§1185n Reporting on pharmacy benefits and drug costs

Summary

Group health plans and their insurers must send yearly reports to the Secretaries of Labor, Health and Human Services, and the Treasury. The first report was due no later than 1 year after December 27, 2020, and then by June 1 each year after that. The report must say the plan year start and end dates, how many people the plan covers, which States the plan is offered in, the 50 prescription drugs most often paid for and how many claims each had, the 50 drugs with the highest total spending and how much was spent on each, the 50 drugs with the biggest increase in spending compared to the prior year and the dollar change, total health care spending broken into hospital care, provider/clinical care (separating primary and specialty), prescription drugs, and other medical costs (including wellness), prescription drug spending split between the plan and the people covered, average monthly premiums paid by employers and by participants, how rebates, fees, or other payments from drug makers affected premiums (amounts by drug class and the 25 drugs with the largest payments), and any drop in premiums or out-of-pocket costs tied to those payments. Eighteen months after the first report and every two years after that, the Department of Labor will post a public, aggregated internet report about drug reimbursements, pricing trends, and how drug costs affect premiums. The public report will not include confidential or trade-secret information, and it will not reveal any plan- or drug-specific data.