IIB 
116TH CONGRESS 
1ST SESSION H. R. 2115 
IN THE SENATE OF THE UNITED STATES 
OCTOBER 29, 2019 
Received; read twice and referred to the Committee on Finance 
AN ACT 
To amend titles XI and XVIII of the Social Security Act 
to provide greater transparency for discounts provided 
by manufacturers, to include real-time benefit informa-
tion as part of a prescription drug plan’s electronic pre-
scription program under the Medicare program, and for 
other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Public Disclosure of 
Drug Discounts and Real-Time Beneficiary Drug Cost 
Act’’. 
SEC. 2. PUBLIC DISCLOSURE OF DRUG DISCOUNTS. 
Section 1150A of the Social Security Act (42 U.S.C. 
1320b–23) is amended— 
(1) in subsection (c), in the matter preceding 
paragraph (1), by inserting ‘‘(other than as per-
mitted under subsection (e))’’ after ‘‘disclosed by the 
Secretary’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(e) PUBLIC AVAILABILITY OF CERTAIN INFORMA-
TION.— 
‘‘(1) IN GENERAL.—In order to allow the com-
parison of PBMs’ ability to negotiate rebates, dis-
counts, direct and indirect remuneration fees, ad-
ministrative fees, and price concessions and the 
amount of such rebates, discounts, direct and indi-
rect remuneration fees, administrative fees, and 
price concessions that are passed through to plan 
sponsors, beginning January 1, 2020, the Secretary 
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shall make available on the Internet website of the 
Department of Health and Human Services the in-
formation with respect to the second preceding cal-
endar year provided to the Secretary on generic dis-
pensing rates (as described in paragraph (1) of sub-
section (b)) and information provided to the Sec-
retary under paragraphs (2) and (3) of such sub-
section that, as determined by the Secretary, is with 
respect to each PBM. 
‘‘(2) AVAILABILITY OF DATA.—In carrying out 
paragraph (1), the Secretary shall ensure the fol-
lowing: 
‘‘(A) CONFIDENTIALITY.—The information 
described in such paragraph is displayed in a 
manner that prevents the disclosure of informa-
tion, with respect to an individual drug or an 
individual plan, on rebates, discounts, direct 
and indirect remuneration fees, administrative 
fees, and price concessions. 
‘‘(B) CLASS OF DRUG.—The information 
described in such paragraph is made available 
by class of drug, using an existing classification 
system, but only if the class contains such num-
ber of drugs, as specified by the Secretary (but 
not fewer than three drugs), to ensure confiden-
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tiality of proprietary information or other infor-
mation that is prevented to be disclosed under 
subparagraph (A).’’. 
SEC. 3. REQUIRING PRESCRIPTION DRUG PLAN SPONSORS 
TO INCLUDE REAL-TIME BENEFIT INFORMA-
TION AS PART OF SUCH SPONSOR’S ELEC-
TRONIC PRESCRIPTION PROGRAM UNDER 
THE MEDICARE PROGRAM. 
Section 1860D–4(e)(2) of the Social Security Act (42 
U.S.C. 1395w–104(e)(2)) is amended— 
(1) in subparagraph (D), by striking ‘‘To the 
extent’’ and inserting ‘‘Except as provided in sub-
paragraph (F), to the extent’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(F) 
REAL-TIME
BENEFIT
INFORMA-
TION.— 
‘‘(i) IN
GENERAL.—Not later than 
January 1, 2021, the program shall imple-
ment real-time benefit tools that are capa-
ble of integrating with a prescribing health 
care professional’s electronic prescribing or 
electronic health record system for the 
transmission of formulary and benefit in-
formation in real time to prescribing health 
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care professionals. With respect to a cov-
ered part D drug, such tools shall be capa-
ble of transmitting such information spe-
cific to an individual enrolled in a prescrip-
tion drug plan. Such information shall in-
clude the following: 
‘‘(I) A list of any clinically-appro-
priate alternatives to such drug in-
cluded in the formulary of such plan. 
‘‘(II) Cost-sharing information 
for such drug and such alternatives, 
including a description of any vari-
ance in cost sharing based on the 
pharmacy dispensing such drug or 
such alternatives. 
‘‘(III) Information relating to 
whether such drug is included in the 
formulary of such plan and any prior 
authorization or other utilization man-
agement requirements applicable to 
such drug and such alternatives so in-
cluded. 
‘‘(ii) ELECTRONIC
TRANSMISSION.— 
The provisions of subclauses (I) and (II) of 
clause (ii) of subparagraph (E) shall apply 
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to an electronic transmission described in 
clause (i) in the same manner as such pro-
visions apply with respect to an electronic 
transmission described in clause (i) of such 
subparagraph. 
‘‘(iii) SPECIAL RULE FOR 2021.—The 
program shall be deemed to be in compli-
ance with clause (i) for 2021 if the pro-
gram complies with the provisions of sec-
tion 423.160(b)(7) of title 42, Code of 
Federal Regulations (or a successor regula-
tion), for such year. 
‘‘(iv) RULE
OF
CONSTRUCTION.— 
Nothing in this subparagraph shall be con-
strued as to allow a real-time benefits tool 
to steer an individual, without the consent 
of the individual, to a particular pharmacy 
or pharmacy setting over their preferred 
pharmacy setting nor prohibit the designa-
tion of a preferred pharmacy under such 
tool.’’. 
SEC. 4. SENSE OF CONGRESS REGARDING THE NEED TO EX-
PAND 
COMMERCIALLY 
AVAILABLE 
DRUG 
PRICING COMPARISON PLATFORMS. 
It is the sense of Congress that— 
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(1) commercially available drug pricing com-
parison platforms can, at no cost, help patients find 
the lowest price for their medications at their local 
pharmacy; 
(2) such platforms should be integrated, to the 
maximum extent possible, in the health care delivery 
ecosystem; and 
(3) pharmacy benefit managers should work to 
disclose generic and brand name drug prices to such 
platforms to ensure that— 
(A) patients can benefit from the lowest 
possible price available to them; and 
(B) overall drug prices can be reduced as 
more educated purchasing decisions are made 
based on price transparency. 
Passed the House of Representatives October 28, 
2019. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
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