HR 5234 · 111th Congress · Health

PBM Audit Reform and Transparency Act of 2010

Introduced 2010-05-06· Sponsored by Rep. Weiner, Anthony D. [D-NY-9]· House

Bill Progress

Introduced
2
Committee
3
House Vote
4
Senate
5
Enacted
Latest: Referred to the Subcommittee on Health, Employment, Labor, and Pensions.(2010-05-27)

Plain Language Summary

[AI summary unavailable — showing source text] PBM Audit Reform and Transparency Act of 2010 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code, and part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to prohibit a group health plan from entering into a contract with any pharmacy benefit manager (PBM) to manage the prescription drug coverage provided under the plan, or to control the costs of such coverage, unless the PBM satisfies the following requirements. Requires the PBM to report at least annually to each plan, including regarding the PBM's payments to pharmacies, payments received by the PBM from plans and drug manufacturers, and information on generic drugs. Sets forth provisions governing the interaction between a PBM and pharmacies that contract with the PBM, including: (1) requiring the PBM to disclose reimbursement information; (2) requiring prompt payment for clean claims; (3) prohibiting the exclusion of qualified pharmacies from participation in a network; and (4) requiring a pharmacy owner to sign a contract with a PBM before assuming responsibility to participate in a network managed…

Summarized by Claude AI · Non-partisan · For informational purposes only

Cosponsors (20)

15 Democrats5 Republicans