To require the Secretary of Health and Human Services to conduct a study on pharmacy benefit manager audit practices.

[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10050 Introduced in House (IH)]

<DOC>






118th CONGRESS
  2d Session
                               H. R. 10050

  To require the Secretary of Health and Human Services to conduct a 
           study on pharmacy benefit manager audit practices.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 25, 2024

   Ms. Maloy (for herself, Mr. Krishnamoorthi, and Mrs. Harshbarger) 
 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 concerned

_______________________________________________________________________

                                 A BILL


 
  To require the Secretary of Health and Human Services to conduct a 
           study on pharmacy benefit manager audit practices.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. STUDY ON PHARMACY BENEFIT MANAGER AUDIT PRACTICES.

    Not later than 1 year after the date of the enactment of this Act, 
the Secretary of Health and Human Services shall, taking into account 
input from independent pharmacists, pharmacy benefit managers, health 
care providers, and appropriate agencies, conduct a study and submit to 
Congress a report on audit practices of pharmacy benefit managers with 
respect to drugs dispensed under the Medicare and Medicaid programs, 
group health plans, and group or individual health insurance coverage. 
Such report shall include the following:
            (1) An assessment of the financial and operations impacts 
        of current pharmacy benefit manager audit requirements on 
        independent and other retail community pharmacies.
            (2) An evaluation of the appropriateness of current 
        purchase documentation timeframes in relation to medication 
        shelf lives, including with respect to medications that have a 
        shelf life approved by the Food and Drug Administration of 2 
        years or more.
            (3) An evaluation of the transparency of current and 
        historic pharmacy benefit manager audit requirements and 
        recommendations on how to make such requirements more 
        transparent and less burdensome on pharmacists.
            (4) Best practices for pharmacy benefit manager audit 
        processes that ensure fairness and ease burdens on pharmacists 
        without compromising the integrity of the audit.
                                 <all>