Medicare PBM Accountability Act
Latest action · Dec 17, 2024 Referred to the Subcommittee on Health.
Progress
Where this bill reached, and when. A stage with no date was not reached; one that failed a vote and later carried shows the date it carried.
- IntroducedSep 12, 2023
- Passed HouseNot reached
- Passed SenateNot reached
- To the PresidentNot reached
- Became lawNot reached
Summary
Medicare PBM Accountability Act
This bill establishes reporting requirements for pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit and Medicare Advantage, particularly relating to the prices of prescription drugs.
Specifically, PBMs must (1) disclose certain information underlying cost performance measurements (e.g., exclusions and terms), and (2) report to prescription drug plan (PDP) sponsors (and to the Centers for Medicare & Medicaid Services upon request) an itemized list of prescription drugs that were dispensed during the previous year and related data about costs, claims, affiliated pharmacies, and other specified information. PDP sponsors may audit PBMs to ensure compliance with this bill's requirements and must annually certify their compliance; PBMs are responsible for any associated civil penalties for violations.
In addition, the Government Accountability Office must study federal and state reporting requirements for health plans and PBMs with respect to prescription drug price transparency and recommend ways to streamline these requirements.
Cosponsors 1
Members who signed on, in the order they did. All signed on Sep 12, 2023.
| Seat | Cosponsor | Signed on | |
|---|---|---|---|
| R-TN | Diana Harshbarger | Original | Sep 12, 2023 |
Actions 9
Everything that happened, newest first.
- Dec 17, 2024Referred to the Subcommittee on Health.
- Dec 6, 2023Committee Consideration and Mark-up Session Held
- Dec 6, 2023Ordered to be Reported (Amended) by the Yeas and Nays: 44 - 0.
- Dec 5, 2023Committee Consideration and Mark-up Session Held
- Nov 15, 2023Forwarded by Subcommittee to Full Committee by Voice Vote.
Related bills 2
Companion bills and other measures the record links to this one.
| Bill | Title | Relationship | Latest action |
|---|---|---|---|
| S 2254 | Medicare PBM Accountability Act | Identical bill | Jul 12, 2023 |
| S 2973 | Modernizing and Ensuring PBM Accountability Act | Related bill | Dec 7, 2023 |
Subjects
Assigned by the Library of Congress. Policy area: Health.
Text 1
Each version as it was printed, newest first.
- Sep 12, 2023Introduced in House
Everything here is as published by Congress: the summary is the Congressional Research Service's, the action wording is the clerks', and the subjects are the Library of Congress's. How far it got is read from the actions themselves, taking the most recent one of each kind, so a bill that failed a vote and later passed is shown as having passed. Records come from this bill on Congress.gov and govinfo.gov.