Title: Lowest Price for Patients Act
Policy area: Health

Summary:
Lowest Price for Patients Act
This bill requires pharmacies to disclose to consumers when dispensing a prescription drug (1) the cost of the drug under the consumer's insurance plan, and (2) the cost of the drug without using their plan.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5442 Introduced in House (IH)]

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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 
 differential 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 
subsequently 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 individuals use prescription drug coverage to acquire such 
                     drug, and for other purposes.

    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 ``Lowest Price for Patients 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 Insurance 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 amended--
            (1) in paragraph (1)--
                    (A) by striking ``not restrict, directly or 
                indirectly,'' and inserting ``provide that''; and
                    (B) by striking ``from informing (or penalize such 
                pharmacy for informing)'' and inserting ``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 indirectly,'' 
                and inserting ``requires under such contract that''; 
                and
                    (C) by striking ``from informing (or penalize such 
                pharmacy for informing)'' and inserting ``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 inserted by 
        section 6063(c) of the SUPPORT for Patients and Communities Act 
        as subsection (n); and
            (2) by adding at the end the following new subsection:
    ``(o) Pharmacy Disclosure of the Price of a Drug for an Enrollee 
Using and Not Using Prescription 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 provides 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 enrollee of any 
differential between--
            ``(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.''.
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