[Congressional Record Volume 164, Number 148 (Thursday, September 6, 2018)]
[Senate]
[Page S6062]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 4011. Mr. LEE submitted an amendment intended to be proposed by 
him to the bill S. 2554, to ensure that health insurance issuers and 
group health plans do not prohibit pharmacy providers from providing 
certain information to enrollees; which was ordered to lie on the 
table; as follows:

       On page 4, strike line 2 and all that follows through line 
     6 on page 5 and insert the following:
       ``(a) In General.--A self-insured group health plan shall--
       ``(1) not restrict, directly or indirectly, any pharmacy 
     that dispenses a prescription drug to an enrollee in the plan 
     from informing (or penalize such pharmacy for informing) an 
     enrollee of any differential between the enrollee's out-of-
     pocket cost under the plan with respect to acquisition of the 
     drug and the amount an individual would pay for acquisition 
     of the drug without using the plan; and
       ``(2) ensure that any entity that provides pharmacy 
     benefits management services under a contract with any such 
     health plan does not, with respect to such plan, restrict, 
     directly or indirectly, a pharmacy that dispenses a 
     prescription drug from informing (or penalize such pharmacy 
     for informing) an enrollee of any differential between the 
     enrollee's out-of-pocket cost under the plan with respect to 
     acquisition of the drug and the amount an individual would 
     pay for acquisition of the drug without using the plan.
       ``(b) Definition.--For purposes of this section, the term 
     `out-of-pocket cost', with respect to acquisition of a drug, 
     means the amount to be paid by the enrollee under the health 
     plan, including any cost-sharing (including any deductible, 
     copayment, or coinsurance) and, as determined by the 
     Secretary, any other expenditure.''.
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