Ending Hidden Drug Fees: Lower Costs and More Pharmacy Choice for Patients.
This Act establishes strict rules for Pharmacy Benefits Managers (PBMs) operating within Federal health care programs to reduce prescription drug costs for citizens. It mandates that PBMs pass at least 80% of manufacturer rebates directly to patients at the point of sale, immediately lowering out-of-pocket costs. Furthermore, PBMs are prohibited from forcing patients to use specific pharmacies, increasing patient choice and pricing transparency.
Key points
Patients will see lower out-of-pocket costs as PBMs must apply at least 80% of drug rebates directly to copays and deductibles at the pharmacy counter.
PBMs are banned from forcing patients to use specific pharmacies (steering) or charging patients more than the pharmacy is reimbursed for the drug.
The Act prohibits practices like 'spread pricing' and imposing fees or adjustments that reduce pharmacy reimbursement after a claim has been adjudicated.
Increased transparency in the Medicaid program requires public disclosure of national drug acquisition prices and rebate information.
Expired
Citizen Poll