PBM Reporting Transparency Act

Bill: 118-s-2493
Sponsor: full_name: Sen. Warner, Mark R. [D-VA]
Introduced: 2023-07-25
Policy area: Health
Latest action: action_date: 2023-07-25
text: Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2023-07-25
action_desc: Introduced in Senate
text: <p><strong>PBM Reporting Transparency Act</strong></p><p>This bill requires the Medicare Payment Advisory Commission to report certain information about pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit and Medicare Advantage.</p><p>Specifically, the commission must report on trends in agreements between PBMs and prescription drug plans, the impact of any differences in agreements on out-of-pocket spending for enrollees and pharmacy reimbursements, and any appropriate recommendations. The commission must submit an updated report two years after its initial report.</p>

tv_txt: II 118th CONGRESS 1st Session S. 2493 IN THE SENATE OF THE UNITED STATES July 25, 2023 Mr. Warner (for himself, Mr. Thune , Ms. Cortez Masto , and Mr. Tillis ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To require the Medicare Payment Advisory Commission (MedPAC) submit to Congress two reports on arrangements with pharmacy benefit managers with respect to prescription drug plans and MA–PD plans.

1. Short title This Act may be cited as the PBM Reporting Transparency Act . 2. MedPAC reports on agreements with pharmacy benefit managers with respect to prescription drug plans and MA–PD plans (a) In general The Medicare Payment Advisory Commission shall submit to Congress the following reports: (1) Not later than March 31, 2026, a report on agreements with pharmacy benefit managers with respect to prescription drug plans and MA–PD plans. Such report shall include— (A) a description of trends, including high-level averages and totals for each of the types of information submitted; (B) an analysis of any differences in agreements and their effects on plan enrollee out-of-pocket spending and average pharmacy reimbursement, and any other impacts; and (C) any recommendations the Commission determines appropriate. (2) Not later than March 31, 2028, a report describing any changes with respect to the information described in paragraph (1) over time, together with any recommendations the Commission determines appropriate. (b) Confidentiality The Commission shall not report in a manner that would identify a specific pharmacy benefit manager or their affiliates, PDP sponsor, MA organization, or plan, or the prices charged for specific drugs.