I 
118TH CONGRESS 
2D SESSION 
H. R. 7717 
To amend title XI of the Social Security Act to enhance pharmacy benefit 
manager transparency requirements. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 19, 2024 
Mr. GALLEGO introduced the following bill; which was referred to the Com-
mittee 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 XI of the Social Security Act to enhance 
pharmacy benefit manager transparency requirements. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. ENHANCING PBM TRANSPARENCY REQUIRE-
MENTS. 
(a) IN GENERAL.—Section 1150A of the Social Secu-
rity Act (42 U.S.C. 1320b–23) is amended— 
(1) by striking subsection (a) and inserting the 
following: 
‘‘(a) PROVISION OF INFORMATION.— 
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‘‘(1) IN GENERAL.—The following entities shall 
provide the information described in subsection (b) 
to the Secretary and, in the case of an entity de-
scribed in subparagraph (B) or an affiliate of such 
entity described in subparagraph (C), to the health 
benefits plan with which the entity is under contract, 
at such times, and in such form and manner, as the 
Secretary shall specify: 
‘‘(A) A health benefits plan. 
‘‘(B) Any entity that provides pharmacy 
benefits management services on behalf of a 
health benefits plan (in this section referred to 
as a ‘PBM’) that manages prescription drug 
coverage under a contract with— 
‘‘(i) a PDP sponsor of a prescription 
drug plan or an MA organization offering 
an MA–PD plan under part D of title 
XVIII; or 
‘‘(ii) a qualified health benefits plan 
offered through an exchange established by 
a State under section 1311 of the Patient 
Protection and Affordable Care Act. 
‘‘(C) Any affiliate of an entity described in 
subparagraph (B) that acts as a price nego-
tiator or group purchaser on behalf of such 
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PBM, PDP sponsor, MA organization, or quali-
fied health benefits plan. 
‘‘(2) AFFILIATE DEFINED.—In this section, the 
term ‘affiliate’ means any entity that is owned by, 
controlled by, or related under a common ownership 
structure with a PBM (including an entity owned or 
controlled by the PDP sponsor of a prescription 
drug plan, MA organization offering an MA–PD 
plan, or qualified health benefits plan for which such 
entity is acting as a price negotiator or group pur-
chaser).’’; 
(2) in subsection (b)— 
(A) in paragraph (2), by inserting ‘‘and 
percentage’’ after ‘‘and the aggregate amount’’; 
and 
(B) by adding at the end the following new 
paragraph: 
‘‘(4) The amount (in the aggregate and 
disaggregated by type) of all fees the PBM or an af-
filiate of the PBM receives from all pharmaceutical 
manufacturers in connection with patient utilization 
under the plan, and the amount and percentage (in 
the aggregate and disaggregated by type) of such 
fees that are passed through to the plan sponsor or 
issuer.’’; and 
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(3) by adding at the end the following new sub-
section: 
‘‘(e) ANNUAL REPORT.—The Secretary shall make 
publicly available on the Internet website of the Centers 
for Medicare & Medicaid Services an annual report that 
summarizes the trends observed with respect to data re-
ported under subsection (b).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to plan or contract years beginning 
on or after January 1, 2027. 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary may implement the amend-
ments made by this section by program instruction or oth-
erwise. 
(d) NON-APPLICATION OF THE PAPERWORK REDUC-
TION ACT.—Chapter 35 of title 44, United States Code 
(commonly referred to as the ‘‘Paperwork Reduction Act 
of 1995’’), shall not apply to the implementation of the 
amendments made by this section. 
Æ 
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