https://www.govtrack.us/congress/bills/115/s2554/summary

Americans overspend by an estimated $135 million on prescriptions through their insurance, in cases when they would cost less out of pocket. Yet pharmacists are often under gag orders from telling customers about that discrepancy.

A new bill introduced in the Senate would end this practice.

A “pharmacy gag clause” is a tactic under which a pharmacist may not inform customers which of the two options would cost less for a certain product: using their health insurance or paying fully out of pocket.

These clauses are usually instituted by an insurer or pharmacy benefit manager (PBM), the most famous of which include CVS Health, Express Scripts, or United Health. They’re put in for cases in which most consumers would save money by paying out of pocket — if only they knew. Pharmacy benefit managers pocket the difference.

States are increasingly banning the practice, including three in March alone: Mississippi, South Dakota, and Virginia. The total is now 14 states, from red states like the ones mentioned above to blue states like Minnesota and Connecticut.
What the bill does

However, there is no such law on a federal level. The Know the Lowest Price Act would ban the practice of pharmacy gag clauses.

Introduced on March 14 by Sen. Susan Collins (R-ME), the bill is numbered S. 2554.

What supporters say

Supporters argue the legislation would ensure full transparency when consumers make purchasing decisions, as they do with nutrition facts on food and drink products for example.

“Multiple reports have exposed how this egregious practice has harmed consumers, such as one customer who used his insurance to pay $129 for a drug when he could have paid $18 out of pocket,” Senate lead sponsor Collins said in a press release.

“Americans have the right to know which payment method — insurance or cash — would provide the most savings when purchasing prescription drugs,” Collins continued. “By prohibiting gag clauses, our legislation would take concrete action to lower the cost of prescription drugs, saving consumers money.”