House and Senate Committees advanced two separate bills that would increase PBM transparency, study vertical integration in the pharmacy space, and strengthen transparency for hospitals, ambulatory surgical centers, and imaging and lab services providers.
The Senate Finance Committee advanced the Modernizing and Ensuring PBM Accountability Act that would address a range of PBM issues, including on drug rebates, transparency, delinking PBM compensation from a drug manufacturer’s list price, and studying the impact of vertical integration in the pharmacy space.
Spillover impact on employer costs? While the bill would directly impact Medicare Part D covered drugs and spread pricing in the Medicaid program, it could indirectly impact employers as costs are shifted onto employer plans.
The House Ways and Means Committee also advanced the Health Care Price Transparency Act (H.R. 4822) on a party line vote, which would strengthen hospital transparency and also require ambulatory surgical centers and imaging and lab services providers to post prices.
Multiple committee bills will have to be combined this Fall with an eye towards gaining enough bipartisan, bicameral support to be enacted and sent to the President.