macy benefit manager, affiliate, PDP 
sponsor, or plan, or prices charged for 
specific drugs. 
‘‘(C) AUDIT RIGHTS.— 
‘‘(i) IN GENERAL.—Not less than once 
a year, at the request of the PDP sponsor, 
the pharmacy benefit manager shall allow 
for an audit of the pharmacy benefit man-
ager to ensure compliance with all terms 
and conditions under the contract and the 
accuracy of information reported under 
subparagraph (B). 
‘‘(ii) AUDITOR.—The PDP sponsor 
shall have the right to select an auditor. 
The pharmacy benefit manager shall not 
impose any limitations on the selection of 
such auditor. 
‘‘(iii) PROVISION OF INFORMATION.— 
The pharmacy benefit manager shall make 
available to such auditor all records, data, 
contracts, and other information necessary 
to confirm the accuracy of information 
provided under subparagraph (B), subject 
to reasonable restrictions on how such in-
formation must be reported (as determined 
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by the Secretary) to prevent redisclosure of 
such information. 
‘‘(iv) TIMING.—The pharmacy benefit 
manager must provide information under 
clause (iii) and other information, data, 
and records relevant to the audit to such 
auditor within 6 months of the initiation of 
the audit and respond to requests for addi-
tional information from such auditor with-
in 30 days after the request for additional 
information. 
‘‘(v) INFORMATION
FROM
AFFILI-
ATES.—The pharmacy benefit manager 
shall be responsible for providing to such 
auditor information required to be reported 
under subparagraph (B) that is owned or 
held by an affiliate of such pharmacy ben-
efit manager. 
‘‘(D) ENFORCEMENT.—The pharmacy ben-
efit manager shall— 
‘‘(i) reimburse the PDP sponsor for 
any civil money penalty imposed on the 
PDP sponsor as a result of the failure of 
the pharmacy benefit manager to meet the 
requirements of this paragraph that are 
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applicable to the pharmacy benefit man-
ager under the agreement; and 
‘‘(ii) be subject to punitive remedies 
for breach of contract for failure to comply 
with the requirements applicable under this 
paragraph. 
‘‘(2) CERTIFICATION
OF
COMPLIANCE.—Each 
PDP sponsor shall furnish to the Secretary (in a 
time and manner specified by the Secretary) an an-
nual certification of compliance with this subsection, 
as well as such information as the Secretary deter-
mines necessary to carry out this subsection. 
‘‘(3) DEFINITIONS.—For purposes of this sub-
section: 
‘‘(A) AFFILIATE.—The term ‘affiliate’ 
means any entity that is owned by, controlled 
by, or related under a common ownership struc-
ture with a pharmacy benefit manager (includ-
ing an entity owned or controlled by the PDP 
sponsor) or that acts as a contractor or agent 
to such pharmacy benefit manager, insofar as 
such contractor or agent performs any of the 
functions described under subparagraph (B). 
‘‘(B) PHARMACY BENEFIT MANAGER.—The 
term ‘pharmacy benefit manager’ means any 
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person or entity that, either directly or through 
an intermediary, acts as a price negotiator or 
group purchaser on behalf of a PDP sponsor or 
prescription drug plan, or manages the pre-
scription drug benefits provided by such spon-
sor or plan, including the processing and pay-
ment of claims for prescription drugs, the per-
formance of drug utilization review, the proc-
essing of drug prior authorization requests, the 
adjudication of appeals or grievances related to 
the prescription drug benefit, contracting with 
network pharmacies, controlling the cost of cov-
ered part D drugs, or the provision of services 
related thereto. Such term includes any person 
or entity that carries out one or more of the ac-
tivities described in the preceding sentence, ir-
respective of whether such person or entity calls 
itself a ‘pharmacy benefit manager’.’’. 
(2) MA–PD PLANS.—Section 1857(f)(3) of the 
Social Security Act (42 U.S.C. 1395w–27(f)(3)) is 
amended by adding at the end the following new 
subparagraph: 
‘‘(F) PHARMACY BENEFIT MANAGER RE-
PORTING REQUIREMENTS.—For plan years be-
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ginning on or after January 1, 2028, section 
1860D–12(h).’’. 
(b) GAO STUDY AND REPORT ON CERTAIN REPORT-
ING REQUIREMENTS.— 
(1) STUDY.—The Comptroller General of the 
United States (in this subsection referred to as the 
‘‘Comptroller General’’) shall conduct a study on 
Federal and State reporting requirements for health 
plans and pharmacy benefit managers related to the 
transparency of prescription drug costs and prices. 
Such study shall include an analysis of the following: 
(A) Federal statutory and regulatory re-
porting requirements for health plans and phar-
macy benefit managers related to prescription 
drug costs and prices. 
(B) State statutory and regulatory report-
ing requirements for health plans and pharmacy 
benefit managers related to prescription drug 
costs and prices. 
(C) The extent to which the statutory and 
regulatory reporting requirements identified in 
clauses (i) and (ii) overlap and conflict. 
(D) The resources required by health plans 
and pharmacy benefit managers to comply with 
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