Lowest Price for Patients Act

I 117TH CONGRESS 1ST SESSION H. R. 2484 To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to require pharmacies to disclose any differen- tial between the cost of a prescription drug based on whether certain individuals use prescription drug coverage to acquire such drug, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 13, 2021 Ms. PORTER (for herself, Ms. DELAURO, Mr. GRIJALVA, Mrs. HAYES, Mr. KHANNA, Mr. NEGUSE, Mr. LARSON of Connecticut, and Mr. COHEN) in- troduced the following bill; which was referred to the Committee on En- ergy 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 jurisdic- tion of the committee concerned A BILL To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to require pharmacies to disclose any differential between the cost of a prescription drug based on whether certain individ- uals use prescription drug coverage to acquire such drug, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 23:09 May 27, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2484.IH H2484 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2484 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Lowest Price for Pa- 2 tients Act’’. 3 SEC. 2. REQUIREMENT FOR PHARMACIES TO DISCLOSE 4 ANY DIFFERENTIAL BETWEEN THE COST OF 5 A PRESCRIPTION DRUG BASED ON WHETHER 6 CERTAIN INDIVIDUALS USE PRESCRIPTION 7 DRUG COVERAGE TO ACQUIRE SUCH DRUG. 8 (a) ENROLLEES OF PRESCRIPTION DRUG COVERAGE 9 UNDER A GROUP HEALTH PLAN OR A HEALTH INSUR- 10 ANCE ISSUER OFFERING GROUP OR INDIVIDUAL HEALTH 11 INSURANCE COVERAGE.—Section 2729(a) of the Public 12 Health Service Act (42 U.S.C. 300gg–29(a)) is amend- 13 ed— 14 (1) in paragraph (1)— 15 (A) by striking ‘‘not restrict, directly or in- 16 directly,’’ and inserting ‘‘provide that’’; and 17 (B) by striking ‘‘from informing (or penal- 18 ize such pharmacy for informing)’’ and insert- 19 ing ‘‘inform’’; and 20 (2) in paragraph (2)— 21 (A) by striking ‘‘ensure’’ and inserting 22 ‘‘provide’’; 23 (B) by striking ‘‘does not, with respect to 24 such plan or coverage, restrict, directly or indi- 25 VerDate Sep 11 2014 23:09 May 27, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2484.IH H2484 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2484 IH rectly,’’ and inserting ‘‘requires under such con- 1 tract that’’; and 2 (C) by striking ‘‘from informing (or penal- 3 ize such pharmacy for informing)’’ and insert- 4 ing ‘‘inform’’. 5 (b) ENROLLEES OF PRESCRIPTION DRUG COVERAGE 6 UNDER A PRESCRIPTION DRUG PLAN OR MA–PD 7 PLAN.—Section 1860D–4 of the Social Security Act (42 8 U.S.C. 1395w–104) is amended— 9 (1) by redesignating the subsection (m) as in- 10 serted by section 6063(c) of the SUPPORT for Pa- 11 tients and Communities Act as subsection (n); and 12 (2) by adding at the end the following new sub- 13 section: 14 ‘‘(o) PHARMACY DISCLOSURE OF THE PRICE OF A 15 DRUG FOR AN ENROLLEE USING AND NOT USING PRE- 16 SCRIPTION DRUG COVERAGE.—For plan year 2022 and 17 each subsequent plan year, a PDP sponsor and a Medicare 18 Advantage organization offering a prescription drug plan 19 or MA–PD plan under a contract with an entity that pro- 20 vides pharmacy benefits management services on behalf 21 of such MA–PD plan shall provide that each pharmacy 22 that dispenses a coverage part D drug shall inform an en- 23 rollee of any differential between— 24 VerDate Sep 11 2014 23:09 May 27, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2484.IH H2484 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2484 IH ‘‘(1) the price of the drug for an individual that 1 is an enrollee under such prescription drug plan or 2 MA–PD plan (as the case may be) using such plan; 3 and 4 ‘‘(2) the price of the drug for such individual 5 described in paragraph (1) without using such 6 plan.’’. 7 Æ VerDate Sep 11 2014 23:09 May 27, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H2484.IH H2484 kjohnson on DSK79L0C42PROD with BILLS