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Health and Employer Groups Push for Improved Health Pricing Transparency

The ERISA Industry Committee and other health industry groups support two bills aimed at enhancing transparency and reducing costs in health care plan administration. Click here for article.

  • Lower Costs, More Transparency Act:

  • Improves hospital pricing transparency, requiring hospitals to publish prices including discounts and negotiated charges.

  • Pharmacy benefit managers (PBMs) must disclose rebate and fee information for drugs, allowing easier audit of claims and costs.

  • Prohibits spread-pricing by PBMs for pharmacies dealing with Medicaid.

  • Pharmacy Benefit Manager Reform Act:

  • Requires PBMs to report various pricing details to health plans, including copayment assistance funded by drug manufacturers and net spending on prescription drugs.

  • Mandates biannual reports on drugs purchased at pharmacies owned by the PBM.

  • Industry Endorsements:

  • Supported by Purchaser Business Group on Health, American Benefits Council, National Alliance of Healthcare Purchaser Coalitions, Silicon Valley Employers Forum, HR Policy Association, Business Group on Health, and Small Business Majority.

  • Legislative Progress:

  • Lower Costs, More Transparency Act passed the House of Representatives.

  • Pharmacy Benefit Manager Reform Act passed the Senate Health, Education, Labor and Pensions Committee.

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