

4 (i) organizations not organized to 

5 carry on business for their own profit or 

6 that of their members; and 

7 (ii) the business of insurance, and 

8 persons engaged in such business. 

9 (D) AUTHORITY PRESERVED.—Nothing in 

10 this section shall be construed to limit the au11 thority of the Commission under any other pro12 vision of law. 

13 (3) PENALTIES.— 

14 (A) ADDITIONAL CIVIL PENALTY.—In ad15 dition to any penalty applicable under the Fed16 eral Trade Commission Act (15 U.S.C. 41 et 

17 seq.), any person that violates this Act shall be 

18 liable for a civil penalty of not more than 

19 $1,000,000. 

20 (B) METHOD.—The penalties provided by 

21 subparagraph (A) shall be obtained in the same 

22 manner as civil penalties imposed under section 

23 18(a)(1)(B) of the Federal Trade Commission 

24 Act (15 U.S.C. 57a(a)(1)(B)). 


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1 (C) MULTIPLE OFFENSES; MITIGATING

2 FACTORS.—In assessing a penalty under sub3 paragraph (A)— 

4 (i) each day of a continuing violation 

5 shall be considered a separate violation; 

6 and 

7 (ii) the court shall take into consider8 ation, among other factors— 

9 (I) the seriousness of the viola10 tion; 

11 (II) the efforts of the person 

12 committing the violation to remedy 

13 the harm caused by the violation in a 

14 timely manner; and 

15 (III) whether the violation was 

16 intentional. 

17 (b) ENFORCEMENT BY STATES.— 

18 (1) IN GENERAL.—If the attorney general of a 

19 State has reason to believe that an interest of the 

20 residents of the State has been or is being threat21 ened or adversely affected by a practice that violates 

22 this Act, the attorney general of the State may bring 

23 a civil action on behalf of the residents of the State 

24 in an appropriate district court of the United States 

25 to obtain appropriate relief. 


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1 (2) RIGHTS OF THE COMMISSION.— 

2 (A) NOTICE TO THE COMMISSION.— 

3 (i) IN GENERAL.—Except as provided 

4 in clause (iii), the attorney general of a 

5 State, before initiating a civil action under 

6 paragraph (1), shall provide written notifi7 cation to the Commission that the attorney 

8 general intends to bring such civil action. 

9 (ii) CONTENTS.—The notification re10 quired under clause (i) shall include a copy 

11 of the complaint to be filed to initiate the 

12 civil action. 

13 (iii) EXCEPTION.—If it is not feasible 

14 for the attorney general of a State to pro15 vide the notification required under clause 

16 (i) before initiating a civil action under 

17 paragraph (1), the attorney general shall 

18 notify the Commission immediately upon 

19 instituting the civil action. 

20 (B) INTERVENTION BY THE COMMIS21 SION.—The Commission may— 

22 (i) intervene in any civil action 

23 brought by the attorney general of a State 

24 under paragraph (1); and 

25 (ii) upon intervening— 


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1 (I) be heard on all matters aris2 ing in the civil action; and 

3 (II) file petitions for appeal of a 

4 decision in the civil action. 

5 (3) CONSTRUCTION.—Nothing in this sub6 section may be construed to prevent the attorney 

7 general of a State from exercising the powers con8 ferred on the attorney general by the laws of the 

9 State to conduct investigations, to administer oaths 

10 or affirmations, or to compel the attendance of wit11 nesses or the production of documentary or other 

12 evidence. 

13 (4) VENUE; SERVICE OF PROCESS.— 

14 (A) VENUE.—Any action brought under 

15 paragraph (1) may be brought in— 

16 (i) the district court of the United 

17 States that meets applicable requirements 

18 relating to venue under section 1391 of 

19 title 28, United States Code; or 

20 (ii) another court of competent juris21 diction. 

22 (B) SERVICE OF PROCESS.—In an action 

23 brought under paragraph (1), process may be 

24 served in any district in which— 


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1 (i) the defendant is an inhabitant, 

2 may be found, or transacts business; or 

3 (ii) venue is proper under section 

4 1391 of title 28, United States Code. 

5 (5) ACTIONS BY OTHER STATE OFFICIALS.— 

6 (A) IN GENERAL.—If an attorney general 

7 lacks appropriate jurisdiction to bring a civil ac8 tion under paragraph (1), any other officer of 

9 a State who is authorized by the State to do so 

10 may bring a civil action under paragraph (1), 

11 subject to the same requirements and limita12 tions that apply under this subsection to civil 

13 actions brought by attorneys general. 

