H.R.2214 - Delinking Revenue from Unfair Gouging Act; DRUG Act (119th Congress)
Summary
H.R.2214, the "Delinking Revenue from Unfair Gouging Act" or "DRUG Act," aims to improve services provided by pharmacy benefit managers (PBMs). The bill seeks to prevent PBMs from deriving remuneration based on drug prices or rebates, ensuring they only receive flat dollar amounts for bona fide services. This is intended to address concerns about PBMs' role in rising prescription drug costs.
Expected Effects
The DRUG Act, if enacted, would significantly alter the revenue model for PBMs, pushing them towards transparent, flat-fee structures. This shift could lead to lower net costs for prescription drugs for consumers and group health plans. The bill also introduces enforcement mechanisms, including disgorgement of payments and civil monetary penalties for violations.
Potential Benefits
- Increased transparency in PBM pricing and service fees.
- Potential reduction in prescription drug costs for consumers and health plans.
- Fairer pricing models for PBM services, based on flat fees rather than drug prices.
- Stronger enforcement mechanisms to prevent unfair practices by PBMs.
- Improved accountability of PBMs to group health plans and insurance issuers.
Most Benefited Areas:
Potential Disadvantages
- Potential for PBMs to increase flat service fees to offset lost revenue from rebates and price-based remuneration.
- Increased administrative burden for PBMs to comply with new regulations.
- Possible legal challenges from PBMs regarding the scope and enforcement of the Act.
- Uncertainty in the short term as the market adjusts to the new regulatory environment.
- Potential for unintended consequences affecting smaller PBMs or specialized services.
Constitutional Alignment
The bill's provisions related to healthcare and economic regulation fall under the purview of Congress's power to regulate interstate commerce (Article I, Section 8, Clause 3). The enforcement mechanisms and penalties outlined in the bill are subject to due process considerations under the Fifth Amendment. The bill does not appear to infringe upon any specific constitutional rights or freedoms.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).