,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #bhaf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #be1 #bjbc,mrs4
 ,h>%b>g] 7= h]self1 ,ms4 ,spanb]g]1    
,mrs4 ,mill]-,meeks1 & ,mr4             
,kri%namoor?i7 introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title ,,xi 
( ! ,social ,security ,act to /r5g!n    
transp>5cy requirem5ts ) respect to     
ph>macy b5efit manag]s4  #a4 ,%ort title
 ,?is ,act may be cit$ z ! ,ph>macy     
,b5efit ,manag] ,sun%9e & ,acc\ntability
 ,act4  #b4 ,/r5g!n+ ph>macy b5efit     
manag] transp>5cy requirem5ts ,section  
#aaej;,a ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acbj;b-#bc7 is am5d$-- 7#a7 
9 subsection 7a7-- 7,a7 9 p>agraph 7#a71
 by /rik+ 2 or & ins]t+ a semicolon2    
7,b7 9 p>agraph 7#b71 by /rik+ ! comma  

at ! end & ins]t+ 2 or2 &  7,c7 by add+ 
at ! end ! foll[+ new p>agraph3  7#c7 a 
gr\p heal? plan or heal? insurance issu]
 (f]+ gr\p or individual heal? insurance
 cov]age 7z su* t]ms are def9$ 9 section
 #bgia ( ! ,public ,heal? ,s]vice ,act71
  2  7#b7 by am5d+ subsection 7b7 to    
read z foll[s3  7b7 ,in=mation describ$ 
,! in=mation describ$ 9 ?is subsection  
is ! foll[+ ) respect to s]vices provid$
 by a heal? b5efits plan or ,,pbm = a   
contract ye>3 7#a7 ,) respect to a      
contract ) ea* entity describ$ 9        
p>agraphs 7#a7 ?r\gh 7#c7 ( subsection  
7a71 ! aggregate doll> am\nt ( all--    
7,a7 rebates t a ,,pbm or heal? b5efits 
plan receiv$ "u ea* su* contract f all  
drug manufactur]s2  7,b7 adm9i/rative   
fees t a ,,pbm or heal? b5efits plan    
receiv$ "u ea* su* contract ) f all drug
 manufactur]s2  7,c7 adm9i/rative fees t
 a ,,pbm or heal? b5efits plan receiv$  
"u ea* contract f ea* su* entity2  7,d7 
rebates t a ,,pbm or heal? b5efits plan 
receiv$ "u ea* contract ) ea* entity f  

all ph>maceutical manufactur]s t 7 n    
pass$ ?r\gh to su* entities2  7,e7      
adm9i/rative fees t a ,,pbm or heal?    
b5efits plan receiv$ "u ea* contract f  
all ph>maceutical manufactur]s & did n  
pass ?r\gh to su* entities2  7,f7 total 
po/-claim adjudication paym5ts t a ,,pbm
 or heal? b5efits plan collect$ f a     
ph>macy "u ea* contract1 includ+ any    
fees1 reimbursem5ts1 or o!r claw backs  
includ+ g5]ic effective rate & br&      
effective rate contracts2 &  7,g7 any   
po/-claim adjudication paym5ts t a ,,pbm
 or heal? b5efits plan collect$ f a     
ph>macy "u ea* contract1 includ+ any    
fees1 reimbursem5ts1 or o!r claw backs  
includ+ g5]ic effective rate & br&      
effective rate contracts t 7 n pass$    
?r\gh to su* entities4  7#b7 ,!         
aggregate reta9$ rebate p]c5tage "u ea* 
contract 7t is ! value 9 p>agraph       
7#a77;,d7 divid$ by ! value 9 p>agraph  
7#a77;,a774  7#c7 ,across all           
contractual relation%ips = ea* ,,pbm    
:]eby su* ,,pbm is manag+ prescription  

