US SB3345

Requires the Secretary of Health and Human Services to conduct monthly surveys of retail and non-retail pharmacy drug prices to establish national average drug acquisition cost benchmarks for Medicaid, with civil penalties up to $100,000 per violation for pharmacies that fail to report accurate pricing data

Prohibits "spread pricing" in Medicaid by requiring pharmacy benefit managers (PBMs) to use transparent pass-through pricing models where payments to pharmacies are limited to ingredient costs plus professional dispensing fees, with all costs disclosed to states and HHS

Establishes "any willing pharmacy" requirements for Medicare Part D plans beginning January 1, 2028, requiring PDP sponsors to allow any pharmacy meeting standard contract terms to participate as a network pharmacy, with HHS to establish standards for reasonable and relevant contract terms

Restricts PBM compensation under Medicare to bona fide service fees that reflect fair market value and are flat dollar amounts not tied to drug prices, requiring PBMs to annually report detailed drug-level cost, rebate, and pricing data to plan sponsors and HHS

Appropriates $188 million for CMS enforcement of pharmacy access requirements, $113 million for PBM accountability provisions, $20 million for HHS Inspector General oversight, and $5 million for pharmacy survey oversight studies