under paragraphs (1) and (3) required to be submitted to plan sponsors who also are drug manufacturers, drug wholesalers, entities providing pharmacy benefit management services, or other direct participants in the drug supply chain, in the case that such secretaries determine that changes to the standard format are necessary to prevent anticompetitive behavior. (c) Limitations on spread pricing (1) In general For plan years beginning on or after the date that is 30 months after the date of enactment of the Pharmacy Benefit Manager Reform Act , a group health plan or health insurance issuer offering group health insurance coverage shall ensure that the amount required to be paid by a participant or beneficiary for a prescription drug covered under the plan or coverage, and a third-party administrator or an entity providing pharmacy benefit management services on behalf of such a plan or coverage shall ensure that the total amount required to be paid by the plan or issuer and participant or beneficiary for a prescription drug covered under the plan or coverage, does not exceed the price paid to the pharmacy, excluding penalties paid by the pharmacy (as described in paragraph (2)) to such plan, issuer, or entity. (2) Rule of construction For purposes of paragraph (1), penalties paid by pharmacies include only the following: (A) A penalty paid if an original claim for a prescription drug was submitted fraudulently by the pharmacy to the plan, issuer, or entity. (B) A penalty paid if the original claim payment made by the plan, issuer, or entity to the pharmacy was inconsistent with the reimbursement terms in any contract between the pharmacy and the plan, issuer, or entity. (C) A penalty paid if the pharmacist services for which a claim was filed with the plan, issuer, or entity were not rendered by the pharmacy. (d) Full rebate pass-through to plan or health insurance issuer (1) In general For plan years beginning on or after the date that is 30 months after the date of enactment of the Pharmacy Benefit Manager