I 
116TH CONGRESS 
1ST SESSION H. R. 5442 
To amend title XXVII of the Public Health Service Act and title XVIII 
of the Social Security Act to require pharmacies to disclose any differen-
tial between the cost of a prescription drug based on whether certain 
individuals use prescription drug coverage to acquire such drug, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 16, 2019 
Ms. PORTER (for herself and Ms. DELAURO) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XXVII of the Public Health Service Act 
and title XVIII of the Social Security Act to require 
pharmacies to disclose any differential between the cost 
of a prescription drug based on whether certain individ-
uals use prescription drug coverage to acquire such drug, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Lowest Price for Pa-
tients Act’’. 
SEC. 2. REQUIREMENT FOR PHARMACIES TO DISCLOSE 
ANY DIFFERENTIAL BETWEEN THE COST OF 
A PRESCRIPTION DRUG BASED ON WHETHER 
CERTAIN INDIVIDUALS USE PRESCRIPTION 
DRUG COVERAGE TO ACQUIRE SUCH DRUG. 
(a) ENROLLEES OF PRESCRIPTION DRUG COVERAGE 
UNDER A GROUP HEALTH PLAN OR A HEALTH INSUR-
ANCE ISSUER OFFERING GROUP OR INDIVIDUAL HEALTH 
INSURANCE COVERAGE.—Section 2729(a) of the Public 
Health Service Act (42 U.S.C. 300gg–29(a)) is amend-
ed— 
(1) in paragraph (1)— 
(A) by striking ‘‘not restrict, directly or in-
directly,’’ and inserting ‘‘provide that’’; and 
(B) by striking ‘‘from informing (or penal-
ize such pharmacy for informing)’’ and insert-
ing ‘‘inform’’; and 
(2) in paragraph (2)— 
(A) by striking ‘‘ensure’’ and inserting 
‘‘provide’’; 
(B) by striking ‘‘does not, with respect to 
such plan or coverage, restrict, directly or indi-
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rectly,’’ and inserting ‘‘requires under such con-
tract that’’; and 
(C) by striking ‘‘from informing (or penal-
ize such pharmacy for informing)’’ and insert-
ing ‘‘inform’’. 
(b) ENROLLEES OF PRESCRIPTION DRUG COVERAGE 
UNDER
A
PRESCRIPTION
DRUG
PLAN
OR
MA–PD 
PLAN.—Section 1860D–4 of the Social Security Act (42 
U.S.C. 1395w–104) is amended— 
(1) by redesignating the subsection (m) as in-
serted by section 6063(c) of the SUPPORT for Pa-
tients and Communities Act as subsection (n); and 
(2) by adding at the end the following new sub-
section: 
‘‘(o) PHARMACY DISCLOSURE OF THE PRICE OF A 
DRUG FOR AN ENROLLEE USING AND NOT USING PRE-
SCRIPTION DRUG COVERAGE.—For plan year 2020 and 
each subsequent plan year, a PDP sponsor and a Medicare 
Advantage organization offering a prescription drug plan 
or MA–PD plan under a contract with an entity that pro-
vides pharmacy benefits management services on behalf 
of such MA–PD plan shall provide that each pharmacy 
that dispenses a coverage part D drug shall inform an en-
rollee of any differential between— 
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‘‘(1) the price of the drug for an individual that 
is an enrollee under such prescription drug plan or 
MA–PD plan (as the case may be) using such plan; 
and 
‘‘(2) the price of the drug for such individual 
described in paragraph (1) without using such 
plan.’’. 
Æ 
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