264 
facturers, drug wholesalers, or other direct par-
ticipants in the drug supply chain, in order to 
prevent anti-competitive behavior. 
‘‘(4) REPORT
TO
GAO.—A health insurance 
issuer offering group health insurance coverage or 
an entity providing pharmacy benefits management 
services on behalf of a group health plan shall sub-
mit to the Comptroller General of the United States 
each of the first 4 reports submitted to a plan spon-
sor under paragraph (1) with respect to such cov-
erage or plan, and other such reports as requested, 
in accordance with the privacy requirements under 
paragraph (2), the disclosure and redisclosure stand-
ards under paragraph (3), the standards specified 
pursuant to paragraph (5), and such other informa-
tion that the Comptroller General determines nec-
essary to carry out the study under section 602(d) 
of the Restoring Hope for Mental Health and Well- 
Being Act of 2022. 
‘‘(5) STANDARD FORMAT.—Not later than June 
1, 2023, the Secretary shall specify through rule-
making standards for health insurance issuers and 
entities required to submit reports under paragraph 
(4) to submit such reports in a standard format. 
‘‘(c) ENFORCEMENT.—
265 
‘‘(1) IN GENERAL.—The Secretary, in consulta-
tion with the Secretary of Health and Human Serv-
ices and the Secretary of the Treasury, shall enforce 
this section. 
‘‘(2) FAILURE TO PROVIDE TIMELY INFORMA-
TION.—A health insurance issuer or an entity pro-
viding pharmacy benefit management services that 
violates subsection (a) or fails to provide information 
required under subsection (b), or a drug manufac-
turer that fails to provide information under sub-
section (b)(1)(A) in a timely manner, shall be sub-
ject to a civil monetary penalty in the amount of 
$10,000 for each day during which such violation 
continues or such information is not disclosed or re-
ported. 
‘‘(3) FALSE INFORMATION.—A health insurance 
issuer, entity providing pharmacy benefit manage-
ment services, or drug manufacturer that knowingly 
provides false information under this section shall be 
subject to a civil money penalty in an amount not 
to exceed $100,000 for each item of false informa-
tion. 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-
266 
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 health insurance issuer, 
group health plan, or other entity to restrict disclosure to, 
or otherwise limit the access of, the Department of Labor 
to a report described in subsection (b)(1) or information 
related to compliance with subsection (a) by such issuer, 
plan, or entity. 
‘‘(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.’’; and 
(B) in section 502(b)(3) (29 U.S.C. 
1132(b)(3)), by inserting ‘‘(other than section 
726)’’ after ‘‘part 7’’.
267 
(2) CLERICAL AMENDMENT.—The table of con-
tents in section 1 of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1001 et seq.) 
is amended by inserting after the item relating to 
section 725 the following new item: 
‘‘Sec. 726. Oversight of pharmacy benefit manager services.’’. 
(c) IRC.— 
(1) IN
GENERAL.—Subchapter B of chapter 
100 of the Internal Revenue Code of 1986 is amend-
ed by adding at the end the following: 
‘‘SEC. 9826. OVERSIGHT OF PHARMACY BENEFIT MANAGER 
SERVICES. 
‘‘(a) IN GENERAL.—For plan years beginning on or 
after January 1, 2024, a group health plan or an entity 
or subsidiary providing pharmacy benefits management 
services on behalf of such a plan shall not enter into a 
contract with a drug manufacturer, distributor, whole-
saler, subcontractor, rebate aggregator, or any associated 
third party that limits the disclosure of information to 
plan sponsors in such a manner that prevents the plan, 
or an entity or subsidiary providing pharmacy benefits 
management services on behalf of a plan, from making 
the reports described in subsection (b). 
‘‘(b) REPORTS.— 
‘‘(1) IN GENERAL.—For plan years beginning 
on or after January 1, 2024, not less frequently
268 
than once every 6 months, an entity providing phar-
macy benefits management services on behalf of a 
group health plan shall submit to the plan sponsor 
(as defined in section 3(16)(B) of the Employee Re-
tirement Income Security Act of 1974) of such 
group health plan a report in accordance with this 
subsection and make such report available to the 
plan sponsor in a machine-readable format. Each 
such report shall include, with respect to the applica-
ble group health plan— 
‘‘(A) as applicable, information collected 
from drug manufacturers by such entity on the 
total amount of copayment assistance dollars 
paid, or copayment cards applied, that were 
funded by the drug manufacturer with respect 
to the participants and beneficiaries in such 
plan; 
‘‘(B) a list of each drug covered by such 
plan or entity providing pharmacy benefit man-
agement services that was dispensed during the 
reporting period, including, with respect to each 
such drug during the reporting period— 
‘‘(i) the brand name, chemical entity, 
and National Drug Code;
269 
‘‘(ii) the number of participants and 
beneficiaries for whom the drug was filled 
during the plan year, the total number of 
prescription fills for the drug (including 
original prescriptions and refills), and the 
total number of dosage units of the drug 
dispensed across the plan year, including 
whether the dispensing channel was by re-
tail, mail order, or specialty pharmacy; 
‘‘(iii) the wholesale acquisition cost, 
listed as cost per days supply and cost per 
pill, or in the case of a drug in another 
form, per dose; 
‘‘(iv) the total out-of-pocket spending 
by participants and beneficiaries on such 
drug, including participant and beneficiary 
spending through copayments, coinsurance, 
and deductibles; and 
‘‘(v) for any drug for which gross 
spending of the group health plan exceeded 
$10,000 during the reporting period— 
‘‘(I) a list of all other drugs in 
the same therapeutic category or 
class, including brand name drugs 
and biological products and generic