,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #cbbc  ,,in ,,the ,,house ,,of  
,,representatives  ,june #ab1 #bjai ,mr4
 ,marshall 7for himself1 ,mr4 ,welch1   
,mr4 ,carter of ,georgia1 and ,mr4      
,gonzalez of ,texas7 introduced the     
following bill2 which was referred to   
the ,committee on ,energy and ,commerce 
,a ,,bill  ,to require the ,comptroller 
,general of the ,united ,states to study
 the role pharmacy benefit managers play
 in the pharmaceutical supply chain and 
to provide ,congress with appropriate   
policy recommendations1 and for other   
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,pharmacy ,benefit  
,manager ,accountability ,study ,act of 
#bjai4  #b4 ,study by ,comptroller      
,general of ,united ,states  7a7 ,in    
general ,the ,comptroller ,general of   
the ,united ,states shall1 in           
consultation with appropriate           
stakeholders1 conduct a study on the    
role of pharmacy benefit managers with  
respect to federally facilitated        

,exchanges operated pursuant to section 
#acba7;c7 of the ,patient ,protection   
and ,affordable ,care ,act 7#db         
,u4,s4,c4 #ahjda7;c774  7b7 ,permissible
 examination ,in conducting the study   
required under subsection 7a71 the      
,comptroller ,general may examine       
various qualitative and quantitative    
aspects of the role of pharmacy benefit 
managers with respect to federally      
facilitated ,exchanges described in such
 subsection1 such as the following3 7#a7
 ,the role that pharmacy benefit        
managers play in the pharmaceutical     
supply chain of such ,exchanges4  7#b7  
,the state of competition among pharmacy
 benefit managers on such ,exchanges1   
including the market share for the      
,nation's largest pharmacy benefit      
managers4  7#c7 ,the use of rebates and 
fees by pharmacy benefit managers with  
respect to such ,exchanges1 including-- 
7,a7 the extent to which rebates are    
passed on to qualified health plans     
offered on such ,exchanges and whether  

such rebates are passed on to           
individuals enrolled in such plans2     
7,b7 the extent to which rebates are    
kept by such pharmacy benefit managers2 
and  7,c7 the role of any fees charged  
by such pharmacy benefit managers4  7#d7
 ,whether pharmacy benefit managers     
structure their formularies with respect
 to such ,exchanges in favor of         
high-rebate prescription drugs over     
lower-cost1 lower-rebate alternatives4  
7#e7 ,the average prior authorization   
approval time for pharmacy benefit      
managers with respect to such           
,exchanges4  7#f7 ,factors affecting the
 use of step therapy by pharmacy benefit
 managers with respect to such          
,exchanges4  7#g7 ,the extent to which  
the price that pharmacy benefit managers
 charge private payors on such          
,exchanges for a drug is more than such 
pharmacy benefit managers pay the       
pharmacy for the drug4  7c7 ,report ,not
 later than the date that is three years
 after the date of enactment of this    

,act1 the ,comptroller ,general shall   
submit to the ,secretary of ,health and 
,human ,services1 the ,committee on     
,health1 ,education1 ,labor1 and        
,pensions of the ,senate1 and the       
,committee on ,energy and ,commerce of  
the ,house of ,representatives a report 
containing the results of the study     
conducted under subsection 7a71         
including policy recommendations4