Cincinnati, OH – Today, Congressman Greg Landsman (D-OH-01) and Congresswoman Diana Harshbarger (R-TN-01) introduced bipartisan legislation to help lower prescription drug costs for seniors.
Congressman Landsman and Congresswoman Harshbarger have introduced H.R.5385 – the Medicare PBM Accountability Act – bipartisan legislation to help lower the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans.
Under Medicare Part D and Medicare Advantage plans, seniors’ prescription drug benefits are covered by private health insurance companies known as Prescription Drug Plan sponsors, who then contract with third-party companies known as Pharmacy Benefit Managers (PBMs) to control costs. Pharmacy Benefit Managers negotiate with pharmaceutical companies to secure rebates, discounts, and price concessions on prescription drugs, and are supposed to pass those cost savings on to seniors covered by Medicare Part D and Medicare Advantage plans.
However, current federal law does not require Pharmacy Benefit Managers to report to Prescription Drug Plan sponsors the cost savings they have secured. Without this transparency, PBMs are able to withhold the true costs of prescription drugs – potentially keeping the cost savings as profits instead of passing them on to seniors.
Congressman Landsman and Congresswoman Harshbarger’s Medicare PBM Accountability Act would require Pharmacy Benefit Managers to report the cost savings they have secured, empowering Prescription Drug Plan sponsors to be in a stronger position to ensure that cost savings actually benefit seniors through lower prices on prescription drugs as intended.
“Prescription drug costs are out of control, especially for seniors on fixed incomes,” said Congressman Landsman. “To lower costs and improve seniors’ quality of life, we have to hold Pharmacy Benefit Managers accountable. With bipartisan support, our legislation will save seniors real money, and Congress must come together to get this done.”
“For far too long, Pharmacy Benefit Manager middlemen have been playing pricing games in Medicare Part D that raise out-of-pocket costs and limit access to the community pharmacy of choice for seniors, while threatening the viability of small business pharmacies,” said Adam Harbison, Senior Director at the National Community Pharmacists Association. “These anticompetitive practices have gotten worse as PBMs have vertically integrated with insurance companies, as well as their own retail and mail-order pharmacies. The National Community Pharmacists Association applauds Congressman Landsman and Congresswoman Harshbarger for introducing the Medicare PBM Accountability Act to bring some transparency to PBM actions that negatively impact patients and independent pharmacies.”
Congressman Landsman and Congresswoman Harshbarger’s legislation mirrors legislation introduced in the Senate by Senators Catherine Cortez Masto (D-NV), Thom Tillis (R-NC), Ron Wyden (D-OR), and Mike Crapo (R-ID), which passed out of the Senate Committee on Finance in July 2023 as part of a larger legislative healthcare package.
The full text of Congressman Landsman and Congresswoman Harshbarger’s Medicare PBM Accountability Act be found here.