House committee moves another price transparency, PBM reform package forward

A key House panel has advanced yet another legislative package that aims to inject greater transparency into healthcare, particularly for pharmacy benefit managers.

The package, passed in the House Committee on Education and the Workforce, includes four bills that touch on hospital bill practices, PBM fees, employers' fiduciary duties and more. It's the latest effort in Congress to address the rising cost of healthcare, particularly for prescription drugs.

The first bill, the Transparency in Billing Act, would require hospitals to deploy accurate billing practices, which makes sure group health plans are paying the appropriate amount for billed services. The Transparency in Coverage Act, meanwhile, would codify a federal rule that gives consumers access to pricing data on medical services and prescription drugs.

In addition, the bill would bring "much needed light" to PBMs' business practices, according to an announcement from the committee.

“Dishonest billing, opaque rules, and shady industry practices have left patients paying higher costs for health care," Committee Chair Virginia Foxx, R-North Carolina, said in a statement. "Today’s passage of our bipartisan health care package makes great strides towards giving clarity to patients and building a health care system that is more transparent, affordable, and accessible."

The Health Data Act, the third part of the package, would prevent health plan fiduciaries from being restricted in their contracts from access cost or quality information about their plans. And the final bill, the Hidden Fee Disclosure Act, would bolster requirements for PBMs and other third-party administrators to disclose compensation to plan sponsors and other fiduciaries.

Each of the four bills included in the package enjoys bipartisan support.

“Transparency in health care is essential for fostering meaningful competition, which keeps costs in check for both consumers and employers," Ranking Member Bobby Scott, D-Viriginia, said in a statement. "The package of bipartisan health care bills the Committee on Education and the Workforce advanced is a meaningful step to shining a light on many of the commonplace, yet harmful, practices in the health care industry."

"Moreover, this package will help reduce costs for consumers and will help employers meet their obligation to ensure that their workers' premium dollars are spent carefully,” he added.

The committee's health package is just the latest to make its way to a full chamber vote. Similar legislation is winding its way through both the House and Senate, taking aim at everything from price transparency to PBM business practices to consolidation in the industry.

Employers, who are often on the hook for high costs while staying in the dark as to the origin of these expenses, have largely supported reforms that make it easier for them to get their arms around their healthcare spend.

EmployersRx, a nationwide effort on drug pricing backed by major employer groups, applauded the committee's efforts in a statement.

"While we support efforts that increase transparency and access to data, one lesson employers know all too well is that in unregulated, broken markets, transparency is simply not enough," the group said. "Reform of the PBM industry is needed to provide oversight and accountability."