A Republican bill with 4 Democratic cosponsors · See all 7 cosponsors
Last activity — Read twice and referred to the Committee on Finance.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The "Patients Before Middlemen Act" aims to amend the Social Security Act to ensure better pharmacy access and choice for people on Medicare prescription drug plans. It requires drug plans to offer reasonable and relevant contract terms to pharmacies and establishes standards for these contracts. The bill creates a new category called "essential retail pharmacies" to track trends in reimbursement and participation. It also places stricter requirements and transparency mandates on pharmacy benefit managers (PBMs). Additionally, it establishes an enforcement process for pharmacies to report violations regarding contract terms.
Yes· 3 of 9
- Scored +6
Would people over 65 be better off under this?
The bill protects Medicare beneficiaries by ensuring better pharmacy access and more transparent drug plan operations.
- Scored +6
Would retired people be better off under this?
The bill protects the pharmacy access and choice of retirees on Medicare prescription drug plans.
- Scored +6
Does this make what the government does easier for the public to see?
The bill mandates more detailed annual reports from pharmacy benefit managers to the Secretary and the public.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Improved Pharmacy Access and Choice: PDP sponsors would be required to permit any pharmacy that meets standard contract terms and conditions to participate as a network pharmacy (Section 2(a)(i)).
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Fairer Contract Terms: Contract terms and conditions for plan years beginning on or after January 1, 2028, must be "reasonable and relevant" based on standards established by the Secretary (Section 2(a)(ii)).
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Increased Oversight of Essential Pharmacies: The Secretary will publish reports every two years regarding trends in ingredient cost reimbursement, dispensing fees, and participation rates for "essential retail pharmacies" (Section 2(b)(1)).
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Accountability for Pharmacy Benefit Managers: PBMs must enter into written agreements to meet specific requirements, including the ability to be held accountable for violations related to contract terms (Section 2(d)(1) and Section 3(a)(1)).
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Transparency in PBM Operations: PBMs are required to provide detailed annual reports regarding drug dispensing, costs, and manufacturer-derived revenue to provide more clarity on drug pricing (Section 3(a)(1)(C)(i)).
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Protection Against Retaliation: The bill prohibits PDP sponsors from retaliating against a pharmacy for submitting allegations of contract term violations (Section 2(c)(i)(VIII)).
Potential Negative Impacts for People
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Potential for Frivolous Allegations: The Secretary has the authority to temporarily prohibit pharmacies from using the allegation submission process if they determine a pharmacy is submitting frivolous allegations on a routine basis (Section 2(c)(i)(V)).
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Information Restrictions: While the Secretary can use certain information for oversight, the bill restricts the public disclosure of information that could identify specific pharmacies, manufacturers, or contract prices (Section s 3(a)(6)(A)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would retired people be better off under this? — The bill protects the pharmacy access and choice of retirees on Medicare prescription drug plans. Would people over 65 be better off under this? — The bill protects Medicare beneficiaries by ensuring better pharmacy access and more transparent drug plan operations. Would households on low incomes be better off under this? — Increased transparency in drug pricing and pharmacy competition may help lower costs for low-income Medicare enrollees.
- Healthcare
- Does this make health care easier to get in general? — The bill aims to assure pharmacy access and choice for Medicare beneficiaries through standardized contract terms. Does this lower the price of prescription medicines? — The bill increases transparency for pharmacy benefit managers and requires more detailed reporting on drug costs and rebates. Does this put more money into Medicare, the health coverage for people over 65? — The bill enhances Medicare Part D by improving pharmacy access and oversight of drug plans.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — The bill mandates more detailed annual reports from pharmacy benefit managers to the Secretary and the public.
- Economy And Finance
- Does this make it easier to run a small business? — The bill requires pharmacy contract terms to be reasonable and relevant, which helps protect smaller pharmacies from unfair practices.
- Social Issues And Justice
- Is this likely to lift people out of poverty? — By regulating pharmacy benefit managers, the bill aims to create more transparency in drug pricing which may benefit low-income enrollees.
- 3/10/2025
- 2 Cosponsors added.
- 3/6/2025
- Read twice and referred to the Committee on Finance.
- 5 Cosponsors added.
- Introduced in Senate
3 bills Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Bill CassidyRepublican · Louisiana
Catherine Cortez MastoDemocrat · Nevada
Maggie HassanDemocrat · New Hampshire
James LankfordRepublican · Oklahoma
Roger MarshallRepublican · Kansas
Peter WelchDemocrat · Vermont
Mark WarnerDemocrat · Virginia