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Increased Transparency in Medicaid Drug Pricing

This bill aims to increase transparency in drug pricing within the Medicaid program. It requires middlemen (like PBMs) to pass the actual drug cost to pharmacies and limits their fees, potentially lowering program costs and ensuring fair payment for pharmacies.
Key points
Requires Medicaid drug payments to pharmacies to be the actual drug cost plus a dispensing fee, stopping hidden markups by middlemen.
Limits fees paid to middlemen managing drug benefits to a reasonable amount.
Makes drug pricing data collected from pharmacies publicly available to increase transparency.
Protects pharmacies providing discounted drugs under a federal program (340B).
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Additional Information
Drug Price Transparency in Medicaid Act of 2021
Print number: HR 6101
Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1]
Process start date: 2021-12-01