Contact Congress about H.R. 1613: Drug Price Transparency in Medicaid Act of 2023

PBMs could no longer keep hidden markups on Medicaid drug payments. They would have to pass drug payments through to pharmacies and report more pricing details to states and the federal government.

Modern Action explains what the legislation does, helps you choose whether to support, oppose, or ask for changes, and drafts a message tied to the bill, your stance, and the elected officials who can act on it.

Drug Price Transparency in Medicaid Act of 2023 is a House bill in Congress.

Who this affects: This bill mainly affects PBMs, managed care plans, pharmacies, and state Medicaid programs. PBMs and managed care plans would have less room to earn money from drug price gaps. Pharmacies would see payment rules tied more directly to drug cost and a set dispensing fee. States would get more data, but they would also have to build these rules into Medicaid contracts and survey requirements.

Why this matters: Medicaid spends a lot on prescription drugs, but the money trail can be hard to see. This bill would make PBMs pass drug payments through instead of keeping hidden markups. It could help states and the federal government see what drugs really cost and how pharmacies are paid. The exact effect on patient access, pharmacy participation, and total Medicaid savings is not clear from the bill.

Key provisions in H.R. 1613

• Medicaid outpatient drug contracts would have to use pass-through pricing. This applies to PBMs, managed care plans, and other covered entities that handle those drugs.
• Drug payments in those contracts could cover only two main items: the drug ingredient cost and a professional dispensing fee. The dispensing fee must be at least what the state Medicaid plan would pay.
• States could not claim federal Medicaid matching money for spread pricing. Spread pricing means charging more than the pharmacy receives, including later fees or invoice changes. A reasonable admin fee would still be allowed.
• PBMs and managed care plans could earn only a reasonable admin fee for administrative services. They could not make extra profit from a spread on drug prices.
• PBMs and managed care plans would have to show states all drug-related costs and payments. They would also have to give this information to the federal government when asked, including costs, fees, discounts, rebates, and other payments.

How Modern Action helps you take action on H.R. 1613

You do not have to start with a blank letter. Modern Action turns the bill, your position, and the relevant congressional context into a message you can edit and send. The goal is to make contacting Congress clear, specific, and useful without forcing you to parse bill text or figure out the right office on your own.

Questions people ask about H.R. 1613

What is H.R. 1613?

PBMs could no longer keep hidden markups on Medicaid drug payments. They would have to pass drug payments through to pharmacies and report more pricing details to states and the federal government.

How do I support or oppose H.R. 1613?

Choose support, oppose, or ask for changes on Modern Action. The action flow drafts the message for you and keeps the wording tied to this bill.

Who should I contact about H.R. 1613?

Modern Action uses your location to route the action to the congressional offices relevant to the bill and your representation.

How does Modern Action help me act on H.R. 1613?

Modern Action gives you bill-specific context, lets you choose support, opposition, or changes, and drafts a message from your position and reasons.