H.R. 1035

Prescription Drug Price Transparency Act

This bill establishes additional requirements for prescription drug plan sponsors (PDPs) under Medicare and Medicare Advantage, as well as health insurance carriers under the Federal Employees Health Benefits Program, relating to the methodology of payments to pharmacies and the use of pharmacy benefits managers (PBMs).

Specifically, such PDPs and carriers must disclose specified information to pharmacies regarding applicable standards for reimbursement that are based on drug costs, including the sources used to update such standards. Additionally, such PDPs and carriers may not contract with PBMs that require, or that provide an incentive for, plan enrollees to use pharmacies that have a shared ownership interest with the PBM.