Promoting Transparency and Healthy Competition in Medicare Act
- Last Action
- 12/17/2024
Actions
- 2024-12-17Referred to the Subcommittee on Health.
- 2023-05-19Referred to the Subcommittee on Health.
- 2023-05-15Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
- 2023-05-15Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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.
- 2023-05-15Introduced in House
- 2023-05-15Introduced in House
CRS Summary
As of 2023-05-15 (00)
Promoting Transparency and Healthy Competition in Medicare Act
This bill requires Medicare Advantage (MA) organizations and prescription drug plan (PDP) sponsors and pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit to report certain information relating to their ownership interests in participating providers.
Specifically, MA organizations must report on items and services, patient risk scores and associated diagnoses, prior authorization requests, and incentive payments with respect to providers in which the MA organization has an ownership interest as compared to other providers.
Similarly, PDP sponsors under the Medicare prescription drug benefit must report on the prices of prescription drugs with respect to pharmacies in which the PDP sponsor has an ownership interest as compared to other pharmacies. The bill also prohibits PDP sponsors from contracting with PBMs in which the PDP sponsor has an ownership interest unless the PBM reports certain information on rebates and payments between the PBM, PDP sponsor, pharmacies, and drug manufacturers.
Cosponsors (3)
- Kim Schrier (D-WA)
- Gus Bilirakis (R-FL)
- JANICE SCHAKOWSKY (D-IL)
Subjects
- Government information and archives
- Health care costs and insurance
- Health information and medical records
- 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.