PBM re­forms: Sen­ate Fi­nance Com­mit­tee lead­ers in­tro­duce an­oth­er bi­par­ti­san bill

Last sum­mer’s bi­par­ti­san, bi­cam­er­al fo­cus on the phar­ma mid­dle­men known as phar­ma­cy ben­e­fit man­agers is re­turn­ing. Sens. Ron Wyden (D-OR) and Mike Crapo (R-ID) in­tro­duced a bill on Thurs­day fo­cused on trans­paren­cy and halt­ing PBMs’ abu­sive prac­tices.

The text is based on a bill that passed out of the Sen­ate Fi­nance Com­mit­tee in Ju­ly.

Among the pro­vi­sions in this lat­est adap­ta­tion: pre­vent­ing the use of “abu­sive spread pric­ing” in Med­ic­aid, which is when PBMs charge health plans more than they pay phar­ma­cies for drugs; pro­mot­ing trans­paren­cy for phar­ma­cies un­der Medicare Part D; en­sur­ing ac­cu­rate pay­ments to phar­ma­cies un­der Med­ic­aid; and re­quir­ing an OIG study and re­port on drug price mark-ups in Part D.

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