Prescription Drug Transparency: Increased Oversight of Pharmacy Benefit Managers
This Act, cited as the Prescription Drug Transparency and Affordability Act, mandates Pharmacy Benefit Managers (PBMs) to disclose detailed financial information about drug costs, rebates, and fees to group health plans. The goal is to increase oversight and assist plans in selecting PBM services. Plan participants gain the right to receive a benefit summary and request specific cost data related to their claims.
Key points
PBMs must submit regular reports detailing drug spending, including rebates received and the difference between the amount paid by the plan and the amount paid to the pharmacy.
Plan participants and beneficiaries can request specific, claim-level cost information regarding their prescriptions.
The law establishes civil monetary penalties of $10,000 per day for failure to report and up to $100,000 for knowingly providing false information.
Introduced
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