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No Surprises Act Drug Pricing Report to Congress

Publication Date
Authors
ASPE Office of Health Policy

Prescription drug prices are a top concern for policymakers and the public, but little data is available on prescription drug prices or other costs that contribute to premiums for commercial drug coverage. To address the gap in data on availability, Section 204 of Division BB of Title II of the Consolidated Appropriations Act, 2021 directed group health plans and health insurance issuers offering group or individual (non-group) health insurance coverage to submit annually certain data on premiums, enrollment, nondrug medical spending, spending on prescription drugs, and prescription drug rebates to HHS, the Department of Labor, and the Department of the Treasury. The Office of Personnel Management (OPM) has joined the Departments to promote transparency in prescription drug and health care spending in the Federal Employees Health Benefits Program by requiring carriers to report information to the Departments, consistent with Section 204 and implementing regulations issued by the Departments and OPM.

Section 204 further directs the Secretary of HHS, through ASPE and in coordination with the Inspector General of HHS, to biannually make available on the HHS website a report on “prescription drug reimbursements under group health plans and group and individual health insurance coverage, prescription drug pricing trends, and the role of prescription drug costs in contributing to premium increases or decreases under such plans or coverage,” with similar direction to the Department of Labor and the Department of the Treasury. The Departments agreed to address this directive by submitting and posting to their internet websites one report covering all private health insurance plans and issuers subject to Section 204 reporting requirements as well as FEHB plans. This Report represents the first in the biannual series.

*This content is in the process of Section 508 review. If you need immediate assistance accessing this content, please submit a request to Anne Hall, Anne.Hall@hhs.gov. Content will be updated pending the outcome of the Section 508 review.