H.R. 950 — Saving Seniors Money on Prescriptions Act

This section establishes pharmacy benefit manager (PBM) reporting requirements in contracts between prescription drug plan (PDP) sponsors and PBMs under Medicare Part D (i.e., voluntary outpatient prescription drug coverage for Medicare beneficiaries) for plan years beginning on or after January 1, 2028. Such contracts must require PBMs to (1) define and apply pricing terms (e.g., generic drug, rebate) transparently for performance guarantees, identify excluded drugs or concessions, and provide wholesale acquisition cost-based equivalents for guarantees using other benchmarks; and (2) submit reports by July 1 of each year to PDP sponsors (and the Secretary upon request), in machine-readable format at no cost, detailing for the prior plan year and each covered drug the brand/generic name, National Drug Code, claims and dosage units by dispensing channel (e.g., retail, mail order), average wholesale acquisition cost and wholesale price (per day's supply, dosage unit, or course of treatment), enrollee out-of-pocket spending, manufacturer rebates and other direct/indirect remuneration (per Detailed DIR Reports), pharmacy reimbursements by channel, National Average Drug Acquisition Cost, and PBM-retained manufacturer revenue (including service fees). For PBMs with affiliate pharmacies, reports must also include the percentage of prescriptions dispensed by affiliates, interquartile ranges and lowest total costs (plan plus enrollee) paid per dosage unit/course/30- or 90-day supply for affiliate versus non-affiliate network pharmacies, and differences between affiliate acquisition costs and National Average Drug Acquisition Cost.