Title: Patient Right to Know Drug Prices Act
Policy area: Health

Summary:
Patient Right to Know Drug Prices Act
(Sec. 2) This bill amends the Public Health Service Act to prohibit a health insurance plan or pharmacy benefits manager from restricting a pharmacy from informing an enrollee of any difference between the out-of-pocket cost of a drug under the plan and the cost of the drug without health insurance coverage. (Such restrictions are commonly referred to as gag clauses.)
(Sec. 3) The bill also amends the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to apply certain antitrust filing requirements for generic drug applicants to biosimilar biological product applicants. (Biosimilar biological products, commonly referred to as biosimilars, are biological products approved by the Food and Drug Administration based on their similarity to an already-approved biological product.) Under current law, generic drug applicants that make agreements with brand name drug companies or other generic drug applicants regarding the manufacture, marketing, or sale of their drugs must file such agreements with the Federal Trade Commission and the Department of Justice. The bill subjects biosimilar biological product applicants to the same filing requirements.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2554 Introduced in Senate (IS)]

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115th CONGRESS
  2d Session
                                S. 2554

 To ensure that health insurance issuers and group health plans do not 
   prohibit pharmacy providers from providing certain information to 
                               enrollees.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 14, 2018

 Ms. Collins (for herself, Mrs. McCaskill, Mr. Barrasso, Ms. Stabenow, 
 and Mr. Cassidy) introduced the following bill; which was read twice 
and referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To ensure that health insurance issuers and group health plans do not 
   prohibit pharmacy providers from providing certain information to 
                               enrollees.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Patient Right to Know Drug Prices 
Act''.

SEC. 2. PROHIBITION ON LIMITING CERTAIN INFORMATION ON DRUG PRICES.

    (a) Exchange Plans.--Section 1311(e) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031(e)) is amended by adding at the 
end the following:
            ``(4) Information on prescription drugs.--The Exchange 
        shall require health plans seeking certification as qualified 
        health plans to ensure that--
                    ``(A) the health insurance issuer does not restrict 
                any pharmacy that dispenses a prescription drug to an 
                enrollee in the plan from informing (or penalize such 
                pharmacy for informing) an enrollee of any differential 
                between the price of the drug to the enrollee under the 
                plan and the price the individual would pay for the 
                drug if the enrollee obtained the drug without using 
                any health insurance coverage; and
                    ``(B) any entity that provides pharmacy benefits 
                management services under a contract with any such 
                health plan does not, with respect to such plan or any 
                health benefits plan that the entity contracts with to 
                provide pharmacy benefits management services and that 
                is offered by an entity other than such sponsor or 
                organization, restrict a pharmacy that dispenses a 
                prescription drug from informing (or penalize such 
                pharmacy for informing) an enrollee of any differential 
                between the price of the drug to the enrollee under the 
                plan and the price the individual would pay for the 
                drug if the enrollee obtained the drug without using 
                any health insurance coverage.''.
    (b) Other Health Plans.--The provisions of section 1311(e)(4) of 
the Patient Protection and Affordable Care Act (as added by subsection 
(a)) shall apply to all health insurance issuers with respect to health 
insurance coverage and to all group health plans (as such terms are 
defined in section 2791 of the Public Health Service Act (42 U.S.C. 
300gg-91)).
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