Wyden, Crapo Introduce Bipartisan Pharmacy Benefit Manager Legislation

Wyden, Crapo Introduce Bipartisan Pharmacy Benefit Manager Legislation

Washington, D.C. - U.S. Senate Finance Committee Chairman Mike Crapo, R-Idaho., and Ranking Member Ron Wyden, D-Ore., today introduced the Pharmacy Benefit Manager (PBM) Price Transparency and Accountability Act to fix market distortions and increase transparency in federal prescription drug programs to lower patient costs at the pharmacy counter.

"It's long past time to go after middlemen who are making Americans' prescription drugs more expensive," Wyden said. "The Finance Committee has put forward a comprehensive approach to stop the pharmacy benefit manager business practices that are harming seniors and taxpayers who count on Medicare to deliver affordable prescription drugs. It's time to get this done."

"Pharmacy benefit managers should not profit from overcharging patients for their prescriptions," Crapo said. "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."

The PBM Price Transparency and Accountability Act would:
• Delink PBM compensation from their negotiated rebates to disincentivize PBMs from promoting higher-priced medications;
• Increase PBM reporting requirements to Medicare Part D plan sponsors and to the U.S. Department of Health and Human Services (HHS) and empower Part D plan sponsors to audit their PBM for compliance with contract requirements;
• Reinforce existing requirements that plan sponsors contract with any willing pharmacy that meets their standard contract terms and conditions to better protect independent pharmacies in rural areas from practices that have contributed to widespread closures;
• Require participation by retail community pharmacies in the National Average Drug Acquisition Cost (NADAC) survey, which would ensure accurate Medicaid payments to pharmacies; and
• Mandate PBMs pass Medicaid payments directly to pharmacies to ensure transparent drug costs for states and taxpayers.

Senators John Barrasso, R-Wyo., Michael Bennet, D-Colo., Marsha Blackburn, R-Tenn., Catherine Cortez Masto, D-Nev., Bill Cassidy, R-La., Maggie Hassan, D-N.H., John Cornyn, R-Texas., Ben Ray Luján, D-N.M., Steve Daines, R-Mont., Tina Smith, Chuck Grassley, R-Iowa., Mark Warner, D-Va., James Lankford, R-Okla., Raphael Warnock, D-Ga., Roger Marshall, R-Kan., Peter Welch, D-Vt., John Thune, R-S.D., Sheldon Whitehouse, D-R.I., and Thom Tillis, R-N.C., co-sponsored the PBM Price Transparency and Accountability Act.

The legislative text can be found HERE.

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