Bona fide service fees and pass-through to members are not barred
What the document says“prohibit reasonable payments to entities offering pharmacy benefit management services for bona fide services using a fee structure not described in this subparagraph, provided that such fees are transparent and quantifiable to group health plans and health insurance issuers;”
Nothing in the new subparagraph bars reasonable payments to a manager for bona fide services under another fee structure, so long as the fees are transparent and quantifiable to the plan or issuer. Nothing in it requires a third-party administrator or covered service provider to remit bona fide service fees to the plan, limits a plan's ability to pass rebates through to members, changes the health privacy regulations, or limits the existing disclosure requirements.
What the document actually says“prohibit reasonable payments to entities offering pharmacy benefit management services for bona fide services using a fee structure not described in this subparagraph, provided that such fees are transparent and quantifiable to group health plans and health insurance issuers;”
Nothing here bars a fair payment for real work done. The fee must be clear and countable to the plan.
The rule is about rebates, not about pay for work. A middleman may still be paid a fee. A plan may still pass savings to its members.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.