Health plans could not use pharmacy benefit manager contracts that block outside drug price tools. Those tools would show patients their costs under insurance, cash prices, and mail-order options.
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Patient Right to Shop Act is a House bill in Congress.
Who this affects: This bill mainly affects people with group health coverage, the health plans that cover them, insurers, PBMs, and companies that build drug price tools. Patients could see clearer drug price choices before filling prescriptions. Health plans, insurers, and PBMs would need to review contracts and data access rules. Tool providers could get more room to build price comparison tools, but they would still have to follow federal health privacy rules.
Why this matters: Many insured patients do not know the real price of a prescription until they try to fill it. This bill tries to make prices easier to compare before that point. If the tools work well, some patients may find lower-cost options through insurance, cash payment, or mail-order pharmacy benefits. The bill could also change how PBMs and health plans write contracts. Its real effect on drug costs, premiums, and patient choices would depend on future rules and how the industry responds.
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