S.Amdt. 2913

SA 2913. 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. REQUIRING ANY PHARMACY BENEFIT MANAGER THAT
CONTRACTS WITH TRICARE TO MEET REQUIREMENTS
RELATING TO FORMULARY INTEGRITY.

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--
``(i) bases formulary tier placement on list price for
drugs that are considered therapeutically competitive
(defined as drugs containing the same active ingredient); and
``(ii) places the drug with the lowest list price on a
lower, or cheaper, formulary tier than its therapeutic
competitors with higher list prices.
``(B) In this paragraph, 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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