[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3290 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 628
118th CONGRESS
  2d Session
                                H. R. 3290

                          [Report No. 118-757]

     To amend title III of the Public Health Service Act to ensure 
     transparency and oversight of the 340B drug discount program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 15, 2023

 Mr. Bucshon introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

                           November 20, 2024

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
[For text of introduced bill, see copy of bill as introduced on May 15, 
                                 2023]


_______________________________________________________________________

                                 A BILL


 
     To amend title III of the Public Health Service Act to ensure 
     transparency and oversight of the 340B drug discount program.


 


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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``340B Transparency Act''.

SEC. 2. ENSURING TRANSPARENCY AND OVERSIGHT OF THE 340B DRUG DISCOUNT 
              PROGRAM.

    (a) In General.--Section 340B(a)(5) of the Public Health Service 
Act (42 U.S.C. 256b(a)(5)) is amended--
            (1) in subparagraph (C)--
                    (A) by striking ``A covered entity shall permit'' 
                and inserting:
                            ``(i) Duplicate discounts and drug 
                        resale.--A covered entity shall permit''; and
                    (B) by adding at the end the following new clauses:
                            ``(ii) Use of savings.--A covered entity 
                        shall permit the Secretary to audit, at the 
                        Secretary's expense, the records of the entity 
                        to determine--
                                    ``(I) how savings (as defined in 
                                subparagraph (E)(iv)) from covered 
                                outpatient drugs subject to an 
                                agreement under this section furnished 
                                by such entity are used by such entity; 
                                and
                                    ``(II) such entity's compliance 
                                with subparagraph (E).
                            ``(iii) Records retention.--Covered 
                        entities shall retain such records and provide 
                        such records and reports as determined 
                        necessary by the Secretary for carrying out 
                        this subparagraph.''; and
            (2) by adding at the end the following new subparagraph:
                    ``(E) Reporting.--
                            ``(i) In general.--During the first year 
                        beginning on or after the date that is 14 
                        months after the date of enactment of this 
                        subparagraph and during each subsequent year, 
                        each covered entity described in subparagraph 
                        (L) of paragraph (4) (and any other covered 
                        entity specified by the Secretary) shall report 
                        to the Secretary (at a time and in a form and 
                        manner specified by the Secretary) the 
                        following information with respect to the 
                        preceding year:
                                    ``(I) With respect to such covered 
                                entity and each off-campus outpatient 
                                department, as applicable, of such 
                                entity--
                                            ``(aa) the total number of 
                                        individuals who were dispensed 
                                        or administered covered 
                                        outpatient drugs during such 
                                        preceding year that were 
                                        subject to an agreement under 
                                        this section; and
                                            ``(bb) the number of such 
                                        individuals described in a 
                                        category specified in clause 
                                        (iv), broken down by each such 
                                        category.
                                    ``(II) With respect to such covered 
                                entity and each off-campus outpatient 
                                department, as applicable, of such 
                                entity--
                                            ``(aa) the percentage of 
                                        the total number of individuals 
                                        furnished items and services 
                                        during such preceding year who 
                                        were dispensed or administered 
                                        covered outpatient drugs during 
                                        such preceding year that were 
                                        subject to an agreement under 
                                        this section; and
                                            ``(bb) for each category 
                                        specified in clause (iii), the 
                                        percentage of the total number 
                                        of individuals described in 
                                        such category furnished items 
                                        and services during such 
                                        preceding year who were 
                                        dispensed or administered 
                                        covered outpatient drugs during 
                                        such preceding year that were 
                                        subject to an agreement under 
                                        this section.
                                    ``(III) With respect to such 
                                covered entity and each off-campus 
                                outpatient department, as applicable, 
                                of such entity, the total costs 
                                incurred during the year at each such 
                                site and the cost incurred at each such 
                                site for charity care (as defined in 
                                line 23 of worksheet S-10 to the 
                                Medicare cost report, or in any 
                                successor form).
                                    ``(IV) With respect to such covered 
                                entity and each off-campus outpatient 
                                department, as applicable, of such 
                                entity, the costs incurred during the 
                                year of furnishing items and services 
                                at each such department to patients of 
                                such entity who were entitled to 
                                benefits under part A of title XVIII of 
                                the Social Security Act or enrolled 
                                under part B of such title, enrolled in 
                                a State plan under title XIX of such 
                                Act (or a waiver of such plan), or who 
                                were uninsured for services, minus the 
                                sum of--
                                            ``(aa) payments under title 
                                        XVIII of such Act for such 
                                        items and services (including 
                                        any cost sharing for such items 
                                        and services);
