Contact Congress about S. 1038: Drug Price Transparency in Medicaid Act of 2023

Medicaid drug middlemen could no longer keep extra money from spread pricing. They would have to pass drug payments to pharmacies and report more price data. The changes would start about 18 months after the bill becomes law.

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 Senate bill in Congress.

Who this affects: This bill mainly affects state Medicaid programs, pharmacy benefit managers, managed care plans, and pharmacies that serve Medicaid patients. It changes how drug payments flow through Medicaid contracts and what information must be reported. Medicaid patients are not directly given new benefits or new eligibility rules, but pharmacy participation and drug management could change over time.

Why this matters: Medicaid drug payments can pass through several middlemen before a pharmacy gets paid. This bill tries to make that money trail clearer and reduce hidden profits from price gaps. States and the federal government could get better data on what drugs cost and what pharmacies receive. The bill could affect Medicaid drug spending and pharmacy stability, but it does not promise lower drug prices or direct patient savings.

Key provisions in S. 1038

• State Medicaid drug contracts with PBMs and managed care plans would have to use pass-through pricing. PBMs are companies that manage prescription drug benefits.
• Drug payments in these contracts would cover only the drug ingredient cost plus a professional dispensing fee. That fee must be at least what the state Medicaid plan would pay on its own.
• The full drug payment and dispensing fee would have to reach the pharmacy or provider that fills the prescription. The middleman could not keep part of that payment.
• Medicaid could not use spread pricing to claim federal matching funds. Spread pricing means charging Medicaid more than the pharmacy gets paid, except for a reasonable administrative fee.
• PBMs and managed care plans could be paid only reasonable administrative fees for Medicaid drug work. They could not earn extra payment through hidden drug price spreads.

How Modern Action helps you take action on S. 1038

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 S. 1038

What is S. 1038?

Medicaid drug middlemen could no longer keep extra money from spread pricing. They would have to pass drug payments to pharmacies and report more price data. The changes would start about 18 months after the bill becomes law.

How do I support or oppose S. 1038?

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 S. 1038?

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 S. 1038?

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