NO PBMs Act

Bill: 118-hr-5400
Sponsor: full_name: Rep. Carter, Earl L. "Buddy" [R-GA-1]
Introduced: 2023-09-12
Policy area: Health
Subjects: Health care coverage and access

Medicare

Prescription drugs
Latest action: action_date: 2024-12-17
text: Referred to the Subcommittee on Health.

Summaries:
action_date: 2023-09-12
action_desc: Introduced in House
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: I 118th CONGRESS 1st Session H. R. 5400 IN THE HOUSE OF REPRESENTATIVES September 12, 2023 Mr. Carter of Georgia (for himself, Mrs. Dingell , Mr. Rose , and Mr. Krishnamoorthi ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on Ways and Means , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 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. .