                                            ``(bb) payments under title 
                                        XIX of such Act for such items 
                                        and services (including any 
                                        cost sharing for such items and 
                                        services); and
                                            ``(cc) payments by 
                                        uninsured patients for such 
                                        items and services.
                                    ``(V) With respect to such covered 
                                entity and each off-campus outpatient 
                                department, as applicable, of such 
                                entity, savings (as defined in clause 
                                (iv)) from covered outpatient drugs 
                                subject to an agreement under this 
                                section furnished by such entity or 
                                department.
                            ``(ii) Publication.--The Secretary shall 
                        publish data reported under clause (i) with 
                        respect to a year annually on the public 
                        website of the Department of Health and Human 
                        Services in an electronic and searchable 
                        format, which may include the 340B Office of 
                        Pharmacy Affairs Information System (or a 
                        successor to such system), in a manner that 
                        shows each category of data reported in the 
                        aggregate and identified by the specific 
                        covered entity submitting such data. The 
                        Secretary shall include in such publication the 
                        disproportionate patient percentage (as defined 
                        in section 1886(d)(5)(F)(vi) of the Social 
                        Security Act) of each such covered entity (if 
                        applicable) for each cost reporting period 
                        occurring during such year.
                            ``(iii) Categories specified.--For purposes 
                        of clause (i), the categories specified in this 
                        clause are the following:
                                    ``(I) Individuals covered under a 
                                group health plan or group or 
                                individual health insurance coverage 
                                (as such terms are defined in section 
                                2791).
                                    ``(II) Individuals entitled to 
                                benefits under part A or enrolled under 
                                part B of title XVIII of the Social 
                                Security Act.
                                    ``(III) Individuals enrolled under 
                                a State plan under title XIX of such 
                                Act (or a waiver of such plan).
                                    ``(IV) Individuals enrolled under a 
                                State child health plan under title XXI 
                                of such Act (or a waiver of such plan).
                                    ``(V) Individuals not described in 
                                any preceding subclause and not covered 
                                under any Federal health care program 
                                (as defined in section 1128B of such 
                                Act but including the program 
                                established under chapter 89 of title 
                                5, United States Code).
                            ``(iv) Definitions.--For purposes of this 
                        subparagraph:
                                    ``(I) Off-campus outpatient 
                                department.--The term `off-campus 
                                outpatient department' means a 
                                department of a provider (as defined in 
                                section 413.65 of title 42, Code of 
                                Federal Regulations, or any successor 
                                regulation) that is not located--
                                            ``(aa) on the campus (as 
                                        defined in such section) of 
                                        such provider; or
                                            ``(bb) within the distance 
                                        (described in such definition 
                                        of campus) from a remote 
                                        location of a hospital facility 
                                        (as defined in such section).
                                    ``(II) Savings.--The term `savings' 
                                means, with respect to a covered 
                                outpatient drug purchased by a covered 
                                entity, the difference between--
                                            ``(aa) the price for such 
                                        drug that such entity would 
                                        have otherwise paid for such 
                                        drug obtained through a group 
                                        purchasing organization or 
                                        other group purchasing 
                                        arrangement had the requirement 
                                        described in paragraph 
                                        (4)(L)(iii) not applied (or, in 
                                        the case such entity would not 
                                        have obtained covered 
                                        outpatient drugs through such 
                                        an organization or arrangement 
                                        had such requirement not 
                                        applied or information to 
                                        determine such price that such 
                                        entity would have so otherwise 
                                        paid is not available, the 
                                        wholesale acquisition cost (as 
                                        defined in section 
                                        1847A(c)(6)(B) of the Social 
                                        Security Act) for such drug); 
                                        and
                                            ``(bb) the ceiling price 
                                        for such drug.''.
    (b) Enforcement.--Section 340B(d)(2)(B) of the Public Health 
Service Act (42 U.S.C. 256b(d)(2)(B)) is amended by adding at the end 
the following new clause:
                            ``(vi) The imposition of civil monetary 
                        penalties in amounts determined appropriate by 
                        the Secretary in the case that the Secretary 
                        determines that a covered entity is not in 
                        compliance with subsection (a)(5)(E) .''.
    (c) Rulemaking.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Health and Human Services shall 
issue an interim final rule to carry out section 340B(a)(5)(E) of the 
Public Health Service Act, as added by subsection (a)(2).
                                                 Union Calendar No. 628

118th CONGRESS

  2d Session

                               H. R. 3290

                          [Report No. 118-757]

_______________________________________________________________________

                                 A BILL

     To amend title III of the Public Health Service Act to ensure 
     transparency and oversight of the 340B drug discount program.

_______________________________________________________________________

                           November 20, 2024

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed