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Fair Pharmacy Assessment and Transparency in Medicare Part D

New rules aim to ensure pharmacies are evaluated more fairly under Medicare Part D, potentially impacting service quality and drug access. They also introduce greater transparency in billing between pharmacies and insurers, which could help in better understanding drug costs.
Key points
Standardized rules for assessing pharmacy performance and quality in Medicare Part D will be implemented from 2025, aiming for fairer conditions for all pharmacies.
Increased transparency in pharmacy payments: insurers will be required to promptly provide pharmacies with detailed billing information for drugs, including fees and discounts.
The Office of the Inspector General will conduct a study on current pharmacy assessment and billing systems to identify issues and recommend improvements.
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Additional Information
To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes.
Print number: HR 5393
Sponsor: Rep. Griffith, H. Morgan [R-VA-9]
Process start date: 2023-09-12