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Protecting Patients Against PBM Abuses Act

USA118th CongressHR-2880| House 
| Updated: 12/17/2024
Earl L. "Buddy" Carter

Earl L. "Buddy" Carter

Republican Representative

Georgia

Cosponsors (45)
Diana Harshbarger (Republican)Wiley Nickel (Democratic)Jonathan L. Jackson (Democratic)Mikie Sherrill (Democratic)Richard McCormick (Republican)Abigail Davis Spanberger (Democratic)Robert Menendez (Democratic)Lisa Blunt Rochester (Democratic)Mike Garcia (Republican)Gabe Vasquez (Democratic)Emanuel Cleaver (Democratic)Jefferson Van Drew (Republican)Rick W. Allen (Republican)Neal P. Dunn (Republican)Claudia Tenney (Republican)Mariannette Miller-Meeks (Republican)Jerry L. Carl (Republican)Andrea Salinas (Democratic)John James (Republican)Donald G. Davis (Democratic)Jake Auchincloss (Democratic)Lloyd Smucker (Republican)A. Drew Ferguson (Republican)Sheila Cherfilus-McCormick (Democratic)Matt Cartwright (Democratic)Mike Flood (Republican)Carol D. Miller (Republican)Joseph D. Morelle (Democratic)Richard Hudson (Republican)Raja Krishnamoorthi (Democratic)Glenn Grothman (Republican)Charles J. "Chuck" Fleischmann (Republican)Austin Scott (Republican)David G. Valadao (Republican)John W. Rose (Republican)Derrick Van Orden (Republican)Deborah K. Ross (Democratic)Yadira Caraveo (Democratic)Nanette Diaz Barragán (Democratic)Michael Lawler (Republican)Nick LaLota (Republican)Tracey Mann (Republican)Jennifer A. Kiggans (Republican)Mike Levin (Democratic)Nicole Malliotakis (Republican)

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

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Protecting Patients Against PBM Abuses Act This bill establishes requirements for Medicare pharmacy benefit managers (PBMs) with respect to remuneration, payments, and fees. Specifically, the bill restricts PBMs that are under contract with plans under the Medicare prescription drug benefit or Medicare Advantage from (1) receiving income for their services other than flat dollar amount service fees; (2) basing any service fees on the prices of covered drugs or any associated discounts, rebates, or other remuneration; (3) charging plan sponsors for ingredient costs or dispensing fees in amounts that are different than what is reimbursed to the pharmacy; or (4) reimbursing network pharmacies for less than that what is reimbursed to PBM-affiliated pharmacies. Such PBMs must also report on the difference between certain costs for drugs on the plan's formulary and those that are not on the formulary but are therapeutically equivalent. PBMs must also report certain information regarding rebates and fees they receive from drug manufacturers; the Centers for Medicare & Medicaid Services must publish this and other information that is currently reported by PBMs online.
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Timeline
Apr 26, 2023
Introduced in House
Apr 26, 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.
Apr 28, 2023
Referred to the Subcommittee on Health.
Nov 15, 2023
Forwarded by Subcommittee to Full Committee by Voice Vote.
Nov 15, 2023
Subcommittee Consideration and Mark-up Session Held
Dec 5, 2023
Committee Consideration and Mark-up Session Held
Dec 6, 2023
Ordered to be Reported (Amended) by the Yeas and Nays: 46 - 0.
Dec 6, 2023
Committee Consideration and Mark-up Session Held
Dec 17, 2024
Referred to the Subcommittee on Health.
  • April 26, 2023
    Introduced in House


  • April 26, 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.


  • April 28, 2023
    Referred to the Subcommittee on Health.


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


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


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


  • December 6, 2023
    Ordered to be Reported (Amended) by the Yeas and Nays: 46 - 0.


