Protecting Patients Against PBM Abuses Act
- Last Action
- 12/17/2024
Actions
- 2024-12-17Referred to the Subcommittee on Health.
- 2023-12-06Ordered to be Reported (Amended) by the Yeas and Nays: 46 - 0.
- 2023-12-06Committee Consideration and Mark-up Session Held
- 2023-12-05Committee Consideration and Mark-up Session Held
- 2023-11-15Forwarded by Subcommittee to Full Committee by Voice Vote.
- 2023-11-15Subcommittee Consideration and Mark-up Session Held
- 2023-04-28Referred to the Subcommittee on Health.
- 2023-04-26Referred 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.
- 2023-04-26Referred 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.
- 2023-04-26Introduced in House
- 2023-04-26Introduced in House
CRS Summary
As of 2023-04-26 (00)
Protecting Patients Against PBM Abuses Act
This bill establishes requirements for Medicare pharmacy benefit managers (PBMs) with respect to remuneration, payments, and fees.
Specifically, the bill restricts PBMs that are under contract with plans under the Medicare prescription drug benefit or Medicare Advantage from (1) receiving income for their services other than flat dollar amount service fees; (2) basing any service fees on the prices of covered drugs or any associated discounts, rebates, or other remuneration; (3) charging plan sponsors for ingredient costs or dispensing fees in amounts that are different than what is reimbursed to the pharmacy; or (4) reimbursing network pharmacies for less than that what is reimbursed to PBM-affiliated pharmacies.
Such PBMs must also report on the difference between certain costs for drugs on the plan's formulary and those that are not on the formulary but are therapeutically equivalent. PBMs must also report certain information regarding rebates and fees they receive from drug manufacturers; the Centers for Medicare & Medicaid Services must publish this and other information that is currently reported by PBMs online.
Cosponsors (20)
- Lisa Blunt Rochester (D-DE)
- Nicole Malliotakis (R-NY)
- Jake Auchincloss (D-MA)
- Jefferson Van Drew (R-NJ)
- Mariannette Miller-Meeks (R-IA)
- Deborah Ross (D-NC)
- Neal Dunn (R-FL)
- Jerry Carl (R-AL)
- Tracey Mann (R-KS)
- A. Ferguson (R-GA)
- Diana Harshbarger (R-TN)
- Rick Allen (R-GA)
- Carol Miller (R-WV)
- David Valadao (R-CA)
- Emanuel Cleaver (D-MO)
- Mikie Sherrill (D-NJ)
- Nanette Barragán (D-CA)
- Austin Scott (R-GA)
- Sheila Cherfilus-McCormick (D-FL)
- Donald Davis (D-NC)
Subjects
- Government information and archives
- Health care costs and insurance
- Medicare
- Prescription drugs
Sourced from Congress.gov (public domain).
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.