14 (B) CLARIFICATION OF AUTHORITY.—The 

15 authority provided by subparagraph (A) shall 

16 supplant, and not supplement, the authorities of 

17 State attorneys general under paragraph (1). 

18 (C) SAVINGS PROVISION.—Nothing in this 

19 subsection may be construed to prohibit an au20 thorized official of a State from initiating or 

21 continuing any proceeding in a court of the 

22 State for a violation of any civil or criminal law 

23 of the State. 

24 (c) AFFIRMATIVE DEFENSE.—In an action brought 

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1 firmative defense, on which the defendant has the burden 

2 of persuasion by a preponderance of the evidence, that the 

3 conduct alleged to be a violation of section 2 was 

4 nonpretextual and reasonably necessary to— 

5 (1) prevent a violation of, or comply with, Fed6 eral or State law; 

7 (2) protect patient safety; or 

8 (3) protect patient access. 

9 SEC. 7. EFFECT ON STATE LAWS. 

10 Nothing in this Act shall be construed to preempt, 

11 displace, or supplant any State laws, rules, regulations, 

12 or requirements, or the enforcement thereof. 

13 SEC. 8. DEFINITIONS. 

14 In this Act: 

15 (1) COMMISSION.—The term ‘‘Commission’’ 

16 means the Federal Trade Commission. 

17 (2) COVERED INDIVIDUAL.—The term ‘‘covered 

18 individual’’ means a current or former employee, 

19 contractor, subcontractor, service provider, or agent 

20 of a pharmacy benefit manager, health plan, phar21 maceutical manufacturer, pharmacy, or any affiliate, 

22 subsidiary, or agent thereof. 

23 (3) HEALTH PLAN.—The term ‘‘health plan’’ 

24 means any group or individual health insurance plan 

25 or coverage, including any health insurance plan or 


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1 coverage sponsored or funded by the Federal Gov2 ernment or the government of any State, Territory, 

3 or subdivision thereof. 

4 (4) PHARMACY BENEFIT MANAGER.—The term 

5 ‘‘pharmacy benefit manager’’ means any entity that 

6 provides pharmacy benefit management services on 

7 behalf of a health plan, a payer, or health insurance 

8 issuer. 

9 (5) PHARMACY BENEFIT MANAGEMENT SERV10 ICES.—The term ‘‘pharmacy benefit management 

11 services’’ means, pursuant to a written agreement 

12 with a payer or health plan offering group or indi13 vidual health insurance coverage, directly or through 

14 an intermediary, the service of— 

15 (A) negotiating terms and conditions, in16 cluding rebates and price concessions, with re17 spect to a prescription drug on behalf of the 

18 health plan, coverage, or payer; or 

19 (B) managing the prescription drug bene20 fits provided by the health plan, coverage, or 

21 payer, which may include formulary manage22 ment the processing and payment of claims for 

23 prescription drugs, the performance of drug uti24 lization review, the processing of drug prior au25 thorization requests, the adjudication of appeals 


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1 or grievances related to the prescription drug 

2 benefit, contracting with network pharmacies, 

3 or the provision of related services. 

4 (6) PRESCRIPTION DRUG.—The term ‘‘prescrip5 tion drug’’ means— 

6 (A) a drug, as that term is defined in sec7 tion 201(g) of the Federal Food, Drug, and 

8 Cosmetic Act (21 U.S.C. 321(g)), that is— 

9 (i) approved by the Food and Drug 

10 Administration under section 505 of such 

11 Act (21 U.S.C. 355); and 

12 (ii) subject to the requirements of sec13 tion 503(b)(1) of such Act (21 U.S.C. 

14 353(b)(1)); 

15 (B) a biological product as that term is de16 fined in section 351 of the Public Health Serv17 ice Act (42 U.S.C. 262(i)(1)); or 

18 (C) a product that is biosimilar to, or 

19 interchangeable with, a biologic product under 

20 section 351 of the Public Health Service Act 

21 (42 U.S.C. 262(i)). 

22 SECTION 1. SHORT TITLE. 

23 This Act may be cited as the ‘‘Pharmacy Benefit Man24 ager Transparency Act of 2023’’. 


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1 SEC. 2. PROHIBITION ON UNFAIR OR DECEPTIVE PRESCRIP2 TION DRUG PRICING PRACTICES. 

