Sen. Maria Cantwell has offered a group of amendments to Sen. Max Baucus’ health care bill.
(Cantwell is on Baucus’ pivotal Finance Committee, which came out with the lead health care reform bill last week.)
Cantwell’s amendments hit themes she’s been making all along—like stressing outcomes of care over fee-for-service.
But one wonky amendment shouldn’t be overlooked—and it’s classic Cantwell, getting into the fineprint details of policy on behalf of consumers. Cantwell has proposed an amendment to make Pharmaceutical Benefit Management companies (PBMs) more transparent. PBMs are the middleman between drug companies and healtchare providers and there has been a history of controversial set ups between drug companies and PBMs to push certain drugs (more expensive) over others.
I’ve linked the text of Sen. Cantwell’s PBM amendment below the fold.
“She has also co-signed onto amendments addressing a public option,” Sen. Cantwell’s spokeswoman Ciaran Clayton says.
There are scores of amendments, so I’m waiting for Cantwell’s office to point me to the public option amendments Cantwell has signed onto.
Cantwell Amendment #C-2 to America’s Healthy Future Act of 2009
Short Title: Pharmacy Benefit Manager (PBM) Transparency for Health Plans Operating in the Health Insurance Exchanges
Description of Amendment: The amendment requires pharmaceutical benefit managers (PBM) to share basic information with the commissioners of the exchanges and with any plans the PBMs contracts with in the exchanges. This information will be considered confidential and must be protected by the commissioners and the plans. The PBM will be required to confidentially disclose information on: (1) the percent of all prescriptions that are provided through retail pharmacies compared to mail order pharmacies, and the generic dispensing and substitution rates in each location; 2) the aggregate amount and types of rebates, discounts and price concessions that the PBM negotiates on behalf of the plan and the aggregate amount of these that are passed through to the plan sponsor; 3) the average aggregate difference between the amount the plan pays the PBM and the amount that the PBM pays the retail and mail order pharmacy. There are no mandates that these rebates are passed through, only that they be reported to plans.
Offset: This amendment is not expected to require an offset, however, a sufficient offset to ensure that it is revenue neutral will be provided, if needed.
