Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act]

This bill sets new rules for pharmacy benefit managers (PBMs) that handle prescription drug benefits for federal employee health plans. PBMs would have to pay in-network pharmacies a set drug ingredient cost plus a markup, along with a dispensing fee equal to what the state's Medicaid program pays. PBMs would have to use drug maker rebates to lower patients' copays at the pharmacy counter. They could not steer patients to specific pharmacies, cut pharmacy payments after claims are processed, or exclude in-network pharmacies. The federal personnel office could fine PBMs $10,000 per violation and bar a PBM from the program after 10 fines in 10 years, with the rules taking effect one year after enactment.

Full text and official record on Congress.gov

Sponsors

• Jake Auchincloss Democrat sponsor
• 47 cosponsors