S.Amdt. 5392

SA 5392. Mr. MARSHALL submitted an amendment intended to be proposed
to amendment SA 5194 proposed by Mr. Schumer to the bill H.R. 5376, to
provide for reconciliation pursuant to title II of S. Con. Res. 14;
which was ordered to lie on the table; as follows:

At the end of part 5 of subtitle B of title I, add the
following:

SEC. 11406. REQUIREMENTS RELATING TO PAYMENT OF PHARMACY
BENEFIT MANAGERS UNDER MEDICARE PART D.

(a) Prescription Drug Plans.--Section 1860D-12(b) of the
Social Security Act (42 U.S.C. 1395w-112(b)) is amended by
adding at the end the following new paragraph:
``(8) Payment of pharmacy benefit managers.--
``(A) In general.--Each contract entered into with a PDP
sponsor under this part with respect to a prescription drug
plan offered by such sponsor shall provide that any pharmacy
benefit manager (or affiliate, subsidiary, or agent of a
pharmacy benefit manager) that manages prescription drug
coverage under a contract with such sponsor, shall not
receive fees from any entity or individual other than bona
fide service fees.
``(B) Definition of bona fide service fees.--For purposes
of this paragraph, `bona fide service fees' represent fair
market value for a bona fide, itemized service actually
performed on behalf of the fee recipient, that the recipient
would otherwise perform (or contract for) in the absence of
the service arrangement with the pharmacy benefit manager,
and that the pharmacy benefit manager does not pass on to
another party. A bona fide service fee must be a flat fixed
fee that is not based on, contingent upon, or otherwise
related to--
``(i) drug price, such as wholesale acquisition cost or
drug benchmark price (such as average wholesale price);
``(ii) discounts, rebates, fees, or other remuneration with
respect to prescription drugs dispensed to enrollees; or
``(iii) any other amounts prohibited by the Secretary.''.
(b) MA-PD Plans.--Section 1857(f)(3) of the Social Security
Act (42 U.S.C. 1395w-27(f)(3)) is amended by adding at the
end the following new subparagraph:
``(E) Payment of pharmacy benefit managers.--Section 1860D-
12(b)(8).''.
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