3 (a) CONDUCT PROHIBITED.—Except as provided in 

4 subsection (b), it shall be unlawful for any pharmacy ben5 efit manager (or affiliate, subsidiary, or agent of a phar6 macy benefit manager), directly or indirectly, to engage in 

7 any of the following activities related to pharmacy benefit 

8 management services: 

9 (1) Charge a health plan or payer a different 

10 amount for a prescription drug’s ingredient cost or 

11 dispensing fee than the amount the pharmacy benefit 

12 manager reimburses a pharmacy for the prescription 

13 drug’s ingredient cost or dispensing fee where the 

14 pharmacy benefit manager retains the amount of any 

15 such difference. 

16 (2) Arbitrarily, unfairly, or deceptively, by con17 tract or any other means, reduce, rescind, or other18 wise claw back any reimbursement payment, in whole 

19 or in part, to a pharmacist or pharmacy for a pre20 scription drug’s ingredient cost or dispensing fee, un21 less— 

22 (A) the original claim was submitted fraud23 ulently; 

24 (B) the original claim payment was incon25 sistent with the reimbursement terms in the con26 tract; or 


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1 (C) the pharmacist services were not ren2 dered by the pharmacy or pharmacist. 

3 (3) Arbitrarily, unfairly, or deceptively, by con4 tract or any other means, increase fees or lower reim5 bursement to a pharmacy in order to offset reimburse6 ment changes instructed by the Federal Government 

7 under any health plan funded by the Federal Govern8 ment. 

9 (b) EXCEPTIONS.—A pharmacy benefit manager shall 

10 not be in violation of paragraph (1) or (3) of subsection 

11 (a) if the pharmacy benefit manager meets the following 

12 conditions: 

13 (1) The pharmacy benefit manager, affiliate, 

14 subsidiary, or agent passes along or returns 100 per15 cent of any price concession to a health plan or 

16 payer, including any rebate, discount, or other price 

17 concession. 

18 (2) The pharmacy benefit manager, affiliate, 

19 subsidiary, or agent provides full and complete disclo20 sure of— 

21 (A) the cost, price, and reimbursement of a 

22 prescription drug to each health plan, payer, 

23 and pharmacy with which the pharmacy benefit 

24 manager, affiliate, subsidiary, or agent has a 


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1 contract or agreement to provide pharmacy ben2 efit management services; 

3 (B) each fee, markup, and discount charged 

4 or imposed by the pharmacy benefit manager, af5 filiate, subsidiary, or agent to each health plan, 

6 payer, and pharmacy with which the pharmacy 

7 benefit manager, affiliate, subsidiary, or agent 

8 has a contract or agreement for pharmacy ben9 efit management services; or 

10 (C) the aggregate amount of all remunera11 tion the pharmacy benefit manager receives from 

12 a prescription drug manufacturer for a prescrip13 tion drug, including any rebate, discount, ad14 ministration fee, and any other payment or 

15 credit obtained or retained by the pharmacy ben16 efit manager, or affiliate, subsidiary, or agent of 

17 the pharmacy benefit manager, pursuant to a 

18 contract or agreement for pharmacy benefit man19 agement services to a health plan, payer, or any 

20 Federal agency (upon the request of the agency). 

21 SEC. 3. PROHIBITION ON FALSE INFORMATION. 

22 It shall be unlawful for any person to report informa23 tion related to pharmacy benefit management services to 

24 a Federal department or agency if— 


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1 (1) the person knew, or reasonably should have 

2 known, the information to be false or misleading; 

3 (2) the information was required by law to be re4 ported; and 

5 (3) the false or misleading information reported 

6 by the person would affect analysis or information 

7 compiled by the Federal department or agency for 

8 statistical or analytical purposes with respect to the 

9 market for pharmacy benefit management services. 

10 SEC. 4. TRANSPARENCY. 

11 (a) REPORTING BY PHARMACY BENEFIT MANAGERS.— 

12 Subject to subsection (d), not later than 1 year after the 

13 date of enactment of this Act, and annually thereafter, each 

14 pharmacy benefit manager (or affiliate, subsidiary, or 

15 agent of a pharmacy benefit manager) shall report to the 

16 Commission and the Secretary of Health and Human Serv17 ices the following information: 

18 (1) The aggregate amount of the difference be19 tween the amount the pharmacy benefit manager was 

20 paid by each health plan and the amount that the 

21 pharmacy benefit manager paid each pharmacy on 

22 behalf of the health plan for prescription drugs. 

