Pharmacy Benefit Manager Reform Act

Summary

Pharmacy Benefit Manager Reform Act This bill establishes various 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 net spending by the health plan on prescription drugs. PBMs also must provide plan sponsors with a supplementary report every six months with specified information about drugs that were dispensed under the plan by pharmacies that are wholly or partially owned by the PBM. Second, the bill prohibits spread pricing. Under the bill, spread pricing occurs when a PBM charges an insurance plan (or an insurance plan charges plan participants) a price for a prescription drug that exceeds the price paid to the pharmacy for the drug. Finally, PBMs must remit to the plan sponsor all rebates, fees, alternative discounts, and other remuneration received from a drug manufacturer. The bill establishes civil penalties for violations of these requirements and provides funding for the Centers for Medicare & Medicaid Services and the Department of Labor to implement the provisions of this bill.

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Timeline

1. 27 April 2023

   Introduced

   Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

   Source: IntroReferral

2. 27 April 2023

   Introduced

   Introduced in Senate

   Source: IntroReferral

3. 11 May 2023

   Reported

   Committee on Health, Education, Labor, and Pensions. Ordered to be reported with an amendment in the nature of a substitute favorably.

   Source: Committee

4. 22 June 2023

   Calendars

   Placed on Senate Legislative Calendar under General Orders. Calendar No. 113.

   Source: Calendars

5. 22 June 2023

   Reported

   Committee on Health, Education, Labor, and Pensions. Reported by Senator Sanders with an amendment in the nature of a substitute. Without written report.

   Source: Committee

6. 22 June 2023

   Reported

   Committee on Health, Education, Labor, and Pensions. Reported by Senator Sanders with an amendment in the nature of a substitute. Without written report.

   Source: Committee

Votes

No vote records are attached yet.

Versions

• Reported to Senate · 22 June 2023 · Download file
• Introduced in Senate · 27 April 2023 · Download file

Documents

5 official files

• Reported to Senate (text)

  Reported to Senate · EN · 22 June 2023

  ViewDownloadOpen at official source

• Reported to Senate (PDF)

  Reported to Senate · EN · 22 June 2023

  ViewDownloadOpen at official source

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• Introduced in Senate (text)

  Introduced in Senate · EN · 27 April 2023

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• Introduced in Senate (PDF)

  Introduced in Senate · EN · 27 April 2023

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  Vertaal document

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• Introduced in Senate

  summary · EN · 27 April 2023

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  Vertaal document

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Sponsors

• Sen. Sanders, Bernard [I-VT] · I · Sponsor
• Sen. Cassidy, Bill [R-LA] · R · Sponsor
• Sen. Murray, Patty [D-WA] · D · Sponsor
• Sen. Marshall, Roger [R-KS] · R · Sponsor
• Sen. Braun, Mike [R-IN] · R · Cosponsor
• · sshr00 · Standing

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