Title: A bill to amend title XXVII of the Public Health Service Act to establish requirements with respect to prescription drug benefits.
Policy area: Health

Summary:
This bill prohibits health insurers and contracted entities that provide pharmacy benefits management services from receiving a price reduction or other remuneration from prescription drug manufacturers. The prohibition does not apply if (1) the price reduction is reflected at the point-of-sale; and (2) the other remuneration is a transparent, flat service fee that the manufacturer pays in relation to pharmacy benefits management services.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 657 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                 S. 657

  To amend title XXVII of the Public Health Service Act to establish 
        requirements with respect to prescription drug benefits.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 5, 2019

   Mr. Braun introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To amend title XXVII of the Public Health Service Act to establish 
        requirements with respect to prescription drug benefits.

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

SECTION 1. REQUIREMENTS WITH RESPECT TO PRESCRIPTION DRUG BENEFITS.

    (a) In General.--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 BENEFITS.

    ``A group health plan or a health insurance issuer offering group 
or individual health insurance coverage shall not, and shall ensure 
that any entity that provides pharmacy benefits management services 
under a contract with any such health plan or health insurance coverage 
does not, receive from a drug manufacturer a reduction in price or 
other remuneration with respect to any prescription drug received by an 
enrollee in the plan or coverage and covered by the plan or coverage, 
unless--
            ``(1) any such reduction in price is reflected at the point 
        of sale to the enrollee; and
            ``(2) any such other remuneration is a flat fee-based 
        service fee that a manufacturer of prescription drugs pays to a 
        pharmacy benefit manager for services rendered to the 
        manufacturer that relate to arrangements by the pharmacy 
        benefit manager to provide pharmacy benefit management services 
        to a health plan or health insurance issuer, if certain 
        conditions established by the Secretary are met, including 
        requirements that the fees are transparent to the health plan 
        or health insurance issuer.''.
    (b) Effective Date.--Section 2729A of the Public Health Service 
Act, as added by subsection (a), shall take effect on January 1, 2020.
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