23 (2) The aggregate amount of any— 

24 (A) generic effective rate fee charged to each 

25 pharmacy; 


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1 (B) direct and indirect remuneration fee 

2 charged or other price concession to each phar3 macy; and 

4 (C) payment rescinded or otherwise clawed 

5 back from a reimbursement made to each phar6 macy. 

7 (3) If, during the reporting year, the pharmacy 

8 benefit manager moved or reassigned a prescription 

9 drug to a formulary tier that has a higher cost, higher 

10 copayment, higher coinsurance, or higher deductible 

11 to a consumer, or a lower reimbursement to a phar12 macy, an explanation of the reason why the drug was 

13 moved or reassigned from 1 tier to another, including 

14 whether the move or reassignment was determined or 

15 requested by a prescription drug manufacturer or 

16 other entity. 

17 (4) With respect to any pharmacy benefit man18 ager that owns, controls, or is affiliated with a phar19 macy, a report regarding any difference in reimburse20 ment rates or practices, direct and indirect remunera21 tion fees or other price concessions, and clawbacks be22 tween a pharmacy that is owned, controlled, or affili23 ated with the pharmacy benefit manager and any 

24 other pharmacy. 

25 (b) REPORT TO CONGRESS.— 


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1 (1) IN GENERAL.—Not later than 1 year after 

2 the date of enactment of this Act, and annually there3 after, the Commission shall submit to the Committee 

4 on Commerce, Science, and Transportation of the 

5 Senate and the Committee on Energy and Commerce 

6 of the House of Representatives a report that address7 es, at a minimum— 

8 (A) the number actions brought by the Com9 mission during the reporting year to enforce this 

10 Act and the outcome of each such enforcement ac11 tion; 

12 (B) the number of open investigations or in13 quiries into potential violations of this Act as of 

14 the time the report is submitted; 

15 (C) the number and nature of complaints 

16 received by the Commission relating to an alle17 gation of a violation of this Act during the re18 porting year; 

19 (D) an anonymized summary of the reports 

20 filed with the Commission pursuant to subsection 

21 (a) for the reporting year; 

22 (E) an analysis of the requirements of this 

23 Act and whether the implementation of such re24 quirements leads to mergers (including hori25 zontal mergers or vertical mergers) amongst any 


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1 pharmacy benefit managers, or any pharmacy 

2 benefit manager that owns, controls, or is affili3 ated with a pharmacy, or any pharmacy benefit 

4 manager that owns, controls, or is affiliated with 

5 a health plan, and the effect of such merger (in6 cluding the likelihood of a substantial decrease in 

7 competition or the potential for a monopoly); 

8 and 

9 (F) policy or legislative recommendations to 

10 strengthen any enforcement action relating to a 

11 violation of this Act, including recommendations 

12 to include additional prohibited conduct in sec13 tion 2(a), and recommendations to encourage 

14 more competition and decrease the likelihood of 

15 a monopoly in the pharmaceutical supply chain. 

16 (2) FORMULARY DESIGN OR PLACEMENT PRAC17 TICES.—Not later than 1 year after the date of enact18 ment of this Act, the Commission shall submit to the 

19 Committee on Commerce, Science, and Transpor20 tation of the Senate, the Committee on Finance of the 

21 Senate, the Committee on Health, Education, Labor, 

22 and Pensions of the Senate, the Committee on Ways 

23 and Means of the House of Representatives, and the 

24 Committee on Energy and Commerce of the House of 

25 Representatives a report that addresses the policies, 


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1 practices, and role of pharmacy benefit managers (in2 cluding their affiliates, subsidiaries, and agents) re3 garding formulary design or placement, including— 

4 (A) whether pharmacy benefit managers 

5 (including their affiliates, subsidiaries, and 

6 agents) use formulary design or placement to in7 crease their gross revenue without an accom8 panying increase in patient access or decrease in 

9 patient cost; or 

10 (B) recommendations to Congress for legis11 lative action addressing such policies, practices, 

12 and role of pharmacy benefit managers (includ13 ing their affiliates, subsidiaries, and agents). 

14 (3) CONSTRUCTION.—Nothing in this section 

15 shall be construed as authorizing the Commission to 

16 disclose any information that is a trade secret or con17 fidential information described in section 552(b)(4) of 

18 title 5, United States Code, except as necessary to en19 force this Act. 

20 (4) CONFIDENTIALITY.—The Commission may 

21 disclose the information in a form which does not dis22 close the identity of a specific pharmacy benefit man23 ager, pharmacy, or health plan for the following pur24 poses: 


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1 (A) To permit the Comptroller General of 

2 the United States to review the information pro3 vided to carry out this Act. 

