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Medicaid Drug Price Transparency: Ending Hidden Fees

This act aims to increase transparency in drug pricing within the Medicaid program, potentially leading to lower drug costs for taxpayers and better oversight of public spending. It introduces new payment rules for pharmacy benefit managers to prevent price gouging and hidden fees. This means citizens can expect a more efficient use of healthcare funds.
Key points
Pharmacy benefit managers (PBMs) must disclose all drug-related costs and payments, including discounts and administrative fees.
Drug payments will be limited to the ingredient cost and a reasonable dispensing fee, preventing inflated prices.
Practices where companies charge more than they pay pharmacies (spread pricing) will be prohibited, protecting public funds.
Regular surveys of pharmacy drug prices will be conducted to ensure payments align with actual costs.
Pharmacies will be required to participate in price surveys, enhancing data accuracy and market transparency.
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Additional Information
Drug Price Transparency in Medicaid Act of 2023
Print number: HR 1613
Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1]
Process start date: 2023-03-17