WASHINGTON – The House Energy and Commerce Committee approved Congressman Earl L. “Buddy” Carter’s (R-Ga.) legislation today to prohibit “gag clause” provisions.
Currently, Pharmacy Benefit Managers (PBMs) are able to include requirements in contracts that prevent pharmacists from providing advice to their patients on the best and cheapest out-of-pocket alternatives to medications covered under insurance. This is commonly known as a “gag clause.” As a result, patients may be paying more for their prescriptions than is warranted.
Carter’s legislation passed by the committee today prohibits group health plans offered by employers and individual health insurance plans, as well as Medicare Advantage and Medicare Part D Plans, from restricting a pharmacy’s ability to inform a patient about the lower cost, out-of-pocket price options for their prescription. Additionally, the measure will require notifications to Medicare beneficiaries of the potential outcomes of paying out-of-pocket rather than with insurance.
“This bill passed our committee today with strong bipartisan support and now it is heading to the House floor,” said Carter. “As the only pharmacist in Congress, I know firsthand how important it is to prohibit gag clause provisions, and I am very glad my colleagues on both sides of the aisle understand the importance as well. It is unacceptable that pharmacists are not able to tell patients what is in their best interest. Patients need and deserve the most affordable options. I look forward to bringing this bill before the entire House of Representatives as it is an important part of our work to lower prescription drug prices for Americans.”
The Know the Cost Act passed the House Energy and Commerce Committee today. It will now be considered by the full House of Representatives. Similar legislation is currently moving through the United States Senate.
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