Pharmacy Benefits Manager Accountability Act

Summary

Pharmacy Benefits Manager Accountability Act This bill establishes reporting requirements for pharmacy benefit managers (PBMs) with respect to services provided to health insurance plans. First, PBMs must report annually to the plan sponsor certain information about the PBM's services, including the amount of prescription drug copayment assistance funded by drug manufacturers, a list of covered drugs billed under the plan during the reporting period, and the total gross and net spending by the health plan on prescription drugs during the reporting period. PBMs also must submit specified elements of the report (e.g., the total gross spending on prescription drugs) to the Government Accountability Office (GAO). The report must comply with the privacy requirements under the Health Insurance Portability and Accountability Act of 1996. The bill establishes civil penalties for violations of these requirements and provides for enforcement by the appropriate agencies. GAO must report on the pharmacy networks of plans or PBMs, including whether such networks under common ownership with the plans or PBMs are designed to encourage plan enrollees to use network pharmacies over other pharmacies.

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Timeline

1. 18 April 2023

   Introduced

   Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and 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.

   Source: IntroReferral

2. 18 April 2023

   Introduced

   Introduced in House

   Source: IntroReferral

3. 18 April 2023

   Introduced

   Introduced in House

   Source: IntroReferral

4. 17 December 2024

   Referred

   Referred to the Subcommittee on Health.

   Source: Committee

Votes

No vote records are attached yet.

Versions

• Introduced in House · 18 April 2023 · Download file

Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 18 April 2023

  ViewDownloadOpen at official source

• Introduced in House (PDF)

  Introduced in House · EN · 18 April 2023

  ViewDownloadOpen at official source

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• Introduced in House

  summary · EN · 18 April 2023

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  Vertaal document

  Documentvertaling op verzoek met downloadbare PDF (logo + link naar de officiële bron). Het bronbestand blijft leidend.

Sponsors

• Rep. Kuster, Ann M. [D-NH-2] · D · Sponsor
• Rep. Carter, Earl L. "Buddy" [R-GA-1] · R · Sponsor
• Rep. Eshoo, Anna G. [D-CA-18] · D · Sponsor
• Rep. Guthrie, Brett [R-KY-2] · R · Sponsor
• Rep. Perez, Marie Gluesenkamp [D-WA-3] · D · Cosponsor
• Rep. Auchincloss, Jake [D-MA-4] · D · Cosponsor
• · hswm00 · Standing
• · hsed00 · Standing
• · hsif00 · Standing

Related records

• related to ← PATIENT Act of 2023
• related to ← Health Care Price Transparency Act of 2023
• related to ← Better Deals and Lower Prices Act