Title: Transparent Drug Pricing Act of 2019
Policy area: Health

Summary:
Transparent Drug Pricing Act of 2019
This bill establishes several requirements relating to the prices of prescription drugs.
For example, state Medicaid drug-use review programs must require pharmacists to disclose an individual's out-of-pocket cost for a prescription drug, and the price without health insurance, at the point-of-sale. Additionally, health insurers must publish the co-payment amount for each covered prescription drug prior to the annual open-enrollment period.
The bill also temporarily prohibits the retail list price of drugs and biologics from exceeding the lowest retail list price among Canada, France, the United Kingdom, Japan, or Germany.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 977 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                 S. 977

            To address the high cost of prescription drugs.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 1, 2019

   Mr. Scott of Florida (for himself and Mr. Hawley) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
            To address the high cost of prescription drugs.

    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 ``Transparent Drug Pricing Act of 
2019''.

SEC. 2. PRICE TRANSPARENCY AT PHARMACIES.

    Section 1927(g)(2) of the Social Security Act (42 U.S.C. 1396r-
8(g)(2)) is amended by adding at the end the following new 
subparagraph:
                    ``(E) Disclosure of drug prices at point of sale.--
                Beginning January 1, 2022, as part of a State's drug 
                use review program, applicable State law shall require 
                pharmacists to disclose to customers, at the point of 
                sale of any prescription drug--
                            ``(i) the customer's out-of-pocket cost 
                        with respect to acquisition of such drug under 
                        the health plan in which the customer is 
                        enrolled, if applicable; and
                            ``(ii) the cost to the consumer for 
                        acquisition of the drug without using any 
                        health plan.''.

SEC. 3. REQUIREMENTS WITH RESPECT TO PRESCRIPTION DRUG COST-SHARING.

    Subpart II of part A of title XXVII of the Public Health Service 
Act (42 U.S.C. 300gg-11 et seq.) is amended by adding at the end the 
following:

``SEC. 2729A. REQUIREMENTS WITH RESPECT TO PRESCRIPTION DRUG COST-
              SHARING.

    ``(a) Credit Towards Deductible.--With respect to any enrollee in a 
health plan or individual or group health insurance coverage who pays 
out-of-pocket for the full cost of a prescription drug, the group 
health plan or health insurance issuer offering such health insurance 
coverage shall credit the full amount such enrollee paid for such drug 
towards any deductible under the plan or coverage applicable to 
prescription drugs.
    ``(b) Establishment of Co-Payments for Certain Prescription 
Drugs.--
            ``(1) In general.--A group health plan or a health 
        insurance issuer offering group or individual health insurance 
        coverage shall, not later than 60 days before the first annual 
        open enrollment period after the date of enactment of the 
        Transparent Drug Pricing Act of 2019, and 60 days before each 
        annual open enrollment period thereafter, publish a list of the 
        co-payment amounts for the applicable plan year with respect to 
        each prescription drug covered under the plan or coverage.
            ``(2) Prohibition on changes in co-payment amounts.--A 
        group health plan or health insurance issuer described in 
        paragraph (1) may not change the co-payment amount published in 
        accordance with paragraph (1) until the next plan year.
            ``(3) Calculation of out-of-pocket costs.--A group health 
        plan or a health insurance issuer offering group or individual 
        health insurance coverage shall provide a mechanism that 
        enables enrollees in the plan or coverage to determine the 
        projected total out-of-pocket costs of an enrollee in the plan 
        or coverage for each prescription drug covered under such plan 
        or coverage.''.

SEC. 4. INTERNATIONAL RETAIL LIST PRICE INDEX.

    (a) In General.--The retail list price in the United States for a 
drug approved under subsection (c) or (j) of section 505 of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 355) or a biological product 
licensed under subsection (a) or (k) of section 351 of the Public 
Health Service Act (42 U.S.C. 262) may not exceed the lowest retail 
list price for the drug among Canada, France, the United Kingdom, 
Japan, or Germany.
    (b) Sunset.--The requirement under subsection (a) shall terminate 
on the date that is 5 years after the date of enactment of this Act.
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