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 |
Committees 2
Where it was sent and what each committee and subcommittee did with it, in order.
| Chamber | Committee | What it did |
|---|---|---|
| House | Energy and Commerce Committee | Referred Sep 12, 2023Markup Dec 5, 2023Markup Dec 6, 2023 |
| Health Subcommittee | Referred Sep 15, 2023Markup Nov 15, 2023Reported Nov 15, 2023 | |
| House | Ways and Means Committee | Referred Sep 12, 2023 |
| Health Subcommittee | Referred Dec 17, 2024 |
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, 2023Subcommittee Consideration and Mark-up Session Held
- Nov 15, 2023Forwarded by Subcommittee to Full Committee by Voice Vote.
- Sep 15, 2023Referred to the Subcommittee on Health.
- Sep 12, 2023Introduced in House
- Sep 12, 2023Referred to the Committee on Energy and Commerce, and in addition to the Committee on 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.
Research
What has been written about this bill: committee reports, cost estimates, the sponsor’s authority statement, printed hearings and the Congressional Research Service’s work.
Congressional Budget Office cost estimate
- Mar 13, 2024H.R. 5385, Medicare PBM Accountability ActAs ordered reported by the House Committee on Energy and Commerce on December 6, 2023
Constitutional authority
The sponsor’s statement, as printed in the Congressional Record, vol. 169, no. 147, September 12, 2023, page H4264.
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 |
Titles 2
Every title it has carried, official and short, at each stage.
- Official Title as Introduced
- To amend title XVIII of the Social Security Act to establish pharmacy benefit manager reporting requirements with respect to prescription drug plans and MA-PD plans under Medicare part D.
- Short Title(s) as Introduced
- Medicare PBM Accountability Act
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; cost estimates are the Congressional Budget Office's, and the hearings are the printed hearings GovInfo publishes, which can appear months after the hearing.
