,,ii  #aahth ,,congress  #ast ,session  
,s4 #cccj  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #ae1 
#bjbc,mr4 ,braun 7for himself1 ,ms4     
,hassan1 ,mr4 ,marshall1 ,mr4 ,budd1 and
 ,mr4 ,kaine7 introduced the following  
bill2 which was read twice and referred 
to the ,committee on ,health1           
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to require the ,secretary of   
,labor to conduct a study on the        
fiduciary duties of pharmacy benefit    
managers4  #a4 ,study on fiduciary      
duties of pharmacy benefit managers  7a7
 ,in general ,not later than #b years   
after the date of enactment of this     
,act1 the ,secretary of ,labor shall    
conduct1 and submit to ,congress a      
report describing the results of1 a     
study on the impacts of a change in     
policy described in subsection 7b74  7b7
 ,policy described ,under a policy      
referred to in subsection 7a7-- 7#a7 an 
entity providing pharmacy benefit       
management services would be considered 

a fiduciary within the meaning of       
section #c7ba7 of the ,employee         
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #ajjb7ba77 with    
respect to a group health plan or group 
health insurance coverage2  7#b7 such an
 entity would-- 7,a7 be subject to the  
responsibilities1 obligations1 and      
duties imposed on fiduciaries under part
 #d of subtitle ,b of title ,i of such  
,act 7#bi ,u4,s4,c4 #aaja et seq472 and 
7,b7 make the required fiduciary        
disclosure under section                
#djh7;b77#b77;,b77iii7 of such ,act 7#bi
 ,u4,s4,c4 #aajh7;b77#b77;,b77iii77 with
 respect to the pharmacy benefit        
management services provided to the plan
 or coverage2  7#c7 nothing would be    
construed to prohibit entities providing
 pharmacy benefits management services  
from retaining bona fide service fees in
 accordance with the requirements of    
section #djh7;b77#b7 of the ,employee   
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #aajh7;b77#b772 and

  7#d7 bona fide service fees would be  
per se unreasonable for purposes of this
 section and such section if such fees  
are-- 7,a7 based on drug price 7such as 
wholesale acquisition cost7 or drug     
benchmark price 7such as average        
wholesale price72  7,b7 discounts1      
rebates1 fees1 or other remuneration    
with respect to prescription drugs      
prescribed to participants or           
beneficiaries in the plan or coverage2  
or  7,c7 otherwise determined by the    
,secretary to be unreasonable4  7c7     
,definitions ,in this section3 7#a7     
,bona fide service fees ,the term bona  
fide service fees means fees paid by a  
manufacturer1 customer1 or client 7other
 than a group health plan or health     
insurance issuer7 of an entity providing
 pharmacy benefit management services1  
to an entity providing pharmacy benefit 
management services1 that represent     
fair-market value for bona fide1        
itemized services actually performed on 
behalf of the manufacturer1 customer1 or

 client and that the manufacturer1      
customer1 or client would otherwise     
perform or contract for in the absence  
of the service arrangement1 and that are
 not passed on in whole or in part to a 
client or customer of an entity1 whether
 or not the entity takes possession of  
the drug4  7#b7 ,wholesale acquisition  
cost ,the term wholesale acquisition    
cost has the meaning given such term in 
section #ahdg;,a7c77#f77;,b7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#c;a7c77#f77;,b774