§300gg–120 Reporting on Pharmacy Benefits and Drug Costs

Summary

Requires group health plans and insurers (except church plans) to send yearly data to the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury. The first report was due not later than 1 year after December 27, 2020, and then by June 1 each year for the prior plan year. The report must include the plan year dates, number of enrollees, states served; the 50 brand drugs most often dispensed with claim counts; the 50 drugs with the highest total annual spending and the amounts; the 50 drugs with the biggest increase in plan spending and the change from the prior year; total health care spending broken down by type (hospital; provider and clinical services with primary care and specialty care separate; prescription drugs; and other medical including wellness) and by who paid for drugs (the plan and enrollees); average monthly premiums paid by employers and by enrollees; how rebates, fees, or other payments from drug makers affected premiums, with amounts by therapeutic class and for the 25 drugs with the largest such payments; and any reduction in premiums or out-of-pocket costs tied to those payments. The Secretary must publish an HHS website report on drug reimbursements, drug pricing trends, and how drug costs affect premiums no later than 18 months after the first required report and then every two years. The public report must be summed up so no plan or drug can be identified. Any confidential or trade secret information submitted cannot be included in the public report.