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S.1058 - Pharmacy Competition and Consumer Choice Act of 2011

A bill to amend the Public Health Service Act to ensure transparency and proper operation of pharmacy benefit managers. view all titles (2)

All Bill Titles

  • Official: A bill to amend the Public Health Service Act to ensure transparency and proper operation of pharmacy benefit managers. as introduced.
  • Short: Pharmacy Competition and Consumer Choice Act of 2011 as introduced.

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  • Today: 1
  • Past Seven Days: 2
  • All-Time: 2,226
 
Introduced
 
Senate
Passes
 
House
Passes
 
President
Signs
 

 
05/24/11
 
 
 
 
 
 
 

Sponsor

P000590

Senator

Mark Pryor

D-AR

View Co-Sponsors (6)

Official Summary

Pharmacy Competition and Consumer Choice Act of 2011 - Amends the Public Health Service Act, the Employee Retirements Income Security Act of 1974 (ERISA), the Internal Revenue Code, and part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act

Official Summary

Pharmacy Competition and Consumer Choice Act of 2011 - Amends the Public Health Service Act, the Employee Retirements Income Security Act of 1974 (ERISA), the Internal Revenue Code, and part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to prohibit a group or individual health plan from entering into a contract with any pharmacy benefits manager (PBM) to manage the prescription drug coverage provided under such plan or to control the costs of such coverage, unless the PBM satisfies the requirements of this Act. Directs a PBM to provide at least annually a report to each plan sponsor that includes information on the number and total costs of prescriptions under the contract, payments to pharmacies, payments from pharmaceutical manufacturers, and generic drugs and brand name drugs dispensed. Sets forth provisions governing the interaction between a PBM and pharmacies that contract with the PBM, including requiring a PBM to:
(1) include in contracts drug pricing information and agree to provide timely updates on pricing,
(2) agree to pay pharmacies promptly for clean claims,
(3) not exclude qualifying pharmacies willing to accept terms and conditions of PBM, and
(4) require each pharmacy to sign a contract before assuming responsibility to fill prescriptions for a PBM. Prohibits a PBM from mandating or providing incentives to beneficiaries for use of a pharmacy in which the PBM has an ownership interest. Sets forth limits on audits of pharmacy providers by PBM, including with respect to record keeping, appeals, and recoupment. Establishes limits and notice requirements related to PBM's selling claims or utilization data.

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Organizations Supporting S.1058

  • National Association of Chain Drug Stores
  • National Community Pharmacists Association

Organizations Opposing S.1058

  • Pharmaceutical Care Management Association
  • Americans for Tax Reform
  • Cost of Government Center


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