‘‘(cc) the average net spend-
ing per 30-day supply and per 
90-day supply, incurred by the 
plan and its participants and 
beneficiaries, among all drugs 
within the therapeutic class for 
which a claim was filed during 
the reporting period. 
‘‘(2) PRIVACY
REQUIREMENTS.—Entities pro-
viding pharmacy benefits management services on be-
half of a group health plan shall provide information 
under paragraph (1) in a manner consistent with the 
privacy, security, and breach notification regulations 
promulgated under section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996, and 
shall restrict the use and disclosure of such informa-
tion according to such privacy regulations. 
‘‘(3) DISCLOSURE AND REDISCLOSURE.— 
‘‘(A) LIMITATION
TO
BUSINESS
ASSOCI-
ATES.—A group health plan receiving a report 
under paragraph (1) may disclose such informa-
tion only to business associates of such plan as 
defined in section 160.103 of title 45, Code of 
Federal Regulations (or successor regulations). 
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‘‘(B) CLARIFICATION
REGARDING
PUBLIC 
DISCLOSURE OF INFORMATION.—Nothing in this 
section prevents an entity providing pharmacy 
benefits management services on behalf of a 
group health plan from placing reasonable re-
strictions on the public disclosure of the informa-
tion contained in a report described in para-
graph (1), except that such entity may not re-
strict disclosure of such report to the Department 
of Health and Human Services, the Department 
of Labor, the Department of the Treasury, the 
Comptroller General of the United States, or ap-
plicable State agencies. 
‘‘(C) LIMITED FORM OF REPORT.—The Sec-
retary shall define through rulemaking a limited 
form of the report under paragraph (1) required 
of plan administrators who are drug manufac-
turers, drug wholesalers, or other direct partici-
pants in the drug supply chain, in order to pre-
vent anti-competitive behavior. 
‘‘(4) REPORT
TO
GAO.—An entity providing 
pharmacy benefits management services on behalf of 
a group health plan shall submit to the Comptroller 
General of the United States each of the first 4 reports 
submitted to a plan administrator under paragraph 
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(1) with respect to such plan, and other such reports 
as requested, in accordance with the privacy require-
ments under paragraph (2), the disclosure and re-
disclosure standards under paragraph (3), the stand-
ards specified pursuant to paragraph (5). 
‘‘(5) STANDARD
FORMAT.—Not later than 6 
months after the date of enactment of this section, the 
Secretary shall specify through rulemaking standards 
for entities required to submit reports under para-
graph (4) to submit such reports in a standard for-
mat. 
‘‘(c) ENFORCEMENT.— 
‘‘(1) FAILURE
TO
PROVIDE
TIMELY
INFORMA-
TION.—An entity providing pharmacy benefits man-
agement services that violates subsection (a) or fails 
to provide information required under subsection (b) 
shall be subject to a civil monetary penalty in the 
amount of $10,000 for each day during which such 
violation continues or such information is not dis-
closed or reported. 
‘‘(2) FALSE INFORMATION.—An entity providing 
pharmacy benefits management services that know-
ingly 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 
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information. Such civil money penalty shall be in ad-
dition to other penalties as may be prescribed by law. 
‘‘(3) PROCEDURE.—The provisions of section 
1128A of the Social Security Act, other than sub-
section (a) and (b) and the first sentence of subsection 
(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 Security Act. 
‘‘(4) 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 section. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to permit a group health plan, or 
other entity to restrict disclosure to, or otherwise limit the 
access of, the Department of the Treasury to a report de-
scribed in subsection (b)(1) or information related to com-
pliance with subsection (a) by such plan or entity. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) LARGE EMPLOYER.—The term ‘large em-
ployer’ means, in connection with a group health 
plan with respect to a calendar year and a plan year, 
an employer who employed an average of at least 50 
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employees on business days during the preceding cal-
endar year and who employs at least 1 employee on 
the first day of the plan year. 