4 (B) To permit the Director of the Congres5 sional Budget Office to review the information 

6 provided. 

7 (c) GAO STUDY.—Not later than 1 year after the date 

8 of enactment of this Act, the Comptroller General of the 

9 United States shall submit to the Committee on Commerce, 

10 Science, and Transportation, the Committee on Finance, 

11 and the Committee on Health, Education, Labor, and Pen12 sions of the Senate and to the Committee on Ways and 

13 Means and the Committee on Energy and Commerce of the 

14 House of Representatives a report that— 

15 (1) addresses, at minimum— 

16 (A) the role that pharmacy benefit man17 agers play in the pharmaceutical supply chain; 

18 (B) the state of competition among phar19 macy benefit managers, including the market 

20 share for the Nation’s 10 largest pharmacy ben21 efit managers; 

22 (C) the use of rebates and fees by pharmacy 

23 benefit managers, including data for each of the 

24 10 largest pharmacy benefit managers that reVerDate Sep 11 2014 00:41 Dec 14, 2023 Jkt 049200 PO 00000 Frm 00031 Fmt 6652 Sfmt 6203 E:\BILLS\S127.RS S127

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1 flects, for each drug in the formulary of each 

2 such pharmacy benefit manager— 

3 (i) the amount of the rebate passed on 

4 to patients; 

5 (ii) the amount of the rebate passed on 

6 to payors; 

7 (iii) the amount of the rebate kept by 

8 the pharmacy benefit manager; and 

9 (iv) the role of fees charged by the 

10 pharmacy benefit manager; 

11 (D) whether pharmacy benefit managers 

12 structure their formularies in favor of high-re13 bate prescription drugs over lower-cost, lower-re14 bate alternatives; 

15 (E) the average prior authorization ap16 proval time for each of the 10 largest pharmacy 

17 benefit managers; 

18 (F) factors affecting the use of step therapy 

19 in each of the 10 largest pharmacy benefit man20 agers; 

21 (G) the extent to which the price that phar22 macy benefit managers charge payors, such as 

23 the Medicare program under title XXVIII of the 

24 Social Security Act (42 U.S.C. 1395 et seq.), 

25 State Medicaid programs under title XIX of the 


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1 Social Security Act (42 U.S.C. 1396 et seq.), the 

2 Federal Employees Health Benefits Program 

3 under chapter 89 of title 5, United States Code, 

4 or private payors, for a drug is more than such 

5 pharmacy benefit managers pay the pharmacy 

6 for the drug; and 

7 (H) the competitive impact of pharmacy 

8 benefit managers’ business practices, including 

9 the impact that such business practices have on 

10 the cost of health plan premiums or prescription 

11 drugs for consumers; and 

12 (2) provides recommendations for legislative ac13 tion to lower the cost of prescription drugs for con14 sumers and payors, improve the efficiency of the 

15 pharmaceutical supply chain by lowering inter16 mediary costs, improve competition in pharmacy ben17 efit management, and provide transparency in phar18 macy benefit management. 

19 (d) PRIVACY REQUIREMENTS.—Any entity shall pro20 vide information under subsection (a) in a manner con21 sistent with the privacy, security, and breach notification 

22 regulations promulgated under section 264(c) of the Health 

23 Insurance Portability and Accountability Act of 1996 (42 

24 U.S.C. 1320d–2 note) (or any successor regulation), and 


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1 shall restrict the use and disclosure of such information ac2 cording to such regulations. 

3 SEC. 5. WHISTLEBLOWER PROTECTIONS. 

4 (a) IN GENERAL.—A pharmacy benefit manager, 

5 health plan, pharmaceutical manufacturer, pharmacy, or 

6 any affiliate, subsidiary, or agent thereof shall not, directly 

7 or indirectly, discharge, demote, suspend, diminish, or 

8 withdraw benefits from, threaten, harass, or in any other 

9 manner discriminate against or adversely impact a covered 

10 individual because— 

11 (1) the covered individual, or anyone perceived 

12 as assisting the covered individual, takes (or is sus13 pected to have taken or will take) a lawful action in 

14 providing to Congress, an agency of the Federal Gov15 ernment, the attorney general of a State, a State reg16 ulator with authority over the distribution or insur17 ance coverage of prescription drugs, or a law enforce18 ment agency relating to any act or omission that the 

19 covered individual reasonably believes to be a viola20 tion of this Act; 

21 (2) the covered individual provides information 

22 that the covered individual reasonably believes evi23 dences such a violation to— 

