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To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes.
1/6/2025, 11:41 PM
Summary of Bill HR 5393
Bill 118 hr 5393, also known as the Pharmacy DIR Reform Act of 2021, aims to make changes to Medicare Part D in order to ensure fair assessment of pharmacy performance and quality. The bill seeks to address the issue of Direct and Indirect Remuneration (DIR) fees, which are fees that pharmacies must pay to pharmacy benefit managers (PBMs) after the point of sale.
The bill proposes several key changes to the current system. First, it would require PBMs to provide more transparency in their pricing practices, specifically in regards to DIR fees. This would help pharmacies better understand and anticipate the fees they will be charged, leading to more accurate pricing for consumers.
Additionally, the bill aims to reform the way in which pharmacy performance is assessed under Medicare Part D. It would require the Centers for Medicare & Medicaid Services (CMS) to take into account factors such as patient outcomes and quality measures when evaluating pharmacy performance, rather than just focusing on cost. Overall, the Pharmacy DIR Reform Act of 2021 seeks to create a more fair and transparent system for pharmacies participating in Medicare Part D. By addressing the issue of DIR fees and improving the assessment of pharmacy performance, the bill aims to ensure that patients have access to high-quality and affordable medications.
The bill proposes several key changes to the current system. First, it would require PBMs to provide more transparency in their pricing practices, specifically in regards to DIR fees. This would help pharmacies better understand and anticipate the fees they will be charged, leading to more accurate pricing for consumers.
Additionally, the bill aims to reform the way in which pharmacy performance is assessed under Medicare Part D. It would require the Centers for Medicare & Medicaid Services (CMS) to take into account factors such as patient outcomes and quality measures when evaluating pharmacy performance, rather than just focusing on cost. Overall, the Pharmacy DIR Reform Act of 2021 seeks to create a more fair and transparent system for pharmacies participating in Medicare Part D. By addressing the issue of DIR fees and improving the assessment of pharmacy performance, the bill aims to ensure that patients have access to high-quality and affordable medications.
Read the Full Bill
Current Status of Bill HR 5393
Bill HR 5393 is currently in the status of Bill Introduced since September 12, 2023. Bill HR 5393 was introduced during Congress 118 and was introduced to the House on September 12, 2023. Bill HR 5393's most recent activity was Referred to the Subcommittee on Health. as of December 17, 2024
Bipartisan Support of Bill HR 5393
Total Number of Sponsors
3Democrat Sponsors
0Republican Sponsors
3Unaffiliated Sponsors
0Total Number of Cosponsors
4Democrat Cosponsors
2Republican Cosponsors
2Unaffiliated Cosponsors
0Policy Area and Potential Impact of Bill HR 5393
Primary Policy Focus
HealthAlternate Title(s) of Bill HR 5393
To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes.
To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes.
Comments

Brian Wolfe
1,124
1 year ago
I don't like this bill, it's gonna mess with my meds and make it harder for me to get what I need. It's just gonna cause more problems for us seniors. Short term, it's gonna be a pain in the butt for sure.
Sponsors and Cosponsors of HR 5393
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