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Ending Hidden Drug Fees: New Rules for Pharmacy Benefit Managers

This act aims to lower prescription drug costs for citizens by changing how Pharmacy Benefit Managers (PBMs) earn revenue. Starting in 2026, PBMs will only be allowed to charge flat service fees, preventing them from profiting from drug prices or rebates. This is intended to increase transparency and fairness in the drug market, potentially reducing out-of-pocket expenses for prescriptions.
Key points
PBMs will only be allowed to charge flat service fees, not based on drug prices or discounts, to prevent inflated costs.
Steering patients to PBM-owned pharmacies will be prohibited if it increases costs for the patient or health plan.
PBMs cannot charge health plans more for a drug's ingredient cost or dispensing fee than they reimburse pharmacies.
Violations will incur civil monetary penalties of $10,000 per day and require disgorgement of improperly received payments.
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Additional Information
Print number: 118_HR_6283
Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1]
Process start date: 2023-11-08
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Summarized by: gemini-2.5-flash-preview-05-20
Source data: api.congress.gov
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OFFICIAL LEGAL TITLE

DRUG Act

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 118_HR_6283.

Which chamber initiated this legislation?

This legislation was initiated in the House of Representatives.

When did the legislative process begin?

The process officially started on 2023-11-08.

What are the main provisions?

Key points include:

  • PBMs will only be allowed to charge flat service fees, not based on drug prices or discounts, to prevent inflated costs.
  • Steering patients to PBM-owned pharmacies will be prohibited if it increases costs for the patient or health plan.
  • PBMs cannot charge health plans more for a drug's ingredient cost or dispensing fee than they reimburse pharmacies.
  • Violations will incur civil monetary penalties of $10,000 per day and require disgorgement of improperly received payments.
What is the specific legal status?

The current status is Expired.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Rep. Miller-Meeks, Mariannette [R-IA-1].

What is the latest detailed status?

The latest detailed status is: Referred to the Subcommittee on Health.

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-25.

CATEGORIES

Health