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Increased Transparency in Drug Management: New Rules for Insurance Companies

This act aims to increase transparency in the operations of Pharmacy Benefit Managers (PBMs). It will provide citizens and insurance companies with better insight into how much money PBMs retain from drug manufacturer rebates and administrative fees, potentially impacting drug costs. This information will be publicly available, allowing for a clearer understanding of drug pricing.
Key points
PBMs will be required to disclose how much in rebates and administrative fees they receive from drug manufacturers and how much they retain versus passing on.
The act mandates disclosure of post-claim payments PBMs collect from pharmacies, including fees and clawbacks.
Key data on retained rebates will be publicly published, increasing oversight of drug costs.
The definition of PBM is expanded to include related entities, aiming to prevent circumvention of regulations.
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Additional Information
Pharmacy Benefit Manager Sunshine and Accountability Act
Print number: HR 2816
Sponsor: Rep. Harshbarger, Diana [R-TN-1]
Process start date: 2023-04-25