118 HR 5400 IH: Neighborhood Options for Patients Buying Medicines Act U.S. House of Representatives 2023-09-12 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.

I118th CONGRESS1st SessionH. R. 5400IN THE HOUSE OF REPRESENTATIVESSeptember 12, 2023Mr. Carter of Georgia (for himself, Mrs. Dingell, Mr. Rose, and Mr. Krishnamoorthi) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedA BILLTo amend title XVIII of the Social Security Act to assure pharmacy access and choice for Medicare beneficiaries.

1.

Short title

This Act may be cited as the Neighborhood Options for Patients Buying Medicines Act or the NO PBMs Act.

2.

Assuring pharmacy access and choice for Medicare beneficiaries

Section 1860D–4(b)(1) of the Social Security Act (42 U.S.C. 1395w–104(b)(1)) is amended by striking subparagraph (A) and inserting the following: (A)

In general

(i)

Participation of any willing pharmacy

A PDP sponsor offering a prescription drug plan or a pharmacy benefit manager acting to develop a pharmacy network on behalf of such plan shall permit the participation of any pharmacy that meets the standard contract terms and conditions under such plan to participate as a network pharmacy of such plan. (ii)

Contract terms and conditions

In accordance with clause (i), contract terms and conditions offered by such PDP sponsor or pharmacy benefit manager shall be reasonable and relevant. Notwithstanding any other provision of law, not later than January 1, 2026, the Secretary shall establish standards for reasonable and relevant contract terms and conditions for purposes of this clause..