This bill amends federal pension and health plan law to require companies that manage employee health benefits to provide plan administrators with detailed access to health claims data, pricing information, and payment details. Currently, many contracts between health plans and service providers like insurance companies and pharmacy benefit managers include "gag clauses" that restrict plans from seeing claims data and negotiated prices, limiting their ability to identify errors or control costs. The legislation prohibits these restrictions and requires service providers to give plan fiduciaries access to all claims information within 15 days, pricing formulas, overpayment details, and administrative fees without additional charges. Service providers who violate these requirements face civil penalties up to $10,000 per day, and any contract terms that block data access are declared void. The law takes effect one year after enactment and applies to all new and renewed service contracts, affecting millions of workers and retirees in employer-sponsored health plans who may benefit from more transparent and potentially lower-cost health care through better plan oversight.
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