A bill to require the Secretary of Labor to conduct a study on the fiduciary duties of pharmacy benefit managers.
Impact
This bill would further clarify the role of pharmacy benefit managers within the healthcare framework, especially concerning their responsibilities and the disclosure of fiduciary duties. Should the bill be enacted, it could lead to increased accountability of PBMs, which are often criticized for their role in raising prescription drug costs and managing pharmacy benefit plans. This could potentially enhance transparency in the pharmaceutical supply chain and affect how PBMs negotiate prices with manufacturers and insurance companies.
Summary
SB3330 is a bill introduced in the Senate aimed at mandating the Secretary of Labor to conduct a study assessing the fiduciary duties of pharmacy benefit managers (PBMs). The study, to be completed within two years of the bill's enactment, will analyze the impact of recognizing PBMs as fiduciaries under the Employee Retirement Income Security Act (ERISA). Such recognition would impose significant responsibilities and obligations on PBMs regarding their management of pharmaceutical benefits for group health plans.
Contention
While the intent of SB3330 appears to promote accountability and transparency within the pharmacy benefit management sector, some stakeholders may view this as an additional layer of regulation that could impose burdens on PBMs. Concerns might arise among industry representatives about the feasibility of implementing fiduciary rule compliance, especially regarding the definition and management of 'bona fide service fees' and the overall cost implications for healthcare providers and consumers.
Saving Seniors Money on Prescriptions ActThis bill establishes reporting requirements for pharmacy benefit managers (PBMs) under the Medicare prescription drug benefit and Medicare Advantage, particularly relating to the prices of prescription drugs.Specifically, PBMs must (1) disclose certain information underlying cost performance measurements (e.g., exclusions and terms), and (2) report to prescription drug plan (PDP) sponsors (and to the Centers for Medicare & Medicaid Services upon request) an itemized list of prescription drugs that were dispensed during the previous year and related data about costs, claims, affiliated pharmacies, and other specified information. PDP sponsors may audit PBMs to ensure compliance with this bill's requirements and must annually certify their compliance; PBMs are responsible for any associated civil penalties for violations.In addition, the Government Accountability Office must study federal and state reporting requirements for health plans and PBMs with respect to prescription drug price transparency and recommend ways to streamline these requirements.
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