S.Amdt. 2896

SA 2896. Ms. WARREN submitted an amendment intended to be proposed by
her to the bill S. 4638, to authorize appropriations for fiscal year
2025 for military activities of the Department of Defense, for military
construction, and for defense activities of the Department of Energy,
to prescribe military personnel strengths for such fiscal year, and for
other purposes; which was ordered to lie on the table; as follows:

At the end of subtitle A of title VII, insert the
following:

SEC. 710. ENSURING PBM TRANSPARENCY UNDER THE TRICARE
PHARMACY BENEFITS PROGRAM.

Section 1074g(a) of title 10, United States Code, is
amended by adding at the end the following new paragraph:
``(11)(A) Beginning on January 1, 2025, the Secretary may
not contract with a pharmacy benefit manager under the
pharmacy benefits program unless the pharmacy benefit manager
meets the following requirements:
``(i) Not later than 1 year after the date of enactment of
this paragraph, and annually thereafter, the pharmacy benefit
manager (or an affiliate, subsidiary, or agent of the
pharmacy benefit manager) shall submit to the Secretary
information regarding any differences in reimbursement rates
or practices, direct and indirect remuneration fees or other
price concessions, and clawbacks between--
``(I) pharmacies that are affiliates of the pharmacy
benefit manager; and
``(II) pharmacies that are not affiliates of the pharmacy
benefit manager.
``(ii) The pharmacy benefit manager shall disclose to the
Secretary (in a form and manner specified by the Secretary)
the amount of any administrative fee they receive for each
prescription the pharmacy benefit manager processes under the
pharmacy benefits program.
``(B) In this paragraph:
``(i) The term `affiliate' means any entity that is owned
by, controlled by, or related under a common ownership
structure with, a pharmacy benefit manager, or that acts as a
contractor or agent to such pharmacy benefit manager, if such
contractor or agent performs any of the functions described
in clause (ii).
``(ii) The term `pharmacy benefit manager' means any person
or entity that, either directly or through an intermediary,
acts as a price negotiator or group purchaser on behalf of
the pharmacy benefits program, or manages the prescription
drug benefits provided under such program, including the
processing and payment of claims for prescription drugs, the
performance of drug utilization review, the processing of
drug prior authorization requests, the adjudication of
appeals or grievances related to the pharmacy benefits
program, contracting with network pharmacies, controlling the
cost of prescription drugs, or the provision of related
services. Such term includes any person or entity that
carries out one or more of the activities described in the
preceding sentence, irrespective of whether such person or
entity identifies itself as a `pharmacy benefit manager'.''.
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