SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Know the Cost Act 
of 2018’’. 
SEC. 2. PROHIBITION ON LIMITING CERTAIN INFORMATION 
ON DRUG PRICES. 
(a) IN GENERAL.— 
(1) GROUP HEALTH PLANS AND HEALTH IN-
SURANCE ISSUERS.—Subpart II of part A of title 
XXVII of the Public Health Service Act (42 U.S.C. 
300gg–11 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 2729. INFORMATION ON PRESCRIPTION DRUGS. 
‘‘(a) IN GENERAL.—A group health plan or a health 
insurance issuer offering group or individual health insur-
ance coverage shall— 
‘‘(1) not restrict, directly or indirectly, any 
pharmacy that dispenses a prescription drug to an 
enrollee in the plan or coverage from informing (or 
penalize such pharmacy for informing) an enrollee of 
any differential between the enrollee’s out-of-pocket 
cost under the plan or coverage with respect to ac-
quisition of the drug and the amount an individual 
would pay for acquisition of the drug without using 
any health plan or health insurance coverage; and 
‘‘(2) ensure that any entity that provides phar-
macy benefits management services under a contract 
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with any such health plan or health insurance cov-
erage does not, with respect to such plan or cov-
erage, restrict, directly or indirectly, a pharmacy 
that dispenses a prescription drug from informing 
(or penalize such pharmacy for informing) an en-
rollee of any differential between the enrollee’s out- 
of-pocket cost under the plan or coverage with re-
spect to acquisition of the drug and the amount an 
individual would pay for acquisition of the drug 
without using any health plan or health insurance 
coverage. 
‘‘(b) DEFINITION.—For purposes of this section, the 
term ‘out-of-pocket cost’, with respect to acquisition of a 
drug, means the amount to be paid by the enrollee under 
the plan or coverage, including any cost-sharing (including 
any deductible, copayment, or coinsurance) and, as deter-
mined by the Secretary, any other expenditure.’’. 
(2) PRESCRIPTION DRUG PLAN SPONSORS AND 
MEDICARE
ADVANTAGE
ORGANIZATIONS.—Section 
1860D–4 of the Social Security Act (42 U.S.C. 
1395w–104) is amended by adding at the end the 
following new subsection: 
‘‘(m) PROHIBITION ON LIMITING CERTAIN INFORMA-
TION ON DRUG PRICES.—A PDP sponsor and a Medicare 
Advantage organization shall ensure that each prescrip-
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tion drug plan or MA–PD plan offered by the sponsor or 
organization does not restrict a pharmacy that dispenses 
a prescription drug or biological from informing, nor pe-
nalize such pharmacy for informing, an enrollee in such 
plan of any differential between the negotiated price of, 
or copayment or coinsurance for, the drug or biological 
to the enrollee under the plan and a lower price the indi-
vidual would pay for the drug or biological if the enrollee 
obtained the drug without using any health insurance cov-
erage.’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply with respect to plan 
years beginning on or after January 1, 2020. 
(b) MEDICARE
BENEFICIARY
NOTICE
REQUIRE-
MENTS.— 
(1) ANNUAL
NOTICE
REQUIREMENT.—Section 
1804(c) of the Social Security Act (42 U.S.C. 
1395b–2(c)) is amended— 
(A) in paragraph (3), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (4), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
paragraph: 
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‘‘(5) with respect to a notice provided on or 
after January 1, 2020, and an individual enrolled in 
a prescription drug plan under part D or an MA– 
PD plan under part C, information on the potential 
effects purchasing a drug without using benefits pro-
vided under such prescription drug plan or MA–PD 
plan may have on such individual’s deductible and 
future cost-sharing obligations under such prescrip-
tion drug plan or MA–PD plan.’’. 
(2) MA ORGANIZATION AND PDP SPONSOR DIS-
CLOSURES.— 
(A) IN GENERAL.—Section 1852(c)(1) of 
the Social Security Act (42 U.S.C. 1395w– 
22(c)(1)) is amended by adding at the end the 
following new subparagraph: 
‘‘(J) DRUG PURCHASING INFORMATION.— 
With respect to an enrollee in an MA–PD plan, 
information in a form and manner specified by 
the Secretary on the potential effects pur-
chasing a drug without using benefits provided 
under such plan may have on such individual’s 
deductible and future cost-sharing obligations 
under such plan.’’. 
(B) EFFECTIVE
DATE.—The amendment 
made by this paragraph shall apply with respect 
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to disclosures made on or after January 1, 
2020. 
Æ 
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