PBM reform legislation reintroduced
By HME News Staff
Updated 1:47 PM CDT, Thu July 10, 2025
ALEXANDRIA, Va. – A dozen lawmakers have introduced a comprehensive pharmacy benefit manager reform package in the House of Representatives.
The “PBM Reform Act” includes all the reforms that were included, but did not pass, in the original continuing resolution package from December 2024:
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The “Drug Price Transparency in Medicaid Act,” which bans spread pricing in Medicaid and ensures pharmacies are fairly and adequately reimbursed for serving Medicaid beneficiaries;
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The “Protecting Patients Against PBM Abuses Act,” which establishes new requirements for PBMs under Medicare Part D, including a policy to delink PBM compensation from the cost of medications and increase transparency;
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The “PBM Accountability Act,” which promotes price transparency for prescription drugs purchased by employer health plans by ensuring PBMs provide group health plans and issuers with detailed data on prescription drug spending at least semi-annually; and
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The “NO PBMs Act,” which requires CMS to define and enforce “reasonable and relevant” Medicare Part D contract terms from PBM/insurer to pharmacy – including reimbursement.
“As PBMs continue manipulating drug pricing, extinguishing their competition, and raking in massive profits, patients and pharmacies are suffering,” said B. Douglas Hoey, CEO of the National Community Pharmacists Association. “We need help, and we need it quickly. Systemic changes like those in the PBM Reform Act must pass and be enacted as soon as possible. We’re grateful for this bill’s introduction and will do everything we can to push it across the finish line.”
The legislation was introduced by Reps. Buddy Carter, R-Ga., Debbie Dingell, D-Mich., Greg Murphy, R-N.C., Deborah Ross, D-N.C., Jodey Arrington, R-Texas, Diana Harshbarger, R-Tenn., Vicente Gonzalez, D-Texas, Rick Allen, R-Ga., Raja Krishnamoorthi, D-Ill., John Rose, R-Tenn., Derek Tran, D-Calif., and Nicole Malliotakis, R-N.Y.
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