Title: Know the Lowest Price Act of 2018
Policy area: Health

Summary:
Know the Lowest Price Act of 2018
This bill prohibits a health-benefits plan or pharmacy-benefits manager under Medicare or Medicare Advantage from restricting a pharmacy from informing an enrollee of any difference between the price of a drug under the plan and the price of the drug without health-insurance coverage.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 2553 Introduced in Senate (IS)]

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115th CONGRESS
  2d Session
                                S. 2553

  To amend title XVIII of the Social Security Act to prohibit health 
 plans and pharmacy benefit managers from restricting pharmacies from 
   informing individuals regarding the prices for certain drugs and 
                              biologicals.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 14, 2018

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

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to prohibit health 
 plans and pharmacy benefit managers from restricting pharmacies from 
   informing individuals regarding the prices for certain drugs and 
                              biologicals.

    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 ``Know the Lowest Price Act of 2018''.

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

    (a) In General.--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 Information on Drug Prices.--
A PDP sponsor and a Medicare Advantage organization shall ensure that--
            ``(1) any health benefits plan offered by the sponsor or 
        organization, including a prescription drug plan and an MA-PD 
        plan, does not restrict a pharmacy that dispenses a 
        prescription drug or biological from informing (or penalize 
        such pharmacy for informing) an enrollee of any differential 
        between the price of the drug or biological to the enrollee 
        under the plan and the price the individual would pay for the 
        drug or biological if the enrollee obtained the drug without 
        using any health insurance coverage; and
            ``(2) any entity that provides pharmacy benefits management 
        services under a contract with any health benefits plan offered 
        by the sponsor or organization 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 or 
        biological from informing (or penalize such pharmacy for 
        informing) an enrollee of any differential between the price of 
        the drug or biological to the enrollee under the plan and the 
        price the individual would pay for the drug or biological if 
        the enrollee obtained the drug without using any health 
        insurance coverage.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to plan years beginning on or after January 1, 2020.
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