H.R. 6610 · In committee · Health

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

What it does

Requires pharmacy benefit managers administering Federal employee health plans to reimburse in-network pharmacies at national average drug acquisition cost plus the lesser of four percent or fifty dollars per prescription.
Mandates pharmacy benefit managers pay in-network pharmacies a professional dispensing fee equal to the Medicaid rate in the pharmacy's state.
Requires pharmacy benefit managers to apply manufacturer rebates to reduce patient copayments at point of sale and remit remaining rebate amounts to the health plan carrier.
Prohibits pharmacy benefit managers from directing patients to affiliated pharmacies, marketing affiliated pharmacies preferentially, restricting in-network pharmacy participation, or influencing manufacturers to limit distribution.
Imposes civil monetary penalties of ten thousand dollars per violation on pharmacy benefit managers and carriers that breach these requirements, with cumulative annual caps per carrier.

Jul 22, 2026: Ordered to be Reported (Amended) by the Yeas and Nays: 40 - 2.

Committee: House Oversight and Government Reform