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Increased Transparency in Medicare Drug Pricing

New regulations aim to increase transparency in the operations of Pharmacy Benefit Managers (PBMs) within the Medicare program. This means citizens using Medicare can expect a better understanding of drug costs and potentially lower expenses, as these companies will be required to disclose more information about prices and rebates.
Key points
Pharmacy Benefit Managers (PBMs) will be required to disclose detailed information on drug prices, rebates, and other fees, aiming to help lower costs for patients.
Medicare insurers will gain the right to audit PBMs to verify contract compliance and the accuracy of reported data.
New reporting rules will be introduced to prevent the concealment of drug cost information and encourage the offering of cheaper alternatives.
A government study will assess current reporting requirements to streamline and reduce administrative burdens for insurers and PBMs.
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Additional Information
Medicare PBM Accountability Act
Print number: HR 5385
Sponsor: Rep. Landsman, Greg [D-OH-1]
Process start date: 2023-09-12