Prescription Drug Rebate Reform Act of 2023

This bill requires health plans and insurers to calculate patient cost-sharing (like coinsurance) based on a drug's net price - after rebates and discounts - not its full list price. It directly affects enrollees in group health plans or individual insurance who pay coinsurance for prescription drugs, particularly when deductibles aren't met. Key provisions mandate that coinsurance percentages must reflect the actual price paid by the plan (net price), not the manufacturer's list price, though fixed copayments remain allowed. The rule takes effect for plan years starting January 1, 2025.