Congresswoman Diana Harshbarger Introduces Patient Right to Shop Act

WASHINGTON, D.C. - Today, Congresswoman Diana Harshbarger introduced the Patient Right to Shop Act, a bipartisan bill which will prohibit gag clauses in pharmacy benefit manager (PBM) contracts to ensure patients can conveniently access information on the cost of their prescription drugs.

To compare the costs of prescription drugs, patients often use third-party transparency tools provided by their health plan or self-insured employer. These third-party tools enter into data-sharing agreements with insurers, as well as PBMs, to provide patients with online cost-saving insights, such as out-of-pocket costs and copayment, regarding their care. However, PBMs often insert anti-consumer 'gag clauses' into such agreements, which prohibit insurers from sharing this information with patients, sometimes even charging patients for access to their own data.

"As a pharmacist, I understand the patient's need for transparency in drug pricing and better access to information about their medical care all too well," said Congresswoman Diana Harshbarger. "My bill, the Patient Right to Shop Act, will put patients back in the driver's seat by prohibiting shadowy PBMs from engaging in anti-consumer behavior. This critical legislation will allow patients to better understand the costs of the healthcare and make more informed decisions regarding their prescriptions."

The Patient Right to Shop Act has bipartisan support, with Representative Kathy Manning (D-NC) as an original co-sponsor.

“Increasing transparency in health insurance plans helps hardworking Americans find health insurance that is right for their families and their health care needs. Yet, Pharmacy Benefit Managers are withholding data and charging patients for utilizing transparency tools that would allow them to compare drug prices and ensure that they are getting a fair deal. That’s why I’m joining Rep. Harshbarger in introducing the Patient Right to Shop Act, to prohibit ‘gag clauses’ that curtail competition and hurt consumers,” said Congresswoman Kathy Manning. “I applaud my colleagues in the Senate HELP Committee for adopting this legislation as part of the PBM Reform Act and urge my colleagues in the House to support this bipartisan legislation.”

Under this legislation, group health plans and health insurance issuers would be prohibited into entering data-sharing agreements that contain 'gag clauses', ensuring patients unrestricted access to data on the cost of prescription drugs and better allowing them to make sound, cost-effective decisions regarding their healthcare.

The Senate version of the bill was introduced by Senator Roger Marshall (R-KS), and was incorporated into the Senate's bipartisan PBM Reform Act, S. 1339.

Full text of the bill can be found here

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