Bill 118 hr 7717, also known as the "Pharmacy Benefit Manager Transparency Act," aims to make changes to title XI of the Social Security Act in order to increase transparency requirements for pharmacy benefit managers (PBMs). PBMs are entities that manage prescription drug benefits on behalf of health insurers, Medicare Part D plans, and other payers.
The main goal of this bill is to address concerns about the lack of transparency in the PBM industry, which has been criticized for its complex pricing practices and potential conflicts of interest. The bill seeks to improve transparency by requiring PBMs to disclose certain information related to their pricing and reimbursement practices, as well as their relationships with drug manufacturers and pharmacies.
Specifically, the bill would require PBMs to provide detailed information about the rebates, discounts, and other price concessions they receive from drug manufacturers. This information would need to be reported to the Secretary of Health and Human Services on a regular basis, and would be made publicly available in order to increase transparency and accountability.
Additionally, the bill would require PBMs to disclose any financial arrangements they have with pharmacies, including any fees or other payments that could potentially influence their decision-making. This provision is intended to prevent PBMs from steering patients to certain pharmacies based on financial incentives, rather than what is in the best interest of the patient.
Overall, the Pharmacy Benefit Manager Transparency Act seeks to address concerns about the lack of transparency in the PBM industry and ensure that PBMs are acting in the best interest of patients and payers. By increasing transparency and accountability, the bill aims to promote fair competition and lower prescription drug costs for consumers.