24 (A) a person with supervisory authority 

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1 efit manager, health plan, pharmaceutical man2 ufacturer, pharmacy, or any affiliate, sub3 sidiary, or agent thereof; or 

4 (B) another individual working for the 

5 pharmacy benefit manager, health plan, phar6 maceutical manufacturer, pharmacy, or any af7 filiate, subsidiary, or agent thereof who the cov8 ered individual reasonably believes has the au9 thority to investigate, discover, or terminate the 

10 violation or to take any other action to address 

11 the violation; 

12 (3) the covered individual testifies (or it is sus13 pected that the covered individual will testify) in an 

14 investigation or judicial or administrative proceeding 

15 concerning such a violation; or 

16 (4) the covered individual assists or participates 

17 (or it is expected that the covered individual will as18 sist or participate) in such an investigation or judi19 cial or administrative proceeding. 

20 (b) ENFORCEMENT.—An individual who alleges any 

21 adverse action in violation of subsection (a) may bring an 

22 action for a jury trial in the appropriate district court of 

23 the United States for the following relief: 

24 (1) Temporary relief while the case is pending. 


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1 (2) Reinstatement with the same seniority status 

2 that the individual would have had, but for the dis3 charge or discrimination. 

4 (3) Twice the amount of back pay otherwise 

5 owed to the individual, with interest. 

6 (4) Consequential and compensatory damages, 

7 and compensation for litigation costs, expert witness 

8 fees, and reasonable attorneys’ fees. 

9 (c) WAIVER OF RIGHTS AND REMEDIES.—The rights 

10 and remedies provided for in this section shall not be 

11 waived by any policy form or condition of employment, in12 cluding by a predispute arbitration agreement. 

13 (d) PREDISPUTE ARBITRATION AGREEMENTS.—No 

14 predispute arbitration agreement shall be valid or enforce15 able if the agreement requires arbitration of a dispute aris16 ing under this section. 

17 SEC. 6. ENFORCEMENT. 

18 (a) ENFORCEMENT BY THE COMMISSION.— 

19 (1) UNFAIR AND DECEPTIVE ACTS OR PRAC20 TICES.—A violation of this Act shall be treated as a 

21 violation of a rule defining an unfair or deceptive act 

22 or practice under section 18(a)(1)(B) of the Federal 

23 Trade Commission Act (15 U.S.C. 57a(a)(1)(B)). 

24 (2) POWERS OF THE COMMISSION.— 


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1 (A) IN GENERAL.—Except as provided in 

2 subparagraph (C), the Commission shall enforce 

3 this Act in the same manner, by the same means, 

4 and with the same jurisdiction, powers, and du5 ties as though all applicable terms and provi6 sions of the Federal Trade Commission Act (15 

7 U.S.C. 41 et seq.) were incorporated into and 

8 made a part of this Act. 

9 (B) PRIVILEGES AND IMMUNITIES.—Subject 

10 to paragraph (3), any person who violates this 

11 Act shall be subject to the penalties and entitled 

12 to the privileges and immunities provided in the 

13 Federal Trade Commission Act (15 U.S.C. 41 et. 

14 seq.). 

15 (C) NONPROFIT ORGANIZATIONS AND INSUR16 ANCE.—Notwithstanding section 4 or 6 of the 

17 Federal Trade Commission Act (15 U.S.C. 44, 

18 46), section 2 of McCarran-Ferguson Act (15 

19 U.S.C. 1012), or any other jurisdictional limita20 tion of the Commission, the Commission shall 

21 also enforce this Act, in the same manner pro22 vided in subparagraphs (A) and (B) of this 

23 paragraph, with respect to— 


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1 (i) organizations not organized to 

2 carry on business for their own profit or 

3 that of their members; and 

4 (ii) the business of insurance, and per5 sons engaged in such business. 

6 (D) AUTHORITY PRESERVED.—Nothing in 

7 this section shall be construed to limit the au8 thority of the Commission under any other pro9 vision of law. 

10 (3) PENALTIES.— 

11 (A) ADDITIONAL CIVIL PENALTY.—In addi12 tion to any penalty applicable under the Federal 

13 Trade Commission Act (15 U.S.C. 41 et seq.), 

14 any person that violates this Act shall be liable 

15 for a civil penalty of not more than $1,000,000. 

