What is the official ID of this bill?
The official print number for this legislation is HR 4508.
Health Plan Transparency: Mandatory Disclosure of Hidden Fees by PBMs and TPAs.
This Act mandates comprehensive disclosure of all fees, rebates, and compensation received by Pharmacy Benefit Managers (PBMs) and Third Party Administrators (TPAs) operating within employer-sponsored health plans. The goal is to eliminate hidden costs, allowing plan sponsors (employers) to negotiate better contracts. This increased transparency could ultimately lead to lower prescription drug costs and administrative fees for employees, effective January 1, 2025.
Key points
PBMs must disclose all compensation, including rebates and discounts from drug manufacturers, and specify how much of that money is passed back to the health plan or participants.
The law requires transparency regarding "clawbacks"—money retained by PBMs when a patient's co-payment exceeds the actual cost of the drug.
Third Party Administrators (TPAs) must disclose all fees and recovered amounts (e.g., from overpayments or subrogation) that they retain as compensation, increasing clarity on administrative costs.
Status:
Expired
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