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Bill116th CongressFiled Sep 25, 2019Health
S. 2543

Prescription Drug Pricing Reduction Act of 2019

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What it doesSummary introduced in senate (Sep 25, 2019)

Prescription Drug Pricing Reduction Act of 2019

This bill alters several programs and requirements relating to the prices of prescription drugs under Medicare and Medicaid.

Among other things, the bill

  • requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) for certain drugs covered under Medicare for which the average manufacturer price increases faster than inflation;
  • requires drug manufacturers to issue rebates to the CMS for discarded amounts of certain single-dose drugs covered under Medicare, based on information reported by providers;
  • reduces the annual out-of-pocket spending threshold, and eliminates beneficiary cost-sharing above this threshold, under the Medicare prescription drug benefit;
  • requires the CMS to publish certain information, as reported by pharmacy benefit managers (PBMs), relating to drug discounts and rebates, and payments between PBMs, health plans, and pharmacies;
  • requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid; and
  • increases the maximum rebate payable by drug manufacturers under the Medicaid Drug Rebate Program.

What just happenedSep 25, 2019

Placed on Senate Legislative Calendar under General Orders. Calendar No. 225.

Who’s behind it

Sen. Grassley, Chuck [R-IA](R-IA)Sponsor
Read on Congress.gov
1committees4actions11related bills31subjects
  1. Sep 25, 2019Calendars

    Placed on Senate Legislative Calendar under General Orders. Calendar No. 225.

  2. Sep 25, 2019Committee

    Committee on Finance. Original measure reported to Senate by Senator Grassley. With written report No. 116-120.

    Finance Committee
  3. Sep 25, 2019Committee14000

    Committee on Finance. Original measure reported to Senate by Senator Grassley. With written report No. 116-120.

    Finance Committee
  4. Sep 25, 2019IntroReferral10000

    Introduced in Senate

Introduced in SenateSep 25, 2019

Prescription Drug Pricing Reduction Act of 2019

This bill alters several programs and requirements relating to the prices of prescription drugs under Medicare and Medicaid.

Among other things, the bill

  • requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) for certain drugs covered under Medicare for which the average manufacturer price increases faster than inflation;
  • requires drug manufacturers to issue rebates to the CMS for discarded amounts of certain single-dose drugs covered under Medicare, based on information reported by providers;
  • reduces the annual out-of-pocket spending threshold, and eliminates beneficiary cost-sharing above this threshold, under the Medicare prescription drug benefit;
  • requires the CMS to publish certain information, as reported by pharmacy benefit managers (PBMs), relating to drug discounts and rebates, and payments between PBMs, health plans, and pharmacies;
  • requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid; and
  • increases the maximum rebate payable by drug manufacturers under the Medicaid Drug Rebate Program.
Reported to SenateSep 25, 201925

Prescription Drug Pricing Reduction Act of 2019

This bill alters several programs and requirements relating to the prices of prescription drugs under Medicare and Medicaid.

Among other things, the bill

  • requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) for certain drugs covered under Medicare for which the average manufacturer price increases faster than inflation;
  • requires drug manufacturers to issue rebates to the CMS for discarded amounts of certain single-dose drugs covered under Medicare, based on information reported by providers;
  • reduces the annual out-of-pocket spending threshold, and eliminates beneficiary cost-sharing above this threshold, under the Medicare prescription drug benefit;
  • requires the CMS to publish certain information, as reported by pharmacy benefit managers (PBMs), relating to drug discounts and rebates, and payments between PBMs, health plans, and pharmacies;
  • requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid; and
  • increases the maximum rebate payable by drug manufacturers under the Medicaid Drug Rebate Program.
Prescription Drug Pricing Reduction Act of 2019 — Informed