16 (B) METHOD.—The penalties provided by 

17 subparagraph (A) shall be obtained in the same 

18 manner as civil penalties imposed under section 

19 18(a)(1)(B) of the Federal Trade Commission 

20 Act (15 U.S.C. 57a(a(1)(B). 

21 (C) MULTIPLE OFFENSES; MITIGATING FAC22 TORS.—In assessing a penalty under subpara23 graph (A)— 

24 (i) each day of a continuing violation 

25 shall be considered a separate violation; and 


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1 (ii) the court shall take into consider2 ation, among other factors— 

3 (I) the seriousness of the violation; 

4 (II) the efforts of the person com5 mitting the violation to remedy the 

6 harm caused by the violation in a 

7 timely manner; and 

8 (III) whether the violation was 

9 intentional. 

10 (b) ENFORCEMENT BY STATES.— 

11 (1) IN GENERAL.—If the attorney general of a 

12 State has reason to believe that an interest of the resi13 dents of the State has been or is being threatened or 

14 adversely affected by a practice that violates this Act, 

15 the attorney general of the State may bring a civil ac16 tion on behalf of the residents of the State in an ap17 propriate district court of the United States to obtain 

18 appropriate relief. 

19 (2) RIGHTS OF THE COMMISSION.— 

20 (A) NOTICE TO THE COMMISSION.— 

21 (i) IN GENERAL.—Except as provided 

22 in clause (iii), the attorney general of a 

23 State, before initiating a civil action under 

24 paragraph (1), shall provide written notifiVerDate Sep 11 2014 00:41 Dec 14, 2023 Jkt 049200 PO 00000 Frm 00039 Fmt 6652 Sfmt 6203 E:\BILLS\S127.RS S127

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1 cation to the Commission that the attorney 

2 general intends to bring such civil action. 

3 (ii) CONTENTS.—The notification re4 quired under clause (i) shall include a copy 

5 of the complaint to be filed to initiate the 

6 civil action. 

7 (iii) EXCEPTION.—If it is not feasible 

8 for the attorney general of a State to pro9 vide the notification required under clause 

10 (i) before initiating a civil action under 

11 paragraph (1), the attorney general shall 

12 notify the Commission immediately upon 

13 instituting the civil action. 

14 (B) INTERVENTION BY THE COMMISSION.— 

15 The Commission may— 

16 (i) intervene in any civil action 

17 brought by the attorney general of a State 

18 under paragraph (1); and 

19 (ii) upon intervening— 

20 (I) be heard on all matters arising 

21 in the civil action; and 

22 (II) file petitions for appeal of a 

23 decision in the civil action. 

24 (3) CONSTRUCTION.— 


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1 (A) POWERS CONFERRED ON THE ATTOR2 NEY GENERAL OF A STATE.—Nothing in this sub3 section may be construed to prevent the attorney 

4 general of a State from exercising the powers 

5 conferred on the attorney general by the laws of 

6 the State to conduct investigations, to administer 

7 oaths or affirmations, or to compel the attend8 ance of witnesses or the production of documen9 tary or other evidence. 

10 (B) ERISA.—No civil action brought pur11 suant to this subsection shall conflict with the 

12 Employee Retirement Income Security Act of 

13 1974 (29 U.S.C. 1001 et seq.). 

14 (4) VENUE; SERVICE OF PROCESS.— 

15 (A) VENUE.—Any action brought under 

16 paragraph (1) may be brought in— 

17 (i) the district court of the United 

18 States that meets applicable requirements 

19 relating to venue under section 1391 of title 

20 28, United States Code; or 

21 (ii) another court of competent juris22 diction. 

23 (B) SERVICE OF PROCESS.—In an action 

24 brought under paragraph (1), process may be 

25 served in any district in which— 


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1 (i) the defendant is an inhabitant, 

2 may be found, or transacts business; or 

3 (ii) venue is proper under section 1391 

4 of title 28, United States Code. 

5 (5) ACTIONS BY OTHER STATE OFFICIALS.— 

6 (A) IN GENERAL.—If an attorney general 

7 lacks appropriate jurisdiction to bring a civil 

8 action under paragraph (1), any other officer of 

9 a State who is authorized by the State to do so 

10 may bring a civil action under paragraph (1), 

11 subject to the same requirements and limitations 

12 that apply under this subsection to civil actions 

13 brought by attorneys general. 

14 (B) CLARIFICATION OF AUTHORITY.—The 

15 authority provided by subparagraph (A) shall 

16 supplant, and not supplement, the authorities of 

17 State attorneys general under paragraph (1). 

18 (C) SAVINGS PROVISION.—Nothing in this 

19 subsection may be construed to prohibit an au20 thorized official of a State from initiating or 

21 continuing any proceeding in a court of the 

22 State for a violation of any civil or criminal law 

23 of the State. 

