"The bill, titled the PBM Price Transparency and Accountability Act, would delink PBM compensation from negotiated rebates. This would disincentivize PBMs from promoting higher-priced drugs. It would also increase reporting requirements for PBMs to Medicare Part D plan sponsors and HHS, as well as help plan sponsors audit their PBMs."
"In addition, it would strengthen requirements that plan sponsors contract with any willing pharmacy that meets standard terms to protect rural independent pharmacies from harmful practices and closures. It would also mandate retail community pharmacies to participate in the National Average Drug Acquisition Cost (NADAC) survey to ensure more accurate Medicaid reimbursement rates. Lastly, PBMs would be required to pass Medicaid payments directly to pharmacies so that there is more transparency in drug costs for states and taxpayers."
"Pharmacy benefit managers should not profit from overcharging patients for their prescriptions. This bipartisan legislation is a decisive step toward making the prescription drug market easier to navigate for both patients and pharmacies. These proposals form a strong foundation for additional efforts to promote pharmacy access, demystify drug pricing and reduce costs for both taxpayers and seniors."
Pharmacy benefit managers (PBMs) now control roughly 80% of the prescription drug market through the top three firms. The PBM Price Transparency and Accountability Act would delink PBM compensation from negotiated rebates to reduce incentives to favor higher-priced drugs. The bill would require expanded reporting to Medicare Part D plan sponsors and HHS and improve plan sponsor audit authority. The measure would require contracting with any willing pharmacy that meets standard terms to protect rural independents, mandate community pharmacy participation in the NADAC survey for accurate Medicaid reimbursement, and require PBMs to pass Medicaid payments directly to pharmacies.
Read at MedCity News
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