Washington, D.C. - This week, Representative Brad Wenstrup (R-OH) and Representative Nicole Malliotakis (R-NY), members of the House Committee on Ways and Means, announced their legislation, the Protecting Patients from Middlemen Act passed out of the full committee as part of the Health Care Price Transparency Act of 2023.
This legislation would prohibit prescription drug plans and Pharmacy Benefit Managers (PBMs) in Medicare Part D or Medicare Advantage from charging patients more in drug cost-sharing than the net price of the drug.
“This commonsense legislation will provide an important protection for seniors in Medicare by ensuring they will not have to pay more for a prescription than it costs their insurance company. I’m pleased to see that the Ways and Means Committee agreed to put patients first and protect seniors from the opaque pricing tactics of PBMs,”said Rep. Wenstrup.
"When it comes to PBMs, there’s little to no transparency on their practices, and they’re making a lot of money by inflating costs for consumers and putting ‘Mom & Pop’ pharmacies, that are often also their competitors, out of business by dictating how patients can get medication and how much pharmacies get reimbursed for dispensing medication,"said Rep. Malliotakis."I’m pleased to see the Ways and Means Committee push this commonsense legislation forward so we can protect patients from the exploitative pricing techniques of PBMs and work to make prescription drugs more affordable."
"Too many seniors have to make the choice between buying food and buying life-saving or life-extending medication,” said Ways and Means Committee Chairman Jason Smith."Under the leadership of Rep. Malliotakis and Rep. Wenstrup, the Ways and Means Committee is advancing solutions to fight for lower costs for seniors so they will not have to make that choice anymore. Rep. Malliotakis and Rep. Wenstrup’s bill, the Protecting Patients from Middlemen Act that was approved today by the Committee, ensures that Medicare Part D insurers will never charge a patient more than the ‘net price’ of a drug. This patient protection will make sure that our Medicare program is always putting patients over profits."