141 
(e)(1) to the employer) shall be treated as including a ref-
erence to such entity.’’. 
(4) 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 entities that provide pharmacy benefit management 
services.’’. 
SEC. 5. ENSURING ACCURATE PAYMENTS TO PHARMACIES 
UNDER MEDICAID. 
(a) IN GENERAL.—Section 1927(f) of the Social Se-
curity Act (42 U.S.C. 1396r–8(f)) is amended— 
(1) in paragraph (1)(A)— 
(A) by redesignating clause (ii) as clause 
(iii); and 
(B) by striking ‘‘and’’ after the semicolon 
at the end of clause (i) and all that precedes it 
through ‘‘(1)’’ and inserting the following: 
‘‘(1) DETERMINING PHARMACY ACTUAL ACQUI-
SITION COSTS.—The Secretary shall conduct a sur-
vey of retail community pharmacy drug prices and 
applicable non-retail pharmacy drug prices to deter-
mine national average drug acquisition cost bench-
marks (as such term is defined by the Secretary) as 
follows: 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00141
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
142 
‘‘(A) USE
OF
VENDOR.—The Secretary 
may contract services for— 
‘‘(i) with respect to retail community 
pharmacies, the determination of retail 
survey prices of the national average drug 
acquisition cost for covered outpatient 
drugs that represent a nationwide average 
of consumer purchase prices for such 
drugs, net of all discounts, rebates, and 
other price concessions (to the extent any 
information with respect to such discounts, 
rebates, and other price concessions is 
available) based on a monthly survey of 
such pharmacies; 
‘‘(ii) with respect to applicable non-re-
tail pharmacies— 
‘‘(I) the determination of survey 
prices, separate from the survey prices 
described in clause (i), of the non-re-
tail national average drug acquisition 
cost for covered outpatient drugs that 
represent a nationwide average of con-
sumer purchase prices for such drugs, 
net of all discounts, rebates, and other 
price concessions (to the extent any 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00142
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
143 
information with respect to such dis-
counts, rebates, and other price con-
cessions is available) based on a 
monthly survey of such pharmacies; 
and 
‘‘(II) at the discretion of the Sec-
retary, for each type of applicable 
non-retail pharmacy, the determina-
tion of survey prices, separate from 
the survey prices described in clause 
(i) or subclause (I) of this clause, of 
the national average drug acquisition 
cost for such type of pharmacy for 
covered outpatient drugs that rep-
resent a nationwide average of con-
sumer purchase prices for such drugs, 
net of all discounts, rebates, and other 
price concessions (to the extent any 
information with respect to such dis-
counts, rebates, and other price con-
cessions is available) based on a 
monthly survey of such pharmacies; 
and’’; 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00143
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
144 
(2) in subparagraph (B) of paragraph (1), by 
striking ‘‘subparagraph (A)(ii)’’ and inserting ‘‘sub-
paragraph (A)(iii)’’; 
(3) in subparagraph (D) of paragraph (1), by 
striking clauses (ii) and (iii) and inserting the fol-
lowing: 
‘‘(ii) The vendor must update the Sec-
retary no less often than monthly on the 
survey prices for covered outpatient drugs. 
‘‘(iii) The vendor must differentiate, 
in collecting and reporting survey data, for 
all cost information collected, whether a 
pharmacy is a retail community pharmacy 
or an applicable non-retail pharmacy, in-
cluding whether such pharmacy is an affil-
iate (as defined in subsection (k)(14)), 
and, in the case of an applicable non-retail 
pharmacy, which type of applicable non-re-
tail pharmacy it is using the relevant phar-
macy type indicators included in the guid-
ance required by subsection (d)(2) of sec-
tion 44123 of the Act titled ‘An Act to 
provide for reconciliation pursuant to title 
II of H. Con. Res. 14.’ ’’; 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00144
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
145 
(4) by adding at the end of paragraph (1) the 
following: 
‘‘(F) SURVEY
REPORTING.—In order to 
meet the requirement of section 1902(a)(54), a 
State shall require that any retail community 
pharmacy or applicable non-retail pharmacy in 
the State that receives any payment, reimburse-
ment, administrative fee, discount, rebate, or 
other price concession related to the dispensing 
of covered outpatient drugs to individuals re-
ceiving benefits under this title, regardless of 
whether such payment, reimbursement, admin-
istrative fee, discount, rebate, or other price 
concession is received from the State or a man-
aged care entity or other specified entity (as 
such 
terms 
are 
defined 
in 
section 
1903(m)(9)(D)) directly or from a pharmacy 
benefit manager or another entity that has a 
contract with the State or a managed care enti-
ty or other specified entity (as so defined), shall 
respond to surveys conducted under this para-
graph. 
