Prescription Drug Pricing Reduction Act of 2019

This bill alters several programs and requirements relating to the prices of prescription drugs under Medicare and Medicaid.

Among other things, the bill

• requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services (CMS) for certain drugs covered under Medicare for which the average manufacturer price increases faster than inflation;
• requires drug manufacturers to issue rebates to the CMS for discarded amounts of certain single-dose drugs covered under Medicare, based on information reported by providers;
• reduces the annual out-of-pocket spending threshold, and eliminates beneficiary cost-sharing above this threshold, under the Medicare prescription drug benefit;
• requires the CMS to publish certain information, as reported by pharmacy benefit managers (PBMs), relating to drug discounts and rebates, and payments between PBMs, health plans, and pharmacies;
• requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with PBMs under Medicaid; and
• increases the maximum rebate payable by drug manufacturers under the Medicaid Drug Rebate Program.