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1 bill on this topic
“PBMs and Medicaid managed care plans should have to give state Medicaid agencies detailed records on drug costs, pharmacy payments, fees, discounts, rebates, and other compensation, and provide those records to federal officials when asked.”
1 bill on this topic
“Medicaid drug payments through PBMs or managed care plans should be based on the drug's ingredient cost plus a pharmacy dispensing fee, while certain pharmacies or providers that buy drugs at discounts should not have their Medicaid payment lowered just because of that discount.”
1 bill on this topic
“Medicaid drug payments should be based on clear pharmacy costs, and middlemen should not keep hidden markups.”
1 bill on this topic
“HHS should survey retail community pharmacies each month about what they pay for drugs, require Medicaid-connected pharmacies to answer, publish survey participation and available discount or rebate information, and receive $5 million a year for the program starting in fiscal year 2025.”
1 bill on this topic
“Medicare should publish explanations and enough supporting data for laboratories to check clinical lab test payment calculations, and labs should have more ability after 2028 to seek administrative or court review of payment decisions.”
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