‘‘(G) SURVEY INFORMATION.—Information 
on national drug acquisition prices obtained 
under this paragraph shall be made publicly 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00145
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
146 
available in a form and manner to be deter-
mined by the Secretary and shall include at 
least the following: 
‘‘(i) The monthly response rate to the 
survey including a list of pharmacies not in 
compliance with subparagraph (F). 
‘‘(ii) The sampling methodology and 
number of pharmacies sampled monthly. 
‘‘(iii) Information on price concessions 
to pharmacies, including discounts, re-
bates, and other price concessions, to the 
extent that such information may be pub-
licly released and has been collected by the 
Secretary as part of the survey. 
‘‘(H) PENALTIES.— 
‘‘(i) IN GENERAL.—Subject to clauses 
(ii), (iii), and (iv), the Secretary shall en-
force the provisions of this paragraph with 
respect to a pharmacy through the estab-
lishment of civil money penalties applicable 
to a retail community pharmacy or an ap-
plicable non-retail pharmacy. 
‘‘(ii) BASIS
FOR
PENALTIES.—The 
Secretary shall impose a civil money pen-
alty established under this subparagraph 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00146
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
147 
on a retail community pharmacy or appli-
cable non-retail pharmacy if— 
‘‘(I) the retail pharmacy or appli-
cable non-retail pharmacy refuses or 
otherwise fails to respond to a request 
for information about prices in con-
nection with a survey under this sub-
section; 
‘‘(II) knowingly provides false in-
formation in response to such a sur-
vey; or 
‘‘(III) otherwise fails to comply 
with the requirements established 
under this paragraph. 
‘‘(iii) 
PARAMETERS
FOR
PEN-
ALTIES.— 
‘‘(I) IN GENERAL.—A civil money 
penalty established under this sub-
paragraph may be assessed with re-
spect to each violation, and with re-
spect to each non-compliant retail 
community pharmacy (including a 
pharmacy that is part of a chain) or 
non-compliant 
applicable 
non-retail 
pharmacy (including a pharmacy that 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00147
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
148 
is part of a chain), in an amount not 
to exceed $100,000 for each such vio-
lation. 
‘‘(II) CONSIDERATIONS.—In de-
termining the amount of a civil money 
penalty imposed under this subpara-
graph, the Secretary may consider the 
size, business structure, and type of 
pharmacy involved, as well as the type 
of violation and other relevant factors, 
as determined appropriate by the Sec-
retary. 
‘‘(iv) RULE
OF
APPLICATION.—The 
provisions of section 1128A (other than 
subsections (a) and (b)) shall apply to a 
civil money penalty under this subpara-
graph in the same manner as such provi-
sions apply to a civil money penalty or pro-
ceeding under section 1128A(a). 
‘‘(I) LIMITATION ON USE OF AP-
PLICABLE
NON-RETAIL
PHARMACY 
PRICING
INFORMATION.—No 
State 
shall use pricing information reported 
by applicable non-retail pharmacies 
under subparagraph (A)(ii) to develop 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00148
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
149 
or inform payment methodologies for 
retail community pharmacies.’’; 
(5) in paragraph (2)— 
(A) in subparagraph (A), by inserting ‘‘, 
including payment rates and methodologies for 
determining 
ingredient 
cost 
reimbursement 
under managed care entities or other specified 
entities (as such terms are defined in section 
1903(m)(9)(D)),’’ after ‘‘under this title’’; and 
(B) in subparagraph (B), by inserting 
‘‘and the basis for such dispensing fees’’ before 
the semicolon; 
(6) by redesignating paragraph (4) as para-
graph (5); 
(7) by inserting after paragraph (3) the fol-
lowing new paragraph: 
‘‘(4) OVERSIGHT.— 
‘‘(A) IN GENERAL.—The Inspector General 
of the Department of Health and Human Serv-
ices shall conduct periodic studies of the survey 
data reported under this subsection, as appro-
priate, including with respect to substantial 
variations in acquisition costs or other applica-
ble costs, as well as with respect to how internal 
transfer prices and related party transactions 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00149
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
150 
may influence the costs reported by pharmacies 
that are affiliates (as defined in subsection 
(k)(14)) or are owned by, controlled by, or re-
lated under a common ownership structure with 
a wholesaler, distributor, or other entity that 
acquires covered outpatient drugs relative to 
costs reported by pharmacies not affiliated with 
such entities. The Inspector General shall pro-
vide periodic updates to Congress on the results 
of such studies, as appropriate, in a manner 
that does not disclose trade secrets or other 
proprietary information. 
