News Briefs: Senate Advances PBM Regulations
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Mar 23, 2023
The Senate Committee on Commerce, Science and Transportation on March 22 advanced the Pharmacy Benefit Manager Transparency Act, sending the PBM-regulating legislation to the full Senate. The bill would ban spread pricing, the process in which PBMs charge payers more for a prescription drug than what they reimburse the pharmacy and pocket the difference. It would also “prohibit PBMs from arbitrarily, unfairly, or deceptively clawing back payments made to pharmacies, or arbitrarily, unfairly, or deceptively increasing fees or lowering reimbursements to offset reimbursement changes in federally-funded health plans.” And it would require PBMs to file an annual report with the Federal Trade Commission (FTC) that discloses a variety of information, such as “the aggregate total amount of fees the PBM charged to pharmacies and the total amount of reimbursements the PBM clawed back from pharmacies.” To enforce those new mandates, the bill would authorize the FTC and state attorneys general to seek civil penalties from PBM companies for each violation, plus an additional penalty of up to $1 million. Read more
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