Legislation1w ago
42
To authorize implementation grants to community-based nonprofits to operate one-stop reentry centers.
HR8548Rep. Kamlager-Dove, Sydney [D-CA-37] (D-CA)
introduced
HR6580119th CongressWALLET
VA National Formulary Act of 2025
Sponsored By: Representative Rep. Miller-Meeks, Mariannette [R-IA-1]
In Committee
Summary
Creates a single VA national drug formulary to standardize which prescription drugs and supplies are available across all VA medical facilities and centralize management under the VA Pharmacy Benefits Management Service. It also sets rules for nonformulary access, public explanations of major changes, and new governance and purchasing tools.
Show full summary
- Veterans and families: Establishes a tiered 30-day copayment schedule with lower copays for generics and formulary drugs than for brand or nonformulary drugs. Nonformulary access is preserved through a formal electronic request and waiver system with portable approvals across VA facilities.
- Clinicians and care delivery: Creates a Pharmacy and Therapeutics Committee that meets monthly to bi-monthly and bases decisions on clinical evidence and pharmacoeconomics. Clinician nonformulary requests must get an initial decision within 96 hours and a final national-level decision on denied requests within 7 days.
- VA operations and industry: Authorizes supplemental discounts and value-based purchasing tied to outcomes and cost savings, requires periodic outcome and cost-effectiveness reviews, and mandates reports to the House and Senate Veterans’ Affairs Committees within 180 days of reviews. A Veterans Formulary Advisory Committee of up to 10 members will meet at least semiannually and terminate after two years.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 5 benefits, 0 costs, 0 mixed.
Faster requests for nonformulary drugs
If enacted, the VA would require a standard electronic system in the VA health record for clinicians to request drugs not on the national list. The VA must tell clinicians and veterans an initial decision within 96 hours. Denials must include appeal rights, and final national appeal decisions must be made within seven days. Approvals would be valid across VA facilities, and local sites could only use drugs off the national list through this process or a time‑limited waiver.
More pharmacy reviews for high-risk patients
If enacted, the VA would require medication therapy management focused on polypharmacy and high‑risk drugs. Clinical pharmacy specialists would review complex regimens and offer interventions like provider education and patient outreach. The VA must do regular therapeutic class reviews to keep the formulary clinically appropriate. After major formulary actions, the VA would study health outcomes, drug use, and costs and report to Veterans' Affairs Committees within 180 days and a full evaluation within one year.
New VA drug review committee
If enacted, the VA would create a Pharmacy and Therapeutics Committee to guide national formulary choices. Members would be VA clinicians, pharmacists, and pharmacoeconomists who must disclose financial interests and be barred from decisions if they have conflicts. The committee would use clinical evidence and cost‑effectiveness analyses and aim to decide on newly approved FDA drugs within 120 days when practicable. Meetings would occur at least monthly or bimonthly.
One national VA drug list
If enacted, the VA would create one national list of prescription drugs and medical supplies for all VA hospitals and clinics. The VA's Pharmacy Benefits Management Service would run the list and could negotiate extra discounts, rebates, and preferred‑status deals with drug makers. The VA could use volume purchasing and value‑based contracts tied to drug effectiveness, but any deals could not exceed existing statutory price limits. This would aim to lower the VA's net drug costs and make drug availability more consistent across facilities.
More transparency for VA drug choices
If enacted, the VA would set up a small Veterans Formulary Advisory Committee to collect frontline clinician and veteran input. The VA would publish summaries explaining major formulary additions or removals and, when feasible, hold briefings for stakeholders. The VA must also send an annual appeals report to Congress and, for five years after enactment, yearly reports listing drugs added or removed and changes to usage rules.
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Sponsors & CoSponsors
Sponsor
Rep. Miller-Meeks, Mariannette [R-IA-1]
IA • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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