‘‘(B) APPROPRIATION.—There is appro-
priated to the Inspector General of the Depart-
ment of Health and Human Services, out of 
any money in the Treasury not otherwise ap-
propriated, $5,000,000 for fiscal year 2025, to 
remain available until expended, to carry out 
this paragraph.’’; and 
(8) in paragraph (5), as so redesignated— 
(A) by inserting ‘‘, and $9,000,000 for fis-
cal year 2025 and each fiscal year thereafter,’’ 
after ‘‘2010’’; and 
(B) by inserting ‘‘Funds appropriated 
under this paragraph for fiscal year 2025 and 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00150
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
151 
any subsequent fiscal year shall remain avail-
able until expended.’’ after the period. 
(b) DEFINITIONS.—Section 1927(k) of the Social Se-
curity Act (42 U.S.C. 1396r–8(k)) is amended— 
(1) in the matter preceding paragraph (1), by 
striking ‘‘In the section’’ and inserting ‘‘In this sec-
tion’’; and 
(2) by adding at the end the following new 
paragraphs: 
‘‘(12) APPLICABLE NON-RETAIL PHARMACY.— 
The term ‘applicable non-retail pharmacy’ means a 
pharmacy that is licensed as a pharmacy by the 
State and that is not a retail community pharmacy, 
including a pharmacy that dispenses prescription 
medications to patients primarily through mail and 
specialty pharmacies. Such term does not include 
nursing home pharmacies, long-term care facility 
pharmacies, hospital pharmacies, clinics, charitable 
or not-for-profit pharmacies, government phar-
macies, or low dispensing pharmacies (as defined by 
the Secretary). 
‘‘(13) AFFILIATE.—The term ‘affiliate’ means 
any entity that is owned by, controlled by, or related 
under a common ownership structure with a phar-
macy benefit manager or a managed care entity or 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00151
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
152 
other specified entity (as such terms are defined in 
section 1903(m)(9)(D)).’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by this section shall take ef-
fect on the first day of the first quarter that begins 
on or after the date that is 6 months after the date 
of enactment of this Act. 
(2) DELAYED
APPLICATION
TO
APPLICABLE 
NON-RETAIL
PHARMACIES.—The pharmacy survey 
requirements established by the amendments to sec-
tion 1927(f) of the Social Security Act (42 U.S.C. 
1396r–8(f)) made by this section shall apply to re-
tail community pharmacies beginning on the effec-
tive date described in paragraph (1), but shall not 
apply to applicable non-retail pharmacies until the 
first day of the first quarter that begins on or after 
the date that is 18 months after the date of enact-
ment of this Act. 
(d) IDENTIFICATION OF APPLICABLE NON-RETAIL 
PHARMACIES.— 
(1) IN GENERAL.—Not later than January 1, 
2027, the Secretary of Health and Human Services 
shall publish guidance specifying pharmacies that 
meet the definition of applicable non-retail phar-
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00152
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
153 
macies (as such term is defined in subsection 
(k)(12) of section 1927 of the Social Security Act 
(42 U.S.C. 1396r–8), as added by subsection (b)), 
and that will be subject to the survey requirements 
under subsection (f)(1) of such section, as amended 
by subsection (a). 
(2) INCLUSION
OF
PHARMACY
TYPE
INDICA-
TORS.—The guidance published under paragraph (1) 
shall include pharmacy type indicators to distinguish 
between different types of applicable non-retail phar-
macies, such as pharmacies that dispense prescrip-
tions primarily through the mail and pharmacies 
that dispense prescriptions that require special han-
dling or distribution. An applicable non-retail phar-
macy may be identified through multiple pharmacy 
type indicators. 
