PRIME THERAPEUTICS

Health Issues

PBM Transparency-Issues concerning PBM reporting of rebates and payments through the pharmaceutical supply chain. S. 127, The Pharmacy Benefit Manager Transparency Act of 2023," provisions related to the Federal Trade Commission regulation of PBMs. H.R. 4011, Timely Access to Clinical Treatment (TACT) Act of 2023, provisions on pharmacy access standards. Issues related to cost-sharing for insulin and other therapies in the commercial market. S. 1339, the Pharmacy Benefit Manager Reform Act provisions related to PBM disclosure, fee pass through and fee structures. H.R. 3862, Improving Transparency to Lower Drug Cost Act of 2021 (117th Congress)-provisions related to PBM transparency and disclosure. H.R. 3561, The PATIENT Act, provisions related to disclosure of drug price concessions and highly-rebated drugs. H.R. 37999, the CHOICE Act, potential amendments related to PBM pharmacy contracting practices. Issues related to patient cost-sharing and drug coupons. H.R. 3281/H.R. 2681, The Transparence PRICE Act, issues related to disclosure of drug price concessions. H.R. 2679, Pharmacy Benefit Manager Accountability Act, provisions related to client disclosure of drug price concessions particularly coupon use.

TargetedSENATE · HOUSE OF REPRESENTATIVES

Medicare/Medicaid

Implementation of the Inflation Reduction Act of 2022, P.L. 169- Provisions on Medicare Part D modernization and drug price negotiation. Implementation of Center for Medicare and Medicaid Services Final Rule, Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs Final Rule, CMS-4192-F, CMS-1744-F, provisions related to changes in Pharmacy Direct and Indirect Renumeration. S. 1967, Patients Before Middlemen Act, provisions governing how PBM compensation and use of metrics in determining drug rebates. S. 2052, A bill to amend title XVIII of the Social Security Act to enforce any willing pharmacy requirements and establish safeguards to ensure patient access to pharmacists in Medicare Part D and for other purposes. S. 2543 (116th Congress, Prescription Drug Pricing Reform Act of 2019 provisions on drug pricing disclosures. Issues related to utilization of real-time benefit checks.