drug cov]age = a entity describ$ 9 9    
p>agraphs 7#a7 ?r\gh 7#c7 ( subsection  
7a71 ! highe/ reta9$ rebate p]c5tage &  
l[e/ reta9$ rebate p]c5tage = ea*       
contract "u :i* su* ,,pbm provid$       
s]vices4  2  7#c7 9 subsection 7c7--    
7,a7 9 ! matt] prec$+ p>agraph 7#a71 by 
/rik+ 1 plan1 or prices *>g$ = drugs1 & 
ins]t+ or plan1 ! prices *>g$ = a       
specific drug or classes ( drugs1 or !  
am\nt ( any rebates provid$ = a specific
 drug or classes ( drugs12 &  7,b7 by   
add+ at ! end ! foll[+ new p>agraph3    
7#e7 ,to c>ry out ! report+ requirem5t  
"u subsection 7e74  2 &  7#d7 by add+ at
 ! end ! foll[+ new subsections3  7e7   
,public report+ requirem5t ,n lat] ?an !
 fir/ cal5d> qu>t] foll[+ ! fir/ full   
plan ye> beg9n+ on or aft] ! date (     
enactm5t ( ?is subsection1 & annually   
!reaft]1 ! ,secret>y %all publi% on a   
public website ( ! ,dep>tm5t ( ,heal? & 
,human ,s]vices ! in=mation report$ "u  
subsection 7b71 9 accordance ) !        
confid5tiality requirem5ts describ$ 9   

subsection 7c74  7f7 ,def9itions ,9 ?is 
section3 7#a7 ,br& effective rate ,! t]m
 br& effective rate means ! claim       
reimbursem5t = a br& "n drug1 express$ z
 a p]c5tage disc\nt f ! av]age :olesale 
price ( su* drug4  7#b7 ,g5]ic effective
 rate ,! t]m g5]ic effective rate means 
! claim reimbursem5t = a g5]ic drug1    
express$ z a p]c5tage disc\nt f ! av]age
 :olesale price ( su* drug4  7#c7       
,ph>macy b5efits manag] ,! t]m ph>macy  
b5efits manag] or ,,pbm means-- 7,a7 an 
entity t manages prescription drug      
b5efits on behalf ( an entity describ$ 9
 p>agraphs 7#a7 ?r\gh 7#c7 ( subsection 
7a72 &  7,b7 = purposes ( ?is section1  
includes any o!r organization t-- 7i7   
has directly or indirectly 7z det]m9$ by
 ! ,secret>y 9 regulations71 an own]%ip 
int]e/ ( #e p]c5t or m 9 ! ,,pbm2  7ii7 
%>es1 or is o!rwise a "p (1 ! same      
organizational /ructure z ! ,,pbm2      
7iii7 ex]cises op]ational1 f9ancial1 or 
manag]ial control ov] ! ,,pbm or a "p   
!re(1 or provides policies or proc$ures 

= any ( ! op]ations ( ! ,,pbm1 or       
provides f9ancial or ca% managem5t      
s]vices to ! ,,pbm2 or  7iv7 provides   
managem5t or adm9i/rative s]vices1      
managem5t or cl9ical consult+ s]vices1  
or acc\nt+ or f9ancial s]vices to !     
,,pbm4  7#d7 ,organizational /ructure ,!
 t]m organizational /ructure means1 9 ! 
case (-- 7,a7 a corporation1 ! (fic]s1  
directors1 & %>ehold]s ( ! corporation  
:o h an own]%ip int]e/ 9 ! corporation  
:i* is equal to or exce$s #e p]c5t2     
7,b7 a limit$ liability company1 !      
memb]s & manag]s ( ! limit$ liability   
company2  7,c7 a g5]al p>tn]%ip1 !      
p>tn]s ( ! g5]al p>tn]%ip2  7,d7 a      
limit$ p>tn]%ip1 ! g5]al p>tn]s & any   
limit$ p>tn]s ( ! limit$ p>tn]%ip :o h  
an own]%ip int]e/ 9 ! limit$ p>tn]%ip   
:i* is equal to or exce$s #e p]c5t2     
7,e7 a tru/1 ! tru/ees ( ! tru/2 or     
7,f7 any o!r p]son or entity z !        
,secret>y det]m9es appropriate4  4