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This bill requires Medicare Advantage (MA) organizations and prescription drug plan (PDP) sponsors under the Medicare prescription drug benefit to report certain information about affiliated health care providers. Specifically, MA organizations must report to the Centers for Medicare & Medicaid Services health care providers that the organization owns or in which the organization has a controlling interest, as well as the amount of incentive payments made to those health care providers and to other types of providers. PDP sponsors must similarly report pharmacies that the sponsor or a pharmacy benefit manager (PBM) owns or in which the sponsor or PBM has a controlling interest. The Medicare Payment Advisory Commission must report on the status of vertical integration between Medicare health care providers, pharmacies, PDP sponsors, MA organizations, and PBMs.
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