Title: Pharmacy Benefit Manager Accountability Study Act of 2019
Policy area: Health

Summary:
Pharmacy Benefit Manager Accountability Study Act of 2019
This bill requires the Government Accountability Office to study the role of pharmacy benefit managers (PBMs) with respect to federally facilitated exchanges, including the role of PBMs in pharmaceutical supply chains, the competition among PBMs, and the use of rebates and fees by PBMs in such exchanges.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3223 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 3223

 To require the Comptroller General of the United States to study the 
role pharmacy benefit managers play in the pharmaceutical supply chain 
 and to provide Congress with appropriate policy recommendations, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 12, 2019

 Mr. Marshall (for himself, Mr. Welch, Mr. Carter of Georgia, and Mr. 
Gonzalez of Texas) introduced the following bill; which was referred to 
                  the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To require the Comptroller General of the United States to study the 
role pharmacy benefit managers play in the pharmaceutical supply chain 
 and to provide Congress with appropriate policy recommendations, 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 ``Pharmacy Benefit Manager 
Accountability Study Act of 2019''.

SEC. 2. STUDY BY COMPTROLLER GENERAL OF UNITED STATES.

    (a) In General.--The Comptroller General of the United States 
shall, in consultation with appropriate stakeholders, conduct a study 
on the role of pharmacy benefit managers with respect to federally 
facilitated Exchanges operated pursuant to section 1321(c) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18041(c)).
    (b) Permissible Examination.--In conducting the study required 
under subsection (a), the Comptroller General may examine various 
qualitative and quantitative aspects of the role of pharmacy benefit 
managers with respect to federally facilitated Exchanges described in 
such subsection, such as the following:
            (1) The role that pharmacy benefit managers play in the 
        pharmaceutical supply chain of such Exchanges.
            (2) The state of competition among pharmacy benefit 
        managers on such Exchanges, including the market share for the 
        Nation's largest pharmacy benefit managers.
            (3) The use of rebates and fees by pharmacy benefit 
        managers with respect to such Exchanges, including--
                    (A) the extent to which rebates are passed on to 
                qualified health plans offered on such Exchanges and 
                whether such rebates are passed on to individuals 
                enrolled in such plans;
                    (B) the extent to which rebates are kept by such 
                pharmacy benefit managers; and
                    (C) the role of any fees charged by such pharmacy 
                benefit managers.
            (4) Whether pharmacy benefit managers structure their 
        formularies with respect to such Exchanges in favor of high-
        rebate prescription drugs over lower-cost, lower-rebate 
        alternatives.
            (5) The average prior authorization approval time for 
        pharmacy benefit managers with respect to such Exchanges.
            (6) Factors affecting the use of step therapy by pharmacy 
        benefit managers with respect to such Exchanges.
            (7) The extent to which the price that pharmacy benefit 
        managers charge private payors on such Exchanges for a drug is 
        more than such pharmacy benefit managers pay the pharmacy for 
        the drug.
    (c) Report.--Not later than the date that is three years after the 
date of enactment of this Act, the Comptroller General shall submit to 
the Secretary of Health and Human Services, the Committee on Health, 
Education, Labor, and Pensions of the Senate, and the Committee on 
Energy and Commerce of the House of Representatives a report containing 
the results of the study conducted under subsection (a), including 
policy recommendations.
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