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


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

Health

Government information and archivesHealth care costs and insuranceMedicarePrescription drugs

Protecting Patients Against PBM Abuses Act

USA118th CongressHR-2880| House 
| Updated: 12/17/2024
Protecting Patients Against PBM Abuses Act This bill establishes requirements for Medicare pharmacy benefit managers (PBMs) with respect to remuneration, payments, and fees. Specifically, the bill restricts PBMs that are under contract with plans under the Medicare prescription drug benefit or Medicare Advantage from (1) receiving income for their services other than flat dollar amount service fees; (2) basing any service fees on the prices of covered drugs or any associated discounts, rebates, or other remuneration; (3) charging plan sponsors for ingredient costs or dispensing fees in amounts that are different than what is reimbursed to the pharmacy; or (4) reimbursing network pharmacies for less than that what is reimbursed to PBM-affiliated pharmacies. Such PBMs must also report on the difference between certain costs for drugs on the plan's formulary and those that are not on the formulary but are therapeutically equivalent. PBMs must also report certain information regarding rebates and fees they receive from drug manufacturers; the Centers for Medicare & Medicaid Services must publish this and other information that is currently reported by PBMs online.
View Full Text

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Timeline
Apr 26, 2023
Introduced in House
Apr 26, 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.
Apr 28, 2023
Referred to the Subcommittee on Health.
Nov 15, 2023
Forwarded by Subcommittee to Full Committee by Voice Vote.
Nov 15, 2023
Subcommittee Consideration and Mark-up Session Held
Dec 5, 2023
Committee Consideration and Mark-up Session Held
Dec 6, 2023
Ordered to be Reported (Amended) by the Yeas and Nays: 46 - 0.
Dec 6, 2023
Committee Consideration and Mark-up Session Held
Dec 17, 2024
Referred to the Subcommittee on Health.
  • April 26, 2023
    Introduced in House


  • April 26, 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.


  • April 28, 2023
    Referred to the Subcommittee on Health.


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


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


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


  • December 6, 2023
    Ordered to be Reported (Amended) by the Yeas and Nays: 46 - 0.


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


  • December 17, 2024
    Referred to the Subcommittee on Health.
Earl L. "Buddy" Carter

Earl L. "Buddy" Carter

Republican Representative

Georgia

Cosponsors (45)
Diana Harshbarger (Republican)Wiley Nickel (Democratic)Jonathan L. Jackson (Democratic)Mikie Sherrill (Democratic)Richard McCormick (Republican)Abigail Davis Spanberger (Democratic)Robert Menendez (Democratic)Lisa Blunt Rochester (Democratic)Mike Garcia (Republican)Gabe Vasquez (Democratic)Emanuel Cleaver (Democratic)Jefferson Van Drew (Republican)Rick W. Allen (Republican)Neal P. Dunn (Republican)Claudia Tenney (Republican)Mariannette Miller-Meeks (Republican)Jerry L. Carl (Republican)Andrea Salinas (Democratic)John James (Republican)Donald G. Davis (Democratic)Jake Auchincloss (Democratic)Lloyd Smucker (Republican)A. Drew Ferguson (Republican)Sheila Cherfilus-McCormick (Democratic)Matt Cartwright (Democratic)Mike Flood (Republican)Carol D. Miller (Republican)Joseph D. Morelle (Democratic)Richard Hudson (Republican)Raja Krishnamoorthi (Democratic)Glenn Grothman (Republican)Charles J. "Chuck" Fleischmann (Republican)Austin Scott (Republican)David G. Valadao (Republican)John W. Rose (Republican)Derrick Van Orden (Republican)Deborah K. Ross (Democratic)Yadira Caraveo (Democratic)Nanette Diaz Barragán (Democratic)Michael Lawler (Republican)Nick LaLota (Republican)Tracey Mann (Republican)Jennifer A. Kiggans (Republican)Mike Levin (Democratic)Nicole Malliotakis (Republican)

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

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Government information and archivesHealth care costs and insuranceMedicarePrescription drugs