Legis Daily

Pharmacy Benefit Manager Transparency Act of 2022

USA117th CongressS-4293| Senate 
| Updated: 12/14/2022
Maria Cantwell

Maria Cantwell

Democratic Senator

Washington

Cosponsors (8)
Mike Braun (Republican)Thomas Tillis (Republican)Cindy Hyde-Smith (Republican)Jerry Moran (Republican)John Boozman (Republican)Jon Tester (Democratic)Chuck Grassley (Republican)Shelley Moore Capito (Republican)

Commerce, Science, and Transportation Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Pharmacy Benefit Manager Transparency Act of 2022 This bill generally prohibits pharmacy benefit managers (PBMs) from engaging in certain practices when managing the prescription drug benefits under a health insurance plan, including charging the plan a different amount than the PBM reimburses the pharmacy. The bill also prohibits PBMs from arbitrarily, unfairly, or deceptively (1) clawing back reimbursement payments, or (2) increasing fees or lowering reimbursements to pharmacies to offset changes to federally funded health plans. PBMs are not subject to these prohibitions if they (1) pass along 100% of any price concession or discount to the health plan, and (2) disclose specified costs, prices, reimbursements, fees, markups, discounts, and aggregate payments received with respect to their PBM services. Further, PBMs must report annually to the Federal Trade Commission (FTC) certain information about payments received from health plans and fees charged to pharmacies. The FTC and state attorneys general are authorized to enforce the provisions of the bill.

Bill Text Versions

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2 versions available

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Timeline
May 24, 2022
Introduced in Senate
May 24, 2022
Read twice and referred to the Committee on Commerce, Science, and Transportation.
Jun 22, 2022
Committee on Commerce, Science, and Transportation. Ordered to be reported with an amendment in the nature of a substitute favorably.
Dec 14, 2022
Committee on Commerce, Science, and Transportation. Reported by Senator Cantwell with an amendment in the nature of a substitute. Without written report.
Dec 14, 2022
Placed on Senate Legislative Calendar under General Orders. Calendar No. 647.
  • May 24, 2022
    Introduced in Senate


  • May 24, 2022
    Read twice and referred to the Committee on Commerce, Science, and Transportation.


  • June 22, 2022
    Committee on Commerce, Science, and Transportation. Ordered to be reported with an amendment in the nature of a substitute favorably.


  • December 14, 2022
    Committee on Commerce, Science, and Transportation. Reported by Senator Cantwell with an amendment in the nature of a substitute. Without written report.


  • December 14, 2022
    Placed on Senate Legislative Calendar under General Orders. Calendar No. 647.

Health

Related Bills

  • S 117-298: Pharmacy Benefit Manager Accountability Study Act of 2021
  • HR 117-1829: Pharmacy Benefit Manager Accountability Study Act of 2021
Civil actions and liabilityCongressional oversightGovernment information and archivesGovernment studies and investigationsHealth care costs and insuranceMedical ethicsPrescription drugsState and local government operations

Pharmacy Benefit Manager Transparency Act of 2022

USA117th CongressS-4293| Senate 
| Updated: 12/14/2022
Pharmacy Benefit Manager Transparency Act of 2022 This bill generally prohibits pharmacy benefit managers (PBMs) from engaging in certain practices when managing the prescription drug benefits under a health insurance plan, including charging the plan a different amount than the PBM reimburses the pharmacy. The bill also prohibits PBMs from arbitrarily, unfairly, or deceptively (1) clawing back reimbursement payments, or (2) increasing fees or lowering reimbursements to pharmacies to offset changes to federally funded health plans. PBMs are not subject to these prohibitions if they (1) pass along 100% of any price concession or discount to the health plan, and (2) disclose specified costs, prices, reimbursements, fees, markups, discounts, and aggregate payments received with respect to their PBM services. Further, PBMs must report annually to the Federal Trade Commission (FTC) certain information about payments received from health plans and fees charged to pharmacies. The FTC and state attorneys general are authorized to enforce the provisions of the bill.

Bill Text Versions

View Text
2 versions available

Suggested Questions

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

Timeline
May 24, 2022
Introduced in Senate
May 24, 2022
Read twice and referred to the Committee on Commerce, Science, and Transportation.
Jun 22, 2022
Committee on Commerce, Science, and Transportation. Ordered to be reported with an amendment in the nature of a substitute favorably.
Dec 14, 2022
Committee on Commerce, Science, and Transportation. Reported by Senator Cantwell with an amendment in the nature of a substitute. Without written report.
Dec 14, 2022
Placed on Senate Legislative Calendar under General Orders. Calendar No. 647.
  • May 24, 2022
    Introduced in Senate


  • May 24, 2022
    Read twice and referred to the Committee on Commerce, Science, and Transportation.


  • June 22, 2022
    Committee on Commerce, Science, and Transportation. Ordered to be reported with an amendment in the nature of a substitute favorably.


  • December 14, 2022
    Committee on Commerce, Science, and Transportation. Reported by Senator Cantwell with an amendment in the nature of a substitute. Without written report.


  • December 14, 2022
    Placed on Senate Legislative Calendar under General Orders. Calendar No. 647.
Maria Cantwell

Maria Cantwell

Democratic Senator

Washington

Cosponsors (8)
Mike Braun (Republican)Thomas Tillis (Republican)Cindy Hyde-Smith (Republican)Jerry Moran (Republican)John Boozman (Republican)Jon Tester (Democratic)Chuck Grassley (Republican)Shelley Moore Capito (Republican)

Commerce, Science, and Transportation Committee

Health

Related Bills

  • S 117-298: Pharmacy Benefit Manager Accountability Study Act of 2021
  • HR 117-1829: Pharmacy Benefit Manager Accountability Study Act of 2021
  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Civil actions and liabilityCongressional oversightGovernment information and archivesGovernment studies and investigationsHealth care costs and insuranceMedical ethicsPrescription drugsState and local government operations