One hundred percent of rebates must go to the plan
What the document says“remits 100 percent of rebates, fees, alternative discounts, and other remuneration received from any applicable entity that are related to utilization of drugs or drug spending under such health plan or health insurance coverage, to the group health plan”
Section 6702 adds a new subparagraph (C) to section 408(b)(2) of the Employee Retirement Income Security Act of 1974. For plan years beginning 30 months or more after enactment, a contract for pharmacy benefit management services entered, renewed or extended on or after that date is not reasonable unless the entity remits all rebates, fees, alternative discounts and other remuneration related to drug use or spending to the plan, or to the issuer on the plan's behalf, and does not itself contract with an applicable entity unless the same full pass-through applies.
What the document actually says“remits 100 percent of rebates, fees, alternative discounts, and other remuneration received from any applicable entity that are related to utilization of drugs or drug spending under such health plan or health insurance coverage, to the group health plan”
The middleman must hand over every dollar it gets back from a drug firm. All of it goes to the health plan.
A rebate is money a drug maker pays back after a drug is sold. It has often stopped at the middleman. This says it must reach the plan.
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