STAT+: House panel passes key PBM reform for sliver of commercial market
A House panel passed a bill to ban drug middlemen from tying fees to list prices, but it only applies to employees of the federal government.
WASHINGTON — A House panel passed a bipartisan bill to ban drug middlemen from charging fees based on drug list prices — the first in Congress’ raft of PBM reform efforts that would actually ban the practice in at least some of the employer-sponsored insurance market.
The bill, by Rep. Mariannette Miller-Meeks (R-Iowa), would only allow PBMs to charge a flat service fee, separating those fees from list prices. The bill also would ban the PBM practice, called spread pricing, of charging insurers more than they pay pharmacies. And it would prohibit PBMs from steering patients to pharmacies affiliated with them.
Those changes would only apply to health insurance for federal employees. The Federal Employees Health Benefits program covers more than 8 million of the nearly 160 million Americans who are covered by health insurance from their employer.
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