Drug Price Transparency: Ending Spread Pricing Abuse in Medicaid.
This law mandates new rules to stop Pharmacy Benefit Managers (PBMs) from inflating drug costs within the Medicaid program. It requires PBMs to use a 'pass-through' model, ensuring pharmacies receive the full payment for the drug ingredient and dispensing fee, while limiting PBM administrative charges. This aims to save taxpayer money and ensure public funds are spent efficiently on medication.
Key points
Ban on 'Spread Pricing': PBMs are prohibited from charging the state more than they pay the pharmacy for drugs (after a reasonable administrative fee).
Full Cost Disclosure: PBMs must provide states and the federal government with complete transparency regarding all drug costs, fees, discounts, and rebates.
Improved Price Monitoring: Requires retail pharmacies to participate in surveys to accurately determine the national average drug acquisition cost.
Expired
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