WASHINGTON, D.C. – The U.S. House of Representatives today passed the House Energy and Commerce Committee’s bipartisan Lower Costs, More Transparency Act, which included two of Rep. Earl L. “Buddy” Carter’s (R-GA) bills reining in pharmacy benefit managers (PBMs), the shadowy middlemen that drive up costs for prescription medications and create barriers to care.
The bills sponsored by Rep. Carter that passed as part of this package include H.R. 1613, The Drug Price Transparency in Medicaid Act and H.R. 2679, the Pharmacy Benefits Manager Accountability Act.
“I am thrilled that the House voted to pull back the curtains on PBMs by reducing health care costs and increasing price transparency for patients. Combined, my bills that were included in this landmark package will end the predatory spread pricing practice in Medicaid programs, raise reporting requirements for PBMs, and ensure pharmacists are fairly reimbursed when filling prescriptions for Medicaid beneficiaries, getting us one step closer to a health care system that puts patients before profits,” said Rep. Carter.
“This bipartisan legislation delivers on our commitment to lowering health care costs and providing increased transparency for patients—something 95 percent of Americans support. It helps Americans save money on out-of-pocket expenses and seniors save millions on medicines through important Medicare payment reforms. I thank Representative Carter for his leadership on key provisions in the effort,” said Chair Rodgers.
H.R. 1613, the Drug Price Transparency in Medicaid Act, saves taxpayers billions by eliminating the use of wasteful and predatory Medicaid spread pricing by pharmacy benefit managers (PBMs). The program also establishes oversight of, and accountability for, PBM tactics that are threatening patient access to health care and increasing prescription drug spending in Medicaid programs.
H.R. 2679, the Pharmacy Benefits Manager Accountability Act, would raise reporting requirements for PBMs to increase transparency in the drug supply chain.
The Lower Costs, More Transparency Act includes provisions to:
Increase Price Transparency Throughout the Health Care System for Patients
- Empower patients and employers to shop for health care and make informed health care decisions by providing timely and accurate information about the cost of care, treatment, and services
- Make health care price information public by ensuring hospitals, insurance companies, labs, imaging providers, and ambulatory surgical centers publicly list the prices they charge patients, building upon the Trump administration price transparency rules
- Lower costs for patients and employers by requiring health insurers and pharmacy benefit managers (PBMs) to disclose negotiated drug rebates and discounts, revealing the true costs of prescription drugs
Addresses the Cost of Prescription Drugs
- Lower out-of-pocket costs for seniors who receive medication at a hospital-owned outpatient facility or doctor’s office
- Expand access to more affordable generic drugs
- Equip employer health plans with the drug price information they need to get the best deal possible for their employees
Support Patients, Health Care Workers, Community Health Centers, and Hospitals
- Fully pay for expiring programs that strengthen the health care system by:
- Supporting Community Health Centers, which are crucial for patients in rural and underserved areas
- Supporting training programs for new doctors in communities
- Preserving Medicaid for hospitals that take care of uninsured and low-income patients
Read H.R. 1613, The Drug Price Transparency in Medicaid Act, here.
Read H.R. 2679, the Pharmacy Benefits Manager Accountability Act, here.
Read the section-by-section Lower Costs, More Transparency Act summary here.
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