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Latest NewsJuly 15, 2025 Bipartisan Legislators Introduce PBM Reform Act A bipartisan group of legislators in the House of Representatives introduced a new PBM reform package called the PBM Reform Act. The PBM Reform Act includes all of the PBM reforms that were included in the original Continuing Resolution package from December 2024: 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; 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; 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 the NO PBMs Act, which requires the Centers for Medicare & Medicaid Services to define and enforce “reasonable and relevant” Medicare Part D contract terms from PBM/insurer to pharmacy – including reimbursement. The legislation was introduced by Reps. Buddy Carter (R-GA), Debbie Dingell (D-MI), Greg Murphy (R-NC), Deborah Ross (D-NC), Jodey Arrington (R-TX), Diana Harshbarger (R-TN), Vicente Gonzalez (D-TX), Rick Allen (R-GA), Raja Krishnamoorthi (D-IL), John Rose (R-TN), Derek Tran (D-CA), and Nicole Malliotakis (R-NY). [Carter introduces bipartisan PBM reform package. Office of Rep. Buddy Carter 10 July 2025.] |