,,ii #aahth ,,congress #b;d ,session ,s4 #eejc ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #ab1 #bjbd,ms4 ,warren 7for herself and ,mr4 ,hawley7 introduced the following bill2 which was read twice and referred to the ,committee on the ,judiciary ,a ,,bill ,to prohibit pharmacy benefit managers and pharmacies from being under common ownership1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,patients ,before ,monopolies ,act or the ,,pbm ,act4 #b4 ,prohibitions relating to anticompetitive pharmacy ownership and contracts 7a7 ,prohibition on pharmacy ownership by entities providing insurance or pharmacy benefit management services 7#a7 ,in general ,it shall be unlawful for any person to both-- 7,a7 directly or indirectly own1 operate1 control1 or direct the operation of the whole or any part of a pharmacy2 and 7,b7 directly or indirectly own1 operate1 or control the whole or any part of-- 7i7 an insurance company2 or 7ii7 a pharmacy benefit manager4 7#b7 ,divestment ,not later than #c years after the date of enactment of this ,act1 any person in violation of paragraph 7#a7 shall divest the pharmacy of such person4 7b7 ,civil actions 7#a7 ,in general ,when the ,inspector ,general of the ,department of ,health and ,human ,services1 the ,assistant ,attorney ,general in charge of the ,antitrust ,division of the ,department of ,justice1 the ,federal ,trade ,commission1 or an attorney general of a ,state has reason to believe that a person is in violation of subsection 7a71 such ,inspector ,general1 ,assistant ,attorney ,general1 ,federal ,trade ,commission or attorney general of a ,state may bring a civil action in an applicable district court of the ,united ,states for the relief described in paragraph 7#b74 7#b7 ,injunctive and equitable relief ,in any action described in paragraph 7#a71 the applicable court1 on a finding that a person is in violation of subsection 7a71 shall issue an order requiring such person-- 7,a7 to cease and desist from such violation1 and1 if applicable1 divest the pharmacy services of such person2 and 7,b7 to disgorge any revenue received from the pharmacy from the sale of prescription drugs during the period of such violation4 7#c7 ,other relief ,in addition to any relief obtained under paragraph 7#b71 the court may grant any other equitable relief necessary to redress and prevent recurrence of the violation4 7#d7 ,deposit ,any revenue received from the sale of prescription drugs disgorged pursuant to an action under this subsection shall be deposited in a fund created by the ,federal ,trade ,commission and distributed by the ,federal ,trade ,commission to be put to use in the interest of serving the health care needs of the harmed community1 including consumers overcharged at vertically integrated pharmacies4 7c7 ,,ftc review 7#a7 ,reporting required ,any divestment of a pharmacy or pharmacy benefit manager required under subsection 7a7 shall be reported to the ,federal ,trade ,commission and the ,assistant ,attorney ,general in charge of the ,antitrust ,division of the ,department of ,justice under section #g;,a of the ,clayton ,act 7#ae ,u4,s4,c4 #ah;a7 without respect to the thresholds under subsection 7a77#b7 of that section4 7#b7 ,tolling of divestment period during review ,the divestment period under subsection 7a7 shall be tolled during the pendency of any waiting period required under section #g;,a of the ,clayton ,act 7#ae ,u4,s4,c4 #ah;a74 7#c7 ,review of effect of divestiture ,with respect to each divestiture undertaken pursuant to subsection 7a71 in addition to any applicable review under section #g;,a of the ,clayton ,act 7#ae ,u4,s4,c4 #ah;a71 the ,federal ,trade ,commission and the ,assistant ,attorney ,general in charge of the ,antitrust ,division of the ,department of ,justice shall review the effect on competition1 financial viability1 and the public interest-- 7,a7 of the divestiture2 and 7,b7 of the subsequent acquisition of the divested pharmacy by the acquiring person4 7d7 ,rulemaking authority ,the ,federal ,trade ,commission shall promulgate rules to carry out this section4 ,such rules shall not diminish any obligation under this section4 7e7 ,rule of construction ,nothing in this section shall be construed to limit the authority of the ,federal ,trade ,commission1 the ,inspector ,general of the ,department of ,justice1 the ,department of ,health and ,human ,services1 or the attorney general of a ,state under any other provision of law4 7f7 ,definitions ,in this section3 7#a7 ,health plan ,the term health plan means any public or private health insurance plan4 7#b7 ,person ,the term person has the meaning given the term in section #h of the ,sherman ,act 7#ae ,u4,s4,c4 #g74 7#c7 ,pharmacy 7,a7 ,in general ,the term pharmacy means any person1 business1 or entity licensed1 registered1 or otherwise permitted by a ,state or a territory of the ,united ,states to dispense1 deliver1 or distribute a controlled substance1 prescription drug1 or other medication-- 7i7 to the general public2 or 7ii7 to a bed patient for immediate administration4 7,b7 ,inclusions ,the term pharmacy includes-- 7i7 a mail-order pharmacy2 7ii7 a specialty pharmacy2 7iii7 a retail pharmacy2 7iv7 a nursing home pharmacy2 7v7 a long-term care pharmacy2 7vi7 a hospital pharmacy2 7vii7 an infusion or other outpatient treatment pharmacy2 7viii7 any organization the ,national ,provider ,identifier 7,,npi7 registration of which has #a or more taxonomy codes under the pharmacy section of the ,national ,uniform ,claim ,committee 7or a subsequent organization72 and 7ix7 any other type of pharmacy4 7#d7 ,pharmacy benefit manager ,the term pharmacy benefit manager means any person1 business1 or other entity1 such as a third-party administrator1 regardless of whether such person1 business1 or entity identifies itself as a pharmacy benefit manager1 that1 either directly or indirectly through an intermediary 7including an affiliate1 subsidiary1 or agent7 or an arrangement with a third party-- 7,a7 acts as a negotiator of prices1 rebates1 fees1 or discounts for prescription drugs on behalf of a health plan or health plan sponsor2 7,b7 contracts with pharmacies to create pharmacy networks and designs and manages such networks2 or 7,c7 manages or administers the prescription drug benefits provided by a health plan1 including the processing and payment of claims for prescription drugs1 arranging alternative access to or funding for prescription drugs1 the performance of utilization management services1 including drug utilization review1 the processing of drug prior authorization requests1 the adjudication of appeals or grievances related to the prescription drug benefit1 contracting with network pharmacies1 controlling the cost of covered prescription drugs1 or the provision of related services4