PBM Act

This bill prohibits a person from both owning a pharmacy and owning an insurance company or a pharmacy benefit manager. It requires divestment within three years, allows civil actions by certain officials, and mandates FTC review of divestitures.

Sec. 2, Prohibitions relating to anticompetitive pharmacy ownership and contracts: It is unlawful for any person to both own, operate, or control a pharmacy and also own, operate, or control an insurance company or a pharmacy benefit manager. Any person in violation must divest the pharmacy within three years after enactment. The Inspector General of HHS, the Assistant Attorney General for Antitrust, the FTC, or a state attorney general may bring a civil action in federal court. If a violation is found, the court must order the person to cease and desist, divest the pharmacy, and disgorge any revenue from prescription drug sales during the violation. Disgorged funds go to an FTC fund for the health care needs of the harmed community. Any required divestment must be reported to the FTC and the Assistant Attorney General under the Clayton Act, and the divestment period is tolled during any waiting period. The FTC and the Assistant Attorney General must review the effect on competition, financial viability, and public interest of the divestiture and any subsequent acquisition. The FTC must issue rules to carry out this section. The section does not limit authority under other laws. Definitions include 'health plan', 'person', 'pharmacy' (including mail-order, specialty, retail, nursing home, long-term care, hospital, infusion pharmacies, and others), and 'pharmacy benefit manager' (any entity that negotiates drug prices, contracts with pharmacies, or manages prescription drug benefits for a health plan).