Ways and Means Committee, Health Subcommittee, Health Subcommittee, Energy and Commerce Committee
Introduced
In Committee
On Floor
Passed Chamber
Enacted
Promoting Transparency and Healthy Competition in Medicare Act This bill requires Medicare Advantage (MA) organizations and prescription drug plan (PDP) sponsors and pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit to report certain information relating to their ownership interests in participating providers. Specifically, MA organizations must report on items and services, patient risk scores and associated diagnoses, prior authorization requests, and incentive payments with respect to providers in which the MA organization has an ownership interest as compared to other providers. Similarly, PDP sponsors under the Medicare prescription drug benefit must report on the prices of prescription drugs with respect to pharmacies in which the PDP sponsor has an ownership interest as compared to other pharmacies. The bill also prohibits PDP sponsors from contracting with PBMs in which the PDP sponsor has an ownership interest unless the PBM reports certain information on rebates and payments between the PBM, PDP sponsor, pharmacies, and drug manufacturers.
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Timeline
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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Promoting Transparency and Healthy Competition in Medicare Act
USA118th CongressHR-3282| House
| Updated: 12/17/2024
Promoting Transparency and Healthy Competition in Medicare Act This bill requires Medicare Advantage (MA) organizations and prescription drug plan (PDP) sponsors and pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit to report certain information relating to their ownership interests in participating providers. Specifically, MA organizations must report on items and services, patient risk scores and associated diagnoses, prior authorization requests, and incentive payments with respect to providers in which the MA organization has an ownership interest as compared to other providers. Similarly, PDP sponsors under the Medicare prescription drug benefit must report on the prices of prescription drugs with respect to pharmacies in which the PDP sponsor has an ownership interest as compared to other pharmacies. The bill also prohibits PDP sponsors from contracting with PBMs in which the PDP sponsor has an ownership interest unless the PBM reports certain information on rebates and payments between the PBM, PDP sponsor, pharmacies, and drug manufacturers.
Get AI-generated questions to help you understand this bill better
Timeline
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.