Summary: S.2543 — 116th Congress (2019-2020)All Information (Except Text)

Bill summaries are authored by CRS.

Shown Here:
Reported to Senate (09/25/2019)

Prescription Drug Pricing Reduction Act of 2019

This bill alters several programs and requirements relating to the prices of prescription drugs under Medicare and Medicaid.

Among other things, the bill

  • requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) for certain drugs covered under Medicare for which the average manufacturer price increases faster than inflation;
  • requires drug manufacturers to issue rebates to the CMS for discarded amounts of certain single-dose drugs covered under Medicare, based on information reported by providers;
  • reduces the annual out-of-pocket spending threshold, and eliminates beneficiary cost-sharing above this threshold, under the Medicare prescription drug benefit;
  • requires the CMS to publish certain information, as reported by pharmacy benefit managers (PBMs), relating to drug discounts and rebates, and payments between PBMs, health plans, and pharmacies;
  • requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid; and
  • increases the maximum rebate payable by drug manufacturers under the Medicaid Drug Rebate Program.