Phair Pricing Act of 2019
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S 640 — Phair Pricing Act of 2019
Last action — Read twice and referred to the Committee on Finance.
No card. One bill, free forever — alerts when it moves.
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✓Introduced
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2In Committee
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3Passed Senate
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4Passed House
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5To Executive
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6Enacted
This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.
Summary
Phair Pricing Act of 2019 This bill requires that certain negotiated prices for covered drugs under the Medicare prescription drug benefit be disclosed at the point-of-sale. Specifically, negotiated prices offered under a prescription drug plan (PDP) must be disclosed at the point-of-sale; the disclosed price must include specified adjustments, payments, and fees that are negotiated with the pharmacy (e.g., dispensing fees) by the PDP sponsor or pharmacy benefit manager. Additionally, the Centers for Medicare & Medicaid Services must establish certain quality measures for PDP sponsors to use when determining incentive payments and adjustments (e.g., performance payments) to pharmacies.
Bill Text
- Introduced Introduced in Senate Current html March 04, 2019
Compared against current U.S. Code AI-generated reading aid — verify against the official bill.
The bill requires pharmacy-negotiated price concessions to be included in negotiated prices at the point-of-sale under part D of the Medicare program.
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42 U.S.C. 1395w-102(d)(1)(B)
prices.--For purposes→ prices.-- (i) In general.--For purposesThis change introduces a new format for the subparagraph, specifying that it will now contain an introductory clause.
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42 U.S.C. 1395w-102(d)(1)(B)
(ii) Prices negotiated with pharmacy at point-of-sale.-- (I) In general.--Subject to subclause (III), for plan years beginning on or after January 1, 2020, negotiated prices for covered part D drugs described in clause (i) provided under a prescription drug plan, including all contingent and noncontingent concessions, adjustments, payments, and fees (including dispensing fees) negotiated with the pharmacy dispensing such drug, shall be provided at the point-of-sale of such drug. Such negotiated price shall not include any incentive payments and adjustments or any other contingent concessions, adjustments, payments, or fees that increase the amount of such negotiated price.
This addition mandates that certain negotiated prices be disclosed at the point-of-sale, including all negotiated concessions.
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42 U.S.C. 1395w-102(d)(1)(B)
(II) Application of pharmacy incentive payments and adjustments.-- (aa) In general.--For plan years beginning on or after January 1, 2020, a PDP sponsor--
This addition outlines the obligations for PDP sponsors regarding incentive payments and adjustments to pharmacies.
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42 U.S.C. 1395w-102(d)(1)(B)
(iii) Reasonable reimbursement requirement.--In no case may a negotiated price (as described in clause (ii)(I)) for a covered part D drug furnished by a pharmacy during a plan year beginning on or after January 1, 2020, be less than such pharmacy's cost of purchasing and dispensing such drug and providing such other services associated with furnishing such drug as may be specified by the Secretary.
This mandates that negotiated prices cannot be below the cost of purchasing and dispensing the drug, ensuring fair reimbursement to pharmacies.
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42 U.S.C. 1320b-23(b)(2)
excluding→ includingThis change widens the scope of information that pharmacy benefit managers must provide by including previously excluded information.
Action History
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Introduced in Senate
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Read twice and referred to the Committee on Finance.
Sponsors
- John Kennedy · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 0 co-sponsors · 546 not signed on
Sponsors (1)
- Kennedy, John Republican
Co-sponsors (0)
None.
Not signed on (546)
546 members have not signed on to this bill.
Show all 546 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Subjects
Frequently asked questions
- What does S 640 do?
- Phair Pricing Act of 2019 This bill requires that certain negotiated prices for covered drugs under the Medicare prescription drug benefit be disclosed at the point-of-sale. Specifically, negotiated prices offered under a prescription drug plan (PDP) must be disclosed at the point-of-sale; the disclosed price must include specified adjustments, payments, and fees that are negotiated with the pharmacy (e.g., dispensing fees) by the PDP sponsor or pharmacy benefit manager. Additionally, the Centers for Medicare & Medicaid Services must establish certain quality measures for PDP sponsors to use when determining incentive payments and adjustments (e.g., performance payments) to pharmacies.
- Who sponsors S 640?
- S 640 is sponsored by Kennedy, John (Republican).
- What is the current status of S 640?
- This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
- Where can I track S 640?
- Track S 640 free on One Click Politics — get push/email alerts when it moves.
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