(e) IMPLEMENTATION.— 
(1) Implementation of the amendments made 
by this section shall be exempt from the require-
ments of section 553 of title 5, United States Code. 
(f) NONAPPLICATION OF PAPERWORK REDUCTION 
ACT.—Chapter 35 of title 44, United States Code, shall 
not apply to any data collection undertaken by the Sec-
retary of Health and Human Services under section 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00153
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
154 
1927(f) of the Social Security Act (42 U.S.C. 1396r–8(f)), 
as amended by this section. 
SEC. 6. PREVENTING THE USE OF ABUSIVE SPREAD PRIC-
ING IN MEDICAID. 
(a) IN GENERAL.—Section 1927 of the Social Secu-
rity Act (42 U.S.C. 1396r–8) is amended— 
(1) in subsection (e), by adding at the end the 
following new paragraph: 
‘‘(6) TRANSPARENT PRESCRIPTION DRUG PASS- 
THROUGH PRICING REQUIRED.— 
‘‘(A) IN
GENERAL.—A contract between 
the State and a pharmacy benefit manager (re-
ferred to in this paragraph as a ‘PBM’), or a 
contract between the State and a managed care 
entity or other specified entity (as such terms 
are defined in section 1903(m)(9)(D) and col-
lectively referred to in this paragraph as the 
‘entity’) that includes provisions making the en-
tity responsible for coverage of covered out-
patient drugs dispensed to individuals enrolled 
with the entity, shall require that payment for 
such drugs and related administrative services 
(as applicable), including payments made by a 
PBM on behalf of the State or entity, is based 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00154
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
155 
on a transparent prescription drug pass- 
through pricing model under which— 
‘‘(i) any payment made by the entity 
or the PBM (as applicable) for such a 
drug— 
‘‘(I) is limited to— 
‘‘(aa) ingredient cost; and 
‘‘(bb) a professional dis-
pensing fee that is not less than 
the professional dispensing fee 
that the State would pay if the 
State were making the payment 
directly in accordance with the 
State plan; 
‘‘(II) is passed through in its en-
tirety (except as reduced under Fed-
eral or State laws and regulations in 
response to instances of waste, fraud, 
or abuse) by the entity or PBM to the 
pharmacy or provider that dispenses 
the drug; and 
‘‘(III) is made in a manner that 
is consistent with sections 447.502, 
447.512, 447.514, and 447.518 of 
title 42, Code of Federal Regulations 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00155
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
156 
(or any successor regulation) as if 
such requirements applied directly to 
the entity or the PBM, except that 
any payment by the entity or the 
PBM for the ingredient cost of such 
drug purchased by a covered entity 
(as defined in subsection (a)(5)(B)) 
may exceed the actual acquisition cost 
(as defined in 447.502 of title 42, 
Code of Federal Regulations, or any 
successor regulation) for such drug 
if— 
‘‘(aa) such drug was subject 
to an agreement under section 
340B of the Public Health Serv-
ice Act; 
‘‘(bb) such payment for the 
ingredient cost of such drug does 
not exceed the maximum pay-
ment that would have been made 
by the entity or the PBM for the 
ingredient cost of such drug if 
such drug had not been pur-
chased by such covered entity; 
and 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00156
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
157 
‘‘(cc) such covered entity re-
ports to the Secretary (in a form 
and manner specified by the Sec-
retary), on an annual basis and 
with respect to payments for the 
ingredient costs of such drugs so 
purchased by such covered entity 
that are in excess of the actual 
acquisition costs for such drugs, 
the aggregate amount of such ex-
cess; 
‘‘(ii) payment to the entity or the 
PBM (as applicable) for administrative 
services performed by the entity or PBM is 
limited to an administrative fee that re-
flects the fair market value (as defined by 
the Secretary) of such services; 
‘‘(iii) the entity or the PBM (as appli-
cable) makes available to the State, and 
the Secretary upon request in a form and 
manner specified by the Secretary, all costs 
and payments related to covered outpatient 
drugs and accompanying administrative 
services (as described in clause (ii)) in-
curred, received, or made by the entity or 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00157
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
158 
the PBM, broken down (as specified by the 
