Patient Right to Shop Act
If enacted, SB1374 would result in significant changes to the Public Health Service Act, the Employee Retirement Income Security Act (ERISA), and the Internal Revenue Code. Specifically, it prohibits health plans from blocking entities that provide decision-support tools from accessing crucial drug pricing information. This change is expected to enhance the effectiveness of consumer decision-support tools and promote better price comparison among different pharmacies and medications. The bill's implementation is proposed to commence two years following its enactment, giving stakeholders time to adapt to the new regulations.
SB1374, known as the Patient Right to Shop Act, is designed to enhance patient access to drug pricing information. The bill explicitly prohibits group health plans and health insurance issuers from entering contracts that restrict the use of consumer decision-support tools, which are essential for informing patients about prescription drug costs. By ensuring that patients have access to transparent pricing, the bill seeks to empower them in making informed healthcare decisions, potentially leading to increased competition and lower drug costs.
While supporters argue that the bill will foster transparency and lower costs for consumers, opponents may raise concerns about the feasibility of its implementation and the potential impact on contractual agreements between health plans and pharmacy benefit managers. There may also be debates over how broadly or narrowly to define consumer decision-support tools and what constitutes necessary information. Discussions surrounding SB1374 may include points of contention related to market dynamics and the regulatory burden this new transparency requirement could impose on health insurers.