S. 5586 — Ensuring Accurate Payments to Specialty Pharmacies Act

This section requires the Secretary to conduct monthly surveys of applicable non-retail pharmacies to establish separate national average drug acquisition cost benchmarks for covered outpatient drugs, net of discounts and rebates. It mandates responses from such pharmacies (including those owned or affiliated with pharmacy benefit managers), requires public reporting of response rates, sampling methods, and price concessions, and authorizes civil monetary penalties for noncompliance. The section bars states from using non-retail pricing data to set retail pharmacy reimbursement rates, expands existing surveys to cover managed care payments and dispensing fee bases, and directs the HHS Inspector General to conduct periodic studies of the survey data.