Secretary), to the extent such costs and 
payments are attributable to an individual 
covered outpatient drug, by each such 
drug, including any ingredient costs, pro-
fessional dispensing fees, administrative 
fees (as described in clause (ii)), post-sale 
and post-invoice fees, discounts, or related 
adjustments such as direct and indirect re-
muneration fees, and any and all other re-
muneration, as defined by the Secretary; 
and 
‘‘(iv) any form of spread pricing 
whereby any amount charged or claimed by 
the entity or the PBM (as applicable) that 
exceeds the amount paid to the pharmacies 
or providers on behalf of the State or enti-
ty, including any post-sale or post-invoice 
fees, discounts, or related adjustments 
such as direct and indirect remuneration 
fees or assessments, as defined by the Sec-
retary, (after allowing for an administra-
tive fee as described in clause (ii)) is not 
allowable for purposes of claiming Federal 
matching payments under this title. 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00158
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
160 
(2) in subsection (k), as previously amended by 
this title, by adding at the end the following new 
paragraph: 
‘‘(14) PHARMACY
BENEFIT
MANAGER.—The 
term ‘pharmacy benefit manager’ means any person 
or entity that, either directly or through an inter-
mediary, acts as a price negotiator or group pur-
chaser on behalf of a State, managed care entity (as 
defined in section 1903(m)(9)(D)), or other specified 
entity (as so defined), or manages the prescription 
drug benefits provided by a State, managed care en-
tity, or other specified entity, including the proc-
essing and payment of claims for prescription drugs, 
the performance of drug utilization review, the proc-
essing of drug prior authorization requests, the man-
aging of appeals or grievances related to the pre-
scription drug benefits, contracting with pharmacies, 
controlling the cost of covered outpatient drugs, or 
the provision of services related thereto. Such term 
includes any person or entity that acts as a price ne-
gotiator (with regard to payment amounts to phar-
macies and providers for a covered outpatient drug 
or the net cost of the drug) or group purchaser on 
behalf of a State, managed care entity, or other 
specified entity or that carries out 1 or more of the 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00160
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
161 
other activities described in the preceding sentence, 
irrespective of whether such person or entity calls 
itself a pharmacy benefit manager.’’. 
(b) CONFORMING AMENDMENTS.—Section 1903(m) 
of such Act (42 U.S.C. 1396b(m)) is amended— 
(1) in paragraph (2)(A)(xiii)— 
(A) by striking ‘‘and (III)’’ and inserting 
‘‘(III)’’; 
(B) by inserting before the period at the 
end the following: ‘‘, and (IV) if the contract in-
cludes provisions making the entity responsible 
for coverage of covered outpatient drugs, the 
entity shall comply with the requirements of 
section 1927(e)(6)’’; and 
(C) by moving the margin 2 ems to the 
left; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(10) No payment shall be made under 
this title to a State with respect to expenditures 
incurred by the State for payment for services 
provided by an other specified entity (as defined 
in paragraph (9)(D)(iii)) unless such services 
are provided in accordance with a contract be-
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00161
Fmt 6652
Sfmt 6201
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS
162 
tween the State and such entity which satisfies 
the requirements of paragraph (2)(A)(xiii).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to contracts between States and 
managed care entities, other specified entities, or phar-
macy benefit managers that have an effective date begin-
ning on or after the date that is 18 months after the date 
of enactment of this Act. 
(d) IMPLEMENTATION.— 
(1) Implementation of the amendments made 
by this section shall be exempt from the require-
ments of section 553 of title 5, United States Code. 
(e) NONAPPLICATION OF PAPERWORK REDUCTION 
ACT.—Chapter 35 of title 44, United States Code, shall 
not apply to any data collection undertaken by the Sec-
retary of Health and Human Services under section 
1927(e) of the Social Security Act (42 U.S.C. 1396r– 
8(e)), as amended by this section. 
Æ 
VerDate Sep 11 2014 
03:21 Jul 29, 2025
Jkt 059200
PO 00000
Frm 00162
Fmt 6652
Sfmt 6301
E:\BILLS\H4317.IH
H4317
ssavage on LAPJG3WLY3PROD with BILLS