24 (c) AFFIRMATIVE DEFENSE.— 


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1 (1) IN GENERAL.—In an action brought under 

2 this section to enforce section 2, it shall be an affirm3 ative defense, on which the defendant has the burden 

4 of persuasion by a preponderance of the evidence, that 

5 the conduct alleged to be a violation of section 2 was 

6 nonpretextual and reasonably necessary to— 

7 (A) prevent a violation of, or comply with, 

8 Federal or State law; 

9 (B) protect patient safety; or 

10 (C) protect patient access. 

11 (2) CLARIFICATION.—Nothing in this subsection 

12 shall be construed to prohibit a defendant from rais13 ing any other affirmative defense available. 

14 SEC. 7. PROTECTION OF PERSONAL HEALTH INFORMATION. 

15 In making any disclosure or report required by this 

16 Act, a pharmacy benefit manager (including their affiliates, 

17 subsidiaries, and agents) shall not include any information 

18 that would identify a patient or a provider that issued a 

19 prescription. 

20 SEC. 8. EFFECT ON STATE LAWS. 

21 Nothing in this Act shall be construed to preempt, dis22 place, or supplant any State laws, rules, regulations, or re23 quirements, or the enforcement thereof. 

24 SEC. 9. DEFINITIONS. 

25 In this Act: 


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1 (1) COMMISSION.—The term ‘‘Commission’’ 

2 means the Federal Trade Commission. 

3 (2) COVERED INDIVIDUAL.—The term ‘‘covered 

4 individual’’ means a current or former employee, con5 tractor, subcontractor, service provider, or agent of a 

6 pharmacy benefit manager, health plan, pharma7 ceutical manufacturer, pharmacy, or any affiliate, 

8 subsidiary, or agent thereof. 

9 (3) HEALTH PLAN.—The term ‘‘health plan’’ 

10 means any group or individual health insurance plan 

11 or coverage, including any health insurance plan or 

12 coverage sponsored or funded by the Federal Govern13 ment or the government of any State, Territory, or 

14 subdivision thereof. 

15 (4) PHARMACY BENEFIT MANAGER.—The term 

16 ‘‘pharmacy benefit manager’’ means any entity that 

17 provides pharmacy benefit management services on 

18 behalf of a health plan, a payer, or health insurance 

19 issuer. 

20 (5) PHARMACY BENEFIT MANAGEMENT SERV21 ICES.—The term ‘‘pharmacy benefit management 

22 services’’ means, pursuant to a written agreement 

23 with a payer or health plan offering group or indi24 vidual health insurance coverage, directly or through 

25 an intermediary, the service of— 


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1 (A) negotiating terms and conditions, in2 cluding rebates and price concessions, with re3 spect to a prescription drug on behalf of the 

4 health plan, coverage, or payer; or 

5 (B) managing the prescription drug benefits 

6 provided by the health plan, coverage, or payer, 

7 which may include formulary management the 

8 processing and payment of claims for prescrip9 tion drugs, the performance of drug utilization 

10 review, the processing of drug prior authoriza11 tion requests, the adjudication of appeals or 

12 grievances related to the prescription drug ben13 efit, contracting with network pharmacies, or the 

14 provision of related services. 

15 (6) PRESCRIPTION DRUG.—The term ‘‘prescrip16 tion drug’’ means— 

17 (A) a drug, as that term is defined in sec18 tion 201(g) of the Federal Food, Drug, and Cos19 metic Act (21 U.S.C. 321(g)), that is— 

20 (i) approved by the Food and Drug 

21 Administration under section 505 of such 

22 Act (21 U.S.C. 355); and 

23 (ii) subject to the requirements of sec24 tion 503(b)(1) of such Act (21 U.S.C. 

25 353(b)(1)); 


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1 (B) a biological product as that term is de2 fined in section 351 of the Public Health Service 

3 Act (42 U.S.C. 262(i)(1)); or 

4 (C) a product that is biosimilar to, or inter5 changeable with, a biologic product under section 

6 351 of the Public Health Service Act (42 U.S.C. 

7 262(i)). 


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Calendar No. 283 

118TH CONGRESS 

1ST SESSION S. 127 

A BILL 

To prevent unfair and deceptive acts or practices 

for prescription drugs, and for other purposes. lated to pharmacy benefit management services and the dissemination of false information reDECEMBER 13, 2023 

Reported with an amendment 


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