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Medicare PBM Accountability Act

USA118th CongressHR-5385| House 
| Updated: 12/17/2024
Greg Landsman

Greg Landsman

Democratic Representative

Ohio

Cosponsors (1)
Diana Harshbarger (Republican)

Ways and Means Committee, Health Subcommittee, Health Subcommittee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Medicare PBM Accountability Act This bill establishes reporting requirements for pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit and Medicare Advantage, particularly relating to the prices of prescription drugs. Specifically, PBMs must (1) disclose certain information underlying cost performance measurements (e.g., exclusions and terms), and (2) report to prescription drug plan (PDP) sponsors (and to the Centers for Medicare & Medicaid Services upon request) an itemized list of prescription drugs that were dispensed during the previous year and related data about costs, claims, affiliated pharmacies, and other specified information. PDP sponsors may audit PBMs to ensure compliance with this bill's requirements and must annually certify their compliance; PBMs are responsible for any associated civil penalties for violations. In addition, the Government Accountability Office must study federal and state reporting requirements for health plans and PBMs with respect to prescription drug price transparency and recommend ways to streamline these requirements.
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Timeline
Jul 12, 2023

Latest Companion Bill Action

S 118-2254
Introduced in Senate
Sep 12, 2023
Introduced in House
Sep 12, 2023
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Sep 15, 2023
Referred to the Subcommittee on Health.
Nov 15, 2023
Subcommittee Consideration and Mark-up Session Held
Nov 15, 2023
Forwarded by Subcommittee to Full Committee by Voice Vote.
Dec 5, 2023
Committee Consideration and Mark-up Session Held
Dec 6, 2023
Ordered to be Reported (Amended) by the Yeas and Nays: 44 - 0.
Dec 6, 2023
Committee Consideration and Mark-up Session Held
Dec 17, 2024
Referred to the Subcommittee on Health.
  • July 12, 2023

    Latest Companion Bill Action

    S 118-2254
    Introduced in Senate


  • September 12, 2023
    Introduced in House


  • September 12, 2023
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.


  • September 15, 2023
    Referred to the Subcommittee on Health.


  • November 15, 2023
    Subcommittee Consideration and Mark-up Session Held


  • November 15, 2023
    Forwarded by Subcommittee to Full Committee by Voice Vote.


  • December 5, 2023
    Committee Consideration and Mark-up Session Held


  • December 6, 2023
    Ordered to be Reported (Amended) by the Yeas and Nays: 44 - 0.


  • December 6, 2023
    Committee Consideration and Mark-up Session Held


  • December 17, 2024
    Referred to the Subcommittee on Health.

Health

Related Bills

  • S 118-2254: Medicare PBM Accountability Act
  • S 118-2973: Modernizing and Ensuring PBM Accountability Act
Accounting and auditingCongressional oversightContracts and agencyDrug safety, medical device, and laboratory regulationGovernment information and archivesGovernment studies and investigationsHealth care costs and insurancePrescription drugsRetail and wholesale trades

Medicare PBM Accountability Act

USA118th CongressHR-5385| House 
| Updated: 12/17/2024
Medicare PBM Accountability Act This bill establishes reporting requirements for pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit and Medicare Advantage, particularly relating to the prices of prescription drugs. Specifically, PBMs must (1) disclose certain information underlying cost performance measurements (e.g., exclusions and terms), and (2) report to prescription drug plan (PDP) sponsors (and to the Centers for Medicare & Medicaid Services upon request) an itemized list of prescription drugs that were dispensed during the previous year and related data about costs, claims, affiliated pharmacies, and other specified information. PDP sponsors may audit PBMs to ensure compliance with this bill's requirements and must annually certify their compliance; PBMs are responsible for any associated civil penalties for violations. In addition, the Government Accountability Office must study federal and state reporting requirements for health plans and PBMs with respect to prescription drug price transparency and recommend ways to streamline these requirements.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Jul 12, 2023

Latest Companion Bill Action

S 118-2254
Introduced in Senate
Sep 12, 2023
Introduced in House
Sep 12, 2023
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
Sep 15, 2023
Referred to the Subcommittee on Health.
Nov 15, 2023
Subcommittee Consideration and Mark-up Session Held
Nov 15, 2023
Forwarded by Subcommittee to Full Committee by Voice Vote.
Dec 5, 2023
Committee Consideration and Mark-up Session Held
Dec 6, 2023
Ordered to be Reported (Amended) by the Yeas and Nays: 44 - 0.
Dec 6, 2023
Committee Consideration and Mark-up Session Held
Dec 17, 2024
Referred to the Subcommittee on Health.
  • July 12, 2023

    Latest Companion Bill Action

    S 118-2254
    Introduced in Senate


  • September 12, 2023
    Introduced in House


  • September 12, 2023
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.


  • September 15, 2023
    Referred to the Subcommittee on Health.


  • November 15, 2023
    Subcommittee Consideration and Mark-up Session Held


  • November 15, 2023
    Forwarded by Subcommittee to Full Committee by Voice Vote.


  • December 5, 2023
    Committee Consideration and Mark-up Session Held


  • December 6, 2023
    Ordered to be Reported (Amended) by the Yeas and Nays: 44 - 0.


  • December 6, 2023
    Committee Consideration and Mark-up Session Held


  • December 17, 2024
    Referred to the Subcommittee on Health.
Greg Landsman

Greg Landsman

Democratic Representative

Ohio

Cosponsors (1)
Diana Harshbarger (Republican)

Ways and Means Committee, Health Subcommittee, Health Subcommittee, Energy and Commerce Committee

Health

Related Bills

  • S 118-2254: Medicare PBM Accountability Act
  • S 118-2973: Modernizing and Ensuring PBM Accountability Act
  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Accounting and auditingCongressional oversightContracts and agencyDrug safety, medical device, and laboratory regulationGovernment information and archivesGovernment studies and investigationsHealth care costs and insurancePrescription drugsRetail and wholesale trades