[Congressional Record Volume 170, Number 115 (Thursday, July 11, 2024)]
[Senate]
[Page S5137]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 2912. Ms. WARREN submitted an amendment intended to be proposed by 
her to the bill S. 4638, to authorize appropriations for fiscal year 
2025 for military activities of the Department of Defense, for military 
construction, and for defense activities of the Department of Energy, 
to prescribe military personnel strengths for such fiscal year, and for 
other purposes; which was ordered to lie on the table; as follows:

       At the end of subtitle A of title VII, insert the 
     following:

     SEC. 710. REQUIRING ANY PHARMACY BENEFIT MANAGER THAT 
                   CONTRACTS WITH TRICARE TO PASS THROUGH ANY 
                   REBATES, PRICE CONCESSIONS, ALTERNATIVE 
                   DISCOUNTS, OR OTHER REMUNERATION.

       Section 1074g(a) of title 10, United States Code, is 
     amended by adding at the end the following new paragraph:
       ``(11)(A) Beginning on January 1, 2025, the Secretary may 
     not contract with a pharmacy benefit manager under the 
     pharmacy benefits program unless the pharmacy benefit manager 
     meets the following requirements:
       ``(i) The pharmacy benefit manager shall disclose to the 
     Secretary (in a form and manner specified by the Secretary)--
       ``(I) for each category or class of drugs for which a claim 
     was filed, a breakdown of the total gross spending on drugs 
     in such category or class before rebates, price concessions, 
     alternative discounts, or other remuneration from drug 
     manufacturers, and the net spending after such rebates, price 
     concessions, alternative discounts, or other remuneration 
     from drug manufacturers; and
       ``(II) any administrative or other fees received from drug 
     manufacturers.
       ``(ii)(I) The pharmacy benefit manager shall not accept any 
     remuneration for services provided by the pharmacy benefit 
     manager other than bona fide service fees.
       ``(II) For purposes of this clause, a `bona fide service 
     fee'--
       ``(aa) shall be related to services actually provided by 
     the pharmacy benefit manager;
       ``(bb) shall reflect the fair market value of such 
     services; and
       ``(cc) may include an incentive payment if such payment is 
     a flat dollar amount, rather than based or contingent upon 
     the manufacturer list price or other related drug price 
     benchmarks and factors.
       ``(III) Rebates, price concessions, alternative discounts, 
     or other remuneration from drug manufacturers, even if such 
     price concessions are calculated as a percentage of a drug's 
     price, shall not be considered a violation of the 
     requirements of subclause (I) if they are fully passed 
     through to the pharmacy benefits program and exclusively used 
     to lower costs for prescription drugs under such program.
       ``(iii) The pharmacy benefit manager shall not engage in 
     any form of spread pricing, whereby any amount charged or 
     claimed by the pharmacy benefit manager exceeds the amount 
     paid to a pharmacy on behalf of the pharmacy benefits 
     program. The amount of payment to a pharmacy benefit manager 
     for covered outpatient drugs under the pharmacy benefits 
     program may not exceed the ingredient costs for the drug and 
     a professional dispensing fee.
       ``(B) In this paragraph, the term `pharmacy benefit 
     manager' means any person or entity that, either directly or 
     through an intermediary, acts as a price negotiator or group 
     purchaser on behalf of the pharmacy benefits program, or 
     manages the prescription drug benefits provided under such 
     program, including the processing and payment of claims for 
     prescription drugs, the performance of drug utilization 
     review, the processing of drug prior authorization requests, 
     the adjudication of appeals or grievances related to the 
     pharmacy benefits program, contracting with network 
     pharmacies, controlling the cost of prescription drugs, or 
     the provision of related services. Such term includes any 
     person or entity that carries out one or more of the 
     activities described in the preceding sentence, irrespective 
     of whether such person or entity identifies itself as a 
     `pharmacy benefit manager'.''.
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