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To amend title XVIII of the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare part D, and for other purposes.

H.R. 5393 Rep. H. Griffith (R-VA-9) In committee
Bill text PDF
  1. Introduced Sep 12
  2. Committee Sep 12
  3. Passed House Next
  4. Passed Senate Not yet
  5. To President Not yet
  6. Law Not yet
Where it stands
In committee, Sep 12, 2023Next: House vote
680d ago Dec 17, 2024: Referred to the Subcommittee on Health.
Final votes
No roll callsNo recorded vote on this bill yet
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Summary

This bill amends the Social Security Act to ensure fair assessment of pharmacy performance and quality under Medicare Part D and to promote transparency for pharmacies. It requires standardized pharmacy performance measures and mandates that pharmacies receive detailed claim information.

Sec. 1, Ensuring fair assessment of pharmacy performance and quality under Medicare Part D: For plan years starting on or after January 1, 2025, Part D plan sponsors and Medicare Advantage organizations offering Part D plans must only use standardized pharmacy performance measures established or adopted by the Secretary of Health and Human Services for incentive payments, price concessions, or fees based on performance. These measures must be evidence-based and relevant to pharmacy type. The Secretary must publish a list of these measures by June 1, 2024, and update it periodically. The Inspector General must study the use of performance measures in pharmacy agreements and report to Congress by December 31, 2024, with interim and final reports due by July 31, 2025, and December 31, 2025, respectively. $4,000,000 is appropriated for fiscal year 2025 to carry out this section.

Sec. 2, Promoting transparency for pharmacies under Medicare Part D: For plan years starting on or after January 1, 2025, Part D plan sponsors and Medicare Advantage organizations must promptly provide pharmacies with information related to a claim for a covered Part D drug, including the Network Reimbursement ID, fees, price concessions, discounts, incentives, or other remuneration affecting payment. This information must be in a standardized format specified by the Secretary. $2,000,000 is appropriated for fiscal year 2025 to carry out this section.

Summary of the bill text as introduced in House (Sep 12, 2023), generated by SecBot from the official bill text; the Library of Congress summary is not yet published.

Official record from Congress.gov, the House Clerk and the Senate; lobbying from Lobbying Disclosure Act filings. Updated Oct 28, 2026.