strict disclosure of such report to the Depart-
ment of Health and Human Services, the De-
partment of Labor, the Department of the 
Treasury, the Comptroller General of the 
United States, or applicable State agencies. 
‘‘(C) LIMITED
FORM
OF
REPORT.—The 
Secretary shall define through rulemaking a 
limited form of the report under paragraph (1) 
required of plan sponsors who are drug manu-
facturers, drug wholesalers, or other direct par-
ticipants in the drug supply chain, in order to 
prevent anti-competitive behavior. 
‘‘(4) REPORT
TO
GAO.—An entity providing 
pharmacy benefits management services on behalf of 
a group health plan shall submit to the Comptroller 
General of the United States each of the first 4 re-
ports submitted to a plan sponsor under paragraph 
(1) with respect to such plan, and other such reports 
as requested, in accordance with the privacy require-
ments under paragraph (2), the disclosure and re-
disclosure standards under paragraph (3), the stand-
ards specified pursuant to paragraph (5), and such 
other information that the Comptroller General de-
termines necessary to carry out the study under sec-
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tion 2(d) of the Pharmacy Benefits Manager Ac-
countability Act. 
‘‘(5) STANDARD FORMAT.—Not later than June 
1, 2023, the Secretary shall specify through rule-
making standards for entities required to submit re-
ports under paragraph (4) to submit such reports in 
a standard format. 
‘‘(c) ENFORCEMENT.— 
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with the Secretary of Labor and the Secretary 
of Health and Human Services, shall enforce this 
section. 
‘‘(2) FAILURE TO PROVIDE TIMELY INFORMA-
TION.—An entity providing pharmacy benefits man-
agement services that violates subsection (a) or fails 
to provide information required under subsection (b) 
shall be subject to a civil monetary penalty in the 
amount of $10,000 for each day during which such 
violation continues or such information is not dis-
closed or reported. 
‘‘(3) FALSE
INFORMATION.—An entity pro-
viding pharmacy benefits management services that 
knowingly provides false information under this sec-
tion shall be subject to a civil money penalty in an 
amount not to exceed $100,000 for each item of 
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false information. Such civil money penalty shall be 
in addition to other penalties as may be prescribed 
by law. 
‘‘(4) PROCEDURE.—The provisions of section 
1128A of the Social Security Act, other than sub-
section (a) and (b) and the first sentence of sub-
section (c)(1) of such section shall apply to civil 
monetary penalties under this subsection in the 
same manner as such provisions apply to a penalty 
or proceeding under section 1128A of the Social Se-
curity Act. 
‘‘(5) WAIVERS.—The Secretary may waive pen-
alties under paragraph (2), or extend the period of 
time for compliance with a requirement of this sec-
tion, for an entity in violation of this section that 
has made a good-faith effort to comply with this sec-
tion. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to permit a group health plan or 
other entity to restrict disclosure to, or otherwise limit the 
access of, the Department of the Treasury to a report de-
scribed in subsection (b)(1) or information related to com-
pliance with subsection (a) by such plan or entity. 
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‘‘(e) DEFINITION.—In this section, the term ‘whole-
sale acquisition cost’ has the meaning given such term in 
section 1847A(c)(6)(B) of the Social Security Act.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for subchapter B of chapter 100 of the Inter-
nal Revenue Code of 1986 is amended by adding at 
the end the following new item: 
‘‘Sec. 9826. Oversight of pharmacy benefits manager services.’’. 
(d) GAO STUDY.— 
(1) IN GENERAL.—Not later than 3 years after 
the date of enactment of this Act, the Comptroller 
General of the United States shall submit to Con-
gress a report on— 
(A) pharmacy networks of group health 
plans, health insurance issuers, and entities 
providing pharmacy benefits management serv-
ices under such group health plan or group or 
individual health insurance coverage, including 
networks that have pharmacies that are under 
common ownership (in whole or part) with 
group health plans, health insurance issuers, or 
entities providing pharmacy benefits manage-
ment services or pharmacy benefits administra-
tive services under group health plan or group 
or individual health insurance coverage; 
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(B) as it relates to pharmacy networks 
that include pharmacies under common owner-
ship described in subparagraph (A)— 
(i) whether such networks are de-
signed to encourage enrollees of a plan or 
coverage to use such pharmacies over other 
network pharmacies for specific services or 
drugs, and if so, the reasons the networks 
give for encouraging use of such phar-
macies; and 
(ii) whether such pharmacies are used 
by enrollees disproportionately more in the 
aggregate or for specific services or drugs 
compared to other network pharmacies; 
(C) whether group health plans and health 
insurance issuers offering group or individual 
health insurance coverage have options to elect 
different network pricing arrangements in the 
marketplace with entities that provide phar-
macy benefits management services, the preva-
lence of electing such different network pricing 
arrangements; 
(D) pharmacy network design parameters 
that encourage enrollees in the plan or coverage 
to fill prescriptions at mail order, specialty, or 
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retail pharmacies that are wholly or partially- 
owned by that issuer or entity; and 
(E) the degree to which mail order, spe-
cialty, or retail pharmacies that dispense pre-
scription drugs to an enrollee in a group health 
plan or health insurance coverage that are 
under common ownership (in whole or part) 
with group health plans, health insurance 
issuers, or entities providing pharmacy benefits 
management services or pharmacy benefits ad-
ministrative services under group health plan or 
group or individual health insurance coverage 
receive reimbursement that is greater than the 
median price charged to the group health plan 
or health insurance issuer when the same drug 
is dispensed to enrollees in the plan or coverage 
by other pharmacies included in the pharmacy 
network of that plan, issuer, or entity that are 
not wholly or partially owned by the health in-
surance issuer or entity providing pharmacy 
benefits management services. 
(2) REQUIREMENT.—The Comptroller General 
of the United States shall ensure that the report 
under paragraph (1) does not contain information 
that would allow a reader to identify a specific plan 
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or entity providing pharmacy benefits management 
services or otherwise contain commercial or financial 
information that is privileged or confidential. 
(3) DEFINITIONS.—In this subsection, the 
terms ‘‘group health plan’’, ‘‘health insurance cov-
erage’’, and ‘‘health insurance issuer’’ have the 
meanings given such terms in section 2791 of the 
Public Health Service Act (42 U.S.C. 300gg–91). 
Æ 
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