3.0.0 1058 2022-02-03T05:53:47Z 2022-02-03T05:53:47Z Senate S S 2011-05-24 112 sshr00 Health, Education, Labor, and Pensions Committee Senate Standing Referred to 2011-05-24T23:32:28Z Pharmacy Competition and Consumer Choice Act of 2011 112 1971 HR 2011-09-08 Referred to the Subcommittee on Health, Employment, Labor, and Pensions. Identical bill CRS 2011-05-24 sshr00 Health, Education, Labor, and Pensions Committee Senate Read twice and referred to the Committee on Health, Education, Labor, and Pensions. IntroReferral 2011-05-24 Introduced in Senate IntroReferral 10000 9 Library of Congress P000590 Sen. Pryor, Mark L. [D-AR] Mark Pryor D AR Lunsford N M000934 Sen. Moran, Jerry [R-KS] Jerry Moran R KS 2011-05-24 True B001236 Sen. Boozman, John [R-AR] John Boozman R AR 2011-07-05 False J000177 Sen. Johnson, Tim [D-SD] TIM JOHNSON D SD 2011-07-11 False W000437 Sen. Wicker, Roger F. [R-MS] Roger Wicker R MS F. 2011-07-29 False C000567 Sen. Cochran, Thad [R-MS] Thad Cochran R MS 2012-02-07 False C000705 Sen. Conrad, Kent [D-ND] KENT CONRAD D ND 2012-05-10 False Health Health care costs and insurance Prescription drugs Health 00 2011-05-24 Introduced in Senate 2011-08-02T21:58:18Z Pharmacy Competition and Consumer Choice Act of 2011 - Amends the Public Health Service Act, the Employee Retirements Income Security Act of 1974 (ERISA), the Internal Revenue Code, and part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to prohibit a group or individual health plan from entering into a contract with any pharmacy benefits manager (PBM) to manage the prescription drug coverage provided under such plan or to control the costs of such coverage, unless the PBM satisfies the requirements of this Act.

Directs a PBM to provide at least annually a report to each plan sponsor that includes information on the number and total costs of prescriptions under the contract, payments to pharmacies, payments from pharmaceutical manufacturers, and generic drugs and brand name drugs dispensed.

Sets forth provisions governing the interaction between a PBM and pharmacies that contract with the PBM, including requiring a PBM to: (1) include in contracts drug pricing information and agree to provide timely updates on pricing, (2) agree to pay pharmacies promptly for clean claims, (3) not exclude qualifying pharmacies willing to accept terms and conditions of PBM, and (4) require each pharmacy to sign a contract before assuming responsibility to fill prescriptions for a PBM.

Prohibits a PBM from mandating or providing incentives to beneficiaries for use of a pharmacy in which the PBM has an ownership interest.

Sets forth limits on audits of pharmacy providers by PBM, including with respect to record keeping, appeals, and recoupment.

Establishes limits and notice requirements related to PBM's selling claims or utilization data.

]]> Pharmacy Competition and Consumer Choice Act of 2011 Short Titles as Introduced Pharmacy Competition and Consumer Choice Act of 2011 Display Title Pharmacy Competition and Consumer Choice Act of 2011 Official Title as Introduced A bill to amend the Public Health Service Act to ensure transparency and proper operation of pharmacy benefit managers. Introduced in Senate 2011-05-24T04:00:00Z https://www.govinfo.gov/content/pkg/BILLS-112s1058is/xml/BILLS-112s1058is.xml 2011-05-24 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.