S. 3729: PBM Reporting Transparency Act

The bill titled the PBM Reporting Transparency Act aims to enhance transparency regarding agreements between the Medicare Payment Advisory Commission (MedPAC) and pharmacy benefit managers (PBMs) in relation to prescription drug plans and Medicare Advantage plans. Here are the main components of the bill:

Key Provisions

• Initial Report: MedPAC is required to submit an initial report to Congress by March 15, two years after the Secretary of Health and Human Services provides relevant data to the Commission. This report must include:
• A description of trends and patterns in the data, including averages and totals pertinent to the information submitted.
• An analysis of any differences in agreements and their impact on out-of-pocket spending for plan enrollees and average pharmacy reimbursement rates.
• Any recommendations deemed appropriate by the Commission.
• Final Report: A final report is to be submitted two years after the initial report, summarizing any changes to the information previously reported and offering any additional recommendations from the Commission.

Purpose of the Reports

The purpose of these reports is to provide Congress with in-depth insights into the agreements between PBMs and Medicare-related plans. By analyzing trends and the implications of these agreements, the bill seeks to improve understanding of how these arrangements affect both healthcare costs for consumers and compensation rates for pharmacies.

Overall Goals

The overall objective of the bill is to promote transparency in the operations of pharmacy benefit managers, which play a crucial role in managing prescription drug benefits for Medicare beneficiaries. By requiring these reports, the legislation intends to ensure that the impacts of PBM agreements are critically analyzed and publicly accessible, which could lead to informed policy decisions regarding Medicare prescription drug plans.

Relevant Companies

• None found