# 119-hr-10369: Net Effective Cost Transparency and Prescription Drug Affordability Act of 2026

119-hr-10369, Net Effective Cost Transparency and Prescription Drug Affordability Act of 2026, is a 119th Congress bill sponsored by Rep. Mackenzie, Ryan [R-PA-7] (R-PA); status introduced; PRIA reads it as touching household money (as of 2026-09-24).

- Canonical: https://policyrisk.com/legislation/119-hr-10369
- As of: 2026-09-24
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-10369
- Congress: 119
- Title: Net Effective Cost Transparency and Prescription Drug Affordability Act of 2026
- Status: introduced
- Introduced: 2026-09-14
- Sponsor: Rep. Mackenzie, Ryan [R-PA-7] (R-PA)
- Cosponsors: 4
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-09-24

## Summary

**This bill would require _PBM bid and net‑effective‑cost transparency_ across Medicare Part D, Medicare Advantage–Part D (MA‑PD), and ERISA commercial plans to make drug pricing auditable and comparable.** It sets a standardized bidding system, requires audits and quarterly reconciliations, creates penalties and refunds, and adds a MA‑PD drug cost performance measure.

## Cosponsors (4)

- Rep. Auchincloss, Jake [D-MA-4] (D-MA), 2026-09-14T00:00:00.000Z
- Rep. Allen, Rick W. [R-GA-12] (R-GA), 2026-09-14T00:00:00.000Z
- Rep. McBath, Lucy [D-GA-6] (D-GA), 2026-09-14T00:00:00.000Z
- Rep. Miller, Carol D. [R-WV-1] (R-WV), 2026-09-14T00:00:00.000Z

## Provisions PRIA read

- PBM fee disclosures for employer plans: benefit, low. If enacted, PBMs bidding for ERISA employer health plans would have to disclose projected "net effective cost" and itemize bona fide service fees in a uniform format for plan years beginning after calendar year 2027. The bill would define "bona fide service fees" as fair-market payments for itemize…
- More transparency for Medicare drug costs: mixed, medium. If enacted, plans that offer Medicare Part D and Medicare Advantage–Part D would use a standard PBM bidding process starting with plan years on or after January 1, 2028. Bids would list expected PBM fees, rebates and discounts, drug-level financial data, and a projected "net effective cost" for the…

## Related bills

- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act
- 119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act
- 119-hr-4583: Living Donor Protection Act of 2025
- 119-hr-1422: Enhanced Iran Sanctions Act of 2025
- 119-hr-4582: To amend the Family and Medical Leave Act of 1993 and title 5, United States Code, to clarify that organ donation surgery qualifies as a serious health conditi…
- 119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025

## Sources
- [119-hr-10369 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/10369)

## Related
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842)
- [119-hr-4583: Living Donor Protection Act of 2025](https://policyrisk.com/legislation/119-hr-4583)
- [119-hr-1422: Enhanced Iran Sanctions Act of 2025](https://policyrisk.com/legislation/119-hr-1422)
- [119-hr-4582: To amend the Family and Medical Leave Act of 1993 and title 5, United States Co…](https://policyrisk.com/legislation/119-hr-4582)
- [119-hr-3514: Improving Seniors’ Timely Access to Care Act of 2025](https://policyrisk.com/legislation/119-hr-3514)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-10369 (as of 2026-09-24).