Gallego Signs on to Bipartisan Bill to Increase Health Care Price Transparency

PHOENIX, AZ – Today, Rep. Ruben Gallego (AZ-03) cosponsored the bipartisan Promoting Access to Treatments and Increasing Extremely Needed Transparency (PATIENT) Act. The bill would increase price transparency requirements, including for Pharmacy Benefit Managers (PBMs), hospitals, and insurers.

“Healthcare companies – particularly PBMs – have been operating in secret for too long, and it’s costing Arizona families. It is only reasonable that we increase transparency and require them to disclose their pricing decisions. That’s what the PATIENT Act does,” said Rep. Gallego. “I’ve heard from constituents across the political spectrum who support this bill, and I’m proud to sign on to it today.”

PBMs are the middlemen that negotiate drug prices for insurers and are incentivized to steer health plans towards more expensive drugs because their profits are linked to the list price of the drug. The higher the sticker price, the more compensation PBMs receive, and patients are left in the dark on those decisions until they visit their local pharmacy and see how much they’re paying at checkout.

The PATIENT Act would require PBMs to annually disclose a variety of information, including the negotiated price of covered drugs. It would also outlaw spread pricing in Medicaid. Spread pricing occurs when PBMs charge payers, such as Medicaid, more than the PBM paid for the drug and pocket the “spread” as profit.

Additionally, the PATIENT Act would:

1. Codify existing requirements for hospitals and insurers to publicly disclose their prices and would increase the penalties for those who fail to do so.
2. Funds Arizona’s Community Health Centers through calendar year 2025. Gallego has long been a supporter of community health centers, including through community projects.
3. Extends Graduate Medical Education funding through fiscal year 2029, beginning at $175 million and increasing to $275 million. This funding is critical to address Arizona’s physician shortage. Earlier this year, Gallego held a press conference to discuss his work to address this shortage, including adding 14,000 more Medicare-supported medical residency positions through the Physician Shortage Reduction Act.

The PATIENT Act passed the House Energy and Commerce Committee with unanimous support on May 24th. A section-by-section of the legislation can be found here. Full text of the legislation can be found here.