NO PBMs Act

Bill: 118-s-2436
Sponsor: full_name: Sen. Manchin, Joe, III [D-WV]
Introduced: 2023-07-20
Policy area: Health
Subjects: Health care coverage and access

Medicare

Prescription drugs
Latest action: action_date: 2023-07-20
text: Read twice and referred to the Committee on Finance.

Summaries:
action_date: 2023-07-20
action_desc: Introduced in Senate
text: <p><strong>Neighborhood Options for Patients Buying Medicines Act or the NO PBMs Act</strong></p><p>This bill specifies that prescription drug plan sponsors and pharmacy benefit managers under the Medicare prescription drug benefit&nbsp;must permit any pharmacy that meets the plan's contractual terms for network participation to participate in that network and that such terms must be reasonable. The Centers for Medicare &amp; Medicaid Services must set standards for reasonable terms.</p>

tv_txt: II 118th CONGRESS 1st Session S. 2436 IN THE SENATE OF THE UNITED STATES July 20, 2023 Mr. Manchin (for himself and Mrs. Blackburn ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XVIII of the Social Security Act to assure pharmacy access and choice for Medicare beneficiaries.

1. Short title This Act may be cited as the Neighborhood Options for Patients Buying Medicines Act or the NO PBMs Act . 2. Assuring pharmacy access and choice for Medicare beneficiaries Section 1860D–4(b)(1) of the Social Security Act ( 42 U.S.C. 1395w–104(b)(1) ) is amended by striking subparagraph (A) and inserting the following: (A) In general (i) Participation of any willing pharmacy A PDP sponsor offering a prescription drug plan or a pharmacy benefit manager acting to develop a pharmacy network on behalf of such plan shall permit the participation of any pharmacy that meets the standard contract terms and conditions under such plan to participate as a network pharmacy of such plan. (ii) Contract terms and conditions In accordance with clause (i), contract terms and conditions offered by such PDP sponsor or pharmacy benefit manager shall be reasonable and relevant. Notwithstanding any other provision of law, not later than January 1, 2026, the Secretary shall establish standards for reasonable and relevant contract terms and conditions for purposes of this clause. .