‘‘(2) WHOLESALE ACQUISITION COST.—The term 
‘wholesale acquisition cost’ has the meaning given 
such term in section 1847A(c)(6)(B) of the Social Se-
curity Act.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for subchapter B of chapter 100 of the Internal 
Revenue Code of 1986 is amended by adding at the 
end the following new item: 
‘‘Sec. 9826. Oversight of pharmacy benefits manager services.’’. 
SEC. 4. INFORMATION ON PRESCRIPTION DRUGS. 
(a) IN GENERAL.—Subpart B of part 7 of subtitle B 
of title I of the Employee Retirement Income Security Act 
of 1974 (29 U.S.C. 1185 et seq.), as amended by section 
3, is further amended by adding at the end the following 
new section: 
‘‘SEC. 727. INFORMATION ON PRESCRIPTION DRUGS. 
‘‘(a) IN GENERAL.—A group health plan or a health 
insurance issuer offering group health insurance coverage 
shall— 
‘‘(1) not restrict, directly or indirectly, any 
pharmacy that dispenses a prescription drug to a 
participant of beneficiary in the plan or coverage 
from informing (or penalize such pharmacy for in-
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forming) a participant or beneficiary of any differen-
tial between the participant’s or beneficiary’s out-of- 
pocket cost under the plan or coverage with respect 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; and 
‘‘(2) ensure that any entity that provides phar-
macy benefits management services under a contract 
with any such health plan or health insurance cov-
erage does not, with respect to such plan or coverage, 
restrict, directly or indirectly, a pharmacy that dis-
penses a prescription drug from informing (or penal-
ize such pharmacy for informing) a participant or 
beneficiary of any differential between the partici-
pant’s or beneficiary’s out-of-pocket cost under the 
plan or coverage with respect 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 participant or 
beneficiary under the plan or coverage, including any cost- 
sharing (including any deductible, copayment, or coinsur-
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ance) and, as determined by the Secretary, any other ex-
penditure.’’. 
(b) CLERICAL AMENDMENT.—The table of contents in 
section 1 of the Employee Retirement Income Security Act 
of 1974 (29 U.S.C. 1001 et seq.), as amended by section 
3, is further amended by inserting after the item relating 
to section 726 the following new item: 
‘‘Sec. 727. Information on prescription drugs.’’. 
SEC. 5. ADVISORY COMMITTEE ON THE ACCESSIBILITY OF 
CERTAIN INFORMATION. 
(a) IN GENERAL.—Not later than January 1, 2025, 
the Secretary of Labor (in this section referred to as the 
‘‘Secretary’’) shall convene an Advisory Committee (in this 
section referred to as the ‘‘Committee’’) consisting of 9 mem-
bers to advise the Secretary on how to improve the accessi-
bility and usability of information made available in ac-
cordance the amendments made by section 3 and by section 
204 of division BB of the Consolidated Appropriation Act, 
2021 (Public Law 116–260), streamline the reporting of 
such information, and ensure that such information fully 
meets the needs of employers, patients, researchers, regu-
lators, and purchasers. 
(b) MEMBERSHIP.—The Secretary shall appoint mem-
bers representing end-users of the information described in 
subsection (a). Vacancies on the Committee shall be filled 
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by appointment consistent with this subsection not later 
than 3 months after the vacancy arises. 
(c) TERMINATION.—The Committee established under 
this section shall terminate on January 1, 2028. 
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Union Calendar No. 767 
118TH CONGRESS 
2D SESSION 
H. R. 4507 
[Report No. 118–742, Part I] 
A BILL 
To amend the Employee Retirement Income Secu-
rity Act of 1974 to promote transparency in 
health coverage and reform pharmacy benefit 
management services with respect to group 
health plans, and for other purposes. 
DECEMBER 19, 2024 
Committees on Energy and Commerce and Ways and 
Means discharged; committed to the Committee of the 
Whole House on the State of the Union and ordered 
to be printed 
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