116TH CONGRESS 

1ST SESSION H. R. 2115 

AN ACT 

To amend titles XI and XVIII of the Social Security Act 

to provide greater transparency for discounts provided 

by manufacturers, to include real-time benefit information as part of a prescription drug plan’s electronic prescription program under the Medicare program, and for 

other purposes. 
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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 ‘‘Public Disclosure of 

5 Drug Discounts and Real-Time Beneficiary Drug Cost 

6 Act’’. 

7 SEC. 2. PUBLIC DISCLOSURE OF DRUG DISCOUNTS. 

8 Section 1150A of the Social Security Act (42 U.S.C. 

9 1320b–23) is amended— 

10 (1) in subsection (c), in the matter preceding 

11 paragraph (1), by inserting ‘‘(other than as per12 mitted under subsection (e))’’ after ‘‘disclosed by the 

13 Secretary’’; and 

14 (2) by adding at the end the following new sub15 section: 

16 ‘‘(e) PUBLIC AVAILABILITY OF CERTAIN INFORMA17 TION.— 

18 ‘‘(1) IN GENERAL.—In order to allow the com19 parison of PBMs’ ability to negotiate rebates, dis20 counts, direct and indirect remuneration fees, ad21 ministrative fees, and price concessions and the 

22 amount of such rebates, discounts, direct and indi23 rect remuneration fees, administrative fees, and 

24 price concessions that are passed through to plan 

25 sponsors, beginning January 1, 2020, the Secretary 
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1 shall make available on the Internet website of the 

2 Department of Health and Human Services the in3 formation with respect to the second preceding cal4 endar year provided to the Secretary on generic dis5 pensing rates (as described in paragraph (1) of sub6 section (b)) and information provided to the Sec7 retary under paragraphs (2) and (3) of such sub8 section that, as determined by the Secretary, is with 

9 respect to each PBM. 

10 ‘‘(2) AVAILABILITY OF DATA.—In carrying out 

11 paragraph (1), the Secretary shall ensure the fol12 lowing: 

13 ‘‘(A) CONFIDENTIALITY.—The information 

14 described in such paragraph is displayed in a 

15 manner that prevents the disclosure of informa16 tion, with respect to an individual drug or an 

17 individual plan, on rebates, discounts, direct 

18 and indirect remuneration fees, administrative 

19 fees, and price concessions. 

20 ‘‘(B) CLASS OF DRUG.—The information 

21 described in such paragraph is made available 

22 by class of drug, using an existing classification 

23 system, but only if the class contains such num24 ber of drugs, as specified by the Secretary (but 

25 not fewer than three drugs), to ensure confiden-
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1 tiality of proprietary information or other infor2 mation that is prevented to be disclosed under 

3 subparagraph (A).’’. 

4 SEC. 3. REQUIRING PRESCRIPTION DRUG PLAN SPONSORS 

5 TO INCLUDE REAL-TIME BENEFIT INFORMA6 TION AS PART OF SUCH SPONSOR’S ELEC7 TRONIC PRESCRIPTION PROGRAM UNDER 

8 THE MEDICARE PROGRAM. 

9 Section 1860D–4(e)(2) of the Social Security Act (42 

10 U.S.C. 1395w–104(e)(2)) is amended— 

11 (1) in subparagraph (D), by striking ‘‘To the 

12 extent’’ and inserting ‘‘Except as provided in sub13 paragraph (F), to the extent’’; and 

14 (2) by adding at the end the following new sub15 paragraph: 

16 ‘‘(F) REAL-TIME BENEFIT INFORMA17 TION.— 

18 ‘‘(i) IN GENERAL.—Not later than 

19 January 1, 2021, the program shall imple20 ment real-time benefit tools that are capa21 ble of integrating with a prescribing health 

22 care professional’s electronic prescribing or 

23 electronic health record system for the 

24 transmission of formulary and benefit in25 formation in real time to prescribing health 
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1 care professionals. With respect to a cov2 ered part D drug, such tools shall be capa3 ble of transmitting such information spe4 cific to an individual enrolled in a prescrip5 tion drug plan. Such information shall in6 clude the following: 

7 ‘‘(I) A list of any clinically-appro8 priate alternatives to such drug in9 cluded in the formulary of such plan. 

10 ‘‘(II) Cost-sharing information 

11 for such drug and such alternatives, 

12 including a description of any vari13 ance in cost sharing based on the 

14 pharmacy dispensing such drug or 

15 such alternatives. 

16 ‘‘(III) Information relating to 

17 whether such drug is included in the 

18 formulary of such plan and any prior 

19 authorization or other utilization man20 agement requirements applicable to 

21 such drug and such alternatives so in22 cluded. 

23 ‘‘(ii) ELECTRONIC TRANSMISSION.— 

24 The provisions of subclauses (I) and (II) of 

25 clause (ii) of subparagraph (E) shall apply 
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1 to an electronic transmission described in 

2 clause (i) in the same manner as such pro3 visions apply with respect to an electronic 

4 transmission described in clause (i) of such 

5 subparagraph. 

6 ‘‘(iii) SPECIAL RULE FOR 2021.—The 

7 program shall be deemed to be in compli8 ance with clause (i) for 2021 if the pro9 gram complies with the provisions of sec10 tion 423.160(b)(7) of title 42, Code of 

11 Federal Regulations (or a successor regula12 tion), for such year. 

13 ‘‘(iv) RULE OF CONSTRUCTION.— 

14 Nothing in this subparagraph shall be con15 strued as to allow a real-time benefits tool 

16 to steer an individual, without the consent 

17 of the individual, to a particular pharmacy 

18 or pharmacy setting over their preferred 

19 pharmacy setting nor prohibit the designa20 tion of a preferred pharmacy under such 

21 tool.’’. 

22 SEC. 4. SENSE OF CONGRESS REGARDING THE NEED TO EX23 PAND COMMERCIALLY AVAILABLE DRUG 

24 PRICING COMPARISON PLATFORMS. 

25 It is the sense of Congress that— 
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1 (1) commercially available drug pricing com2 parison platforms can, at no cost, help patients find 

3 the lowest price for their medications at their local 

4 pharmacy; 

5 (2) such platforms should be integrated, to the 

6 maximum extent possible, in the health care delivery 

7 ecosystem; and 

8 (3) pharmacy benefit managers should work to 

9 disclose generic and brand name drug prices to such 

10 platforms to ensure that— 

11 (A) patients can benefit from the lowest 

12 possible price available to them; and 

13 (B) overall drug prices can be reduced as 

14 more educated purchasing decisions are made 

15 based on price transparency. 

Passed the House of Representatives October 28, 

2019. 

Attest: 

Clerk. 
116TH CONGRESS 

1ST SESSION H. R. 2115 

AN ACT 

To amend titles XI and XVIII of the Social Secupurposes. gram under the Medicare program, and for other scription drug plan’s electronic prescription pro- real-time benefit information as part of a pre- counts provided by manufacturers, to include rity Act to provide greater transparency for dis-