What is the official ID of this bill?
The official print number for this legislation is S 1542.
New Rules for PBMs: Flat Fees Only, Ending Drug Price Gouging.
This law aims to lower prescription drug costs by fundamentally changing how Pharmacy Benefit Managers (PBMs) are paid. Starting in 2026, PBMs must switch to flat service fees, eliminating incentives to favor expensive drugs or engage in hidden price markups. This change is designed to ensure patients and health plans benefit directly from lower drug prices and have greater freedom in choosing pharmacies.
Key points
Flat Fee Requirement: PBMs must charge only fixed, flat service fees, disconnected from drug prices, rebates, or discounts.
Ban on Spread Pricing: PBMs are prohibited from charging health plans more for a drug than they reimburse the dispensing pharmacy.
Stopping Patient Steering: PBMs cannot steer patients toward pharmacies they own or control, especially if it results in higher out-of-pocket costs for the patient.
Fair Reimbursement for Pharmacies: PBMs must reimburse independent network pharmacies at the same rate they pay their own affiliated pharmacies for the same drug or service.
Status:
Expired
Record your position for audit.
Why does your vote on bills matter?
It creates raw, undeniable proof. Civic Will provides the permanent data to verify the Government's loyalty towards its citizens
(explained here).
Start recording it now.