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Pharmacy Benefit Manager Transparency Act of 2023

Introduced: January 26, 2023 Introduced by: Cantwell, Maria Democratic · Washington See on congress.gov
 Everywhere this bill has been 5 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Dec 13, 2023
Placed on Senate Legislative Calendar under General Orders. Calendar No. 283.
Dec 13, 2023
Committee on Commerce, Science, and Transportation. Reported by Senator Cantwell with an amendment in the nature of a substitute. Without written report.
Mar 22, 2023
Committee on Commerce, Science, and Transportation. Ordered to be reported with an amendment in the nature of a substitute favorably.
Jan 26, 2023
Read twice and referred to the Committee on Commerce, Science, and Transportation.
Jan 26, 2023
Introduced in Senate
 Plain-English summary Congressional Research Service

Pharmacy Benefit Manager Transparency Act of 2023

This bill generally prohibits pharmacy benefit managers (PBMs) from engaging in certain practices when managing the prescription drug benefits under a health insurance plan, including charging the plan a different amount than the PBM reimburses the pharmacy.

The bill also prohibits PBMs from arbitrarily, unfairly, or deceptively (1) clawing back reimbursement payments, or (2) increasing fees or lowering reimbursements to pharmacies to offset changes to federally funded health plans.

PBMs are not subject to these prohibitions if they (1) pass along 100% of any price concession or discount to the health plan, and (2) disclose specified costs, prices, reimbursements, fees, markups, discounts, and aggregate payments received with respect to their PBM services.

Further, PBMs must report annually to the Federal Trade Commission (FTC) certain information about payments received from health plans and fees charged to pharmacies.

The FTC and state attorneys general are authorized to enforce the provisions of the bill.

What's happening now December 13, 2023

Placed on Senate Legislative Calendar under General Orders. Calendar No. 283.

 Committees of jurisdiction 1