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119-hr-2214119th CongressWALLET

DRUG Act

Sponsored By: Representative Miller-Meeks, Mariannette [R-IA-1]

Introduced

Summary

Delink PBM revenue from drug prices. This bill would require pharmacy benefit managers (PBMs) to stop earning pay tied to drug prices, rebates, discounts, or other price-based remuneration. It would allow only flat, written "bona fide" service fees and take effect January 1, 2027.

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  • Families and patients: Health plans could pass through rebates and discounts to lower net drug costs and patients may see lower out-of-pocket charges when plans use those savings.
  • Employers and health plans: Plans and employers could recover improper PBM payments because PBMs must disgorge unlawful remuneration to plans or insurers. Violations would trigger a $10,000 per day civil penalty.
  • PBMs and regulators: PBMs would need to switch to itemized flat fees not tied to price metrics. Federal agencies would enforce the rules across the Public Health Service Act, ERISA, and the Internal Revenue Code and issue interim final regulations.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 0 costs, 1 mixed.

PBMs could only charge flat fees

Starting January 1, 2027, PBMs for group or individual health plans would not be allowed to take pay for drug-benefit work, except a flat "bona fide service fee." The fee would have to be in a written deal, be a fixed dollar amount, and match fair market value for the service. It could not be tied, directly or indirectly, to drug prices, rebates, discounts, or other price-based payments. Paying pharmacies for ingredient costs and dispensing fees would still be allowed, and rebates/discounts could be fully passed through to group plans to lower net costs. PBMs that violate these rules would have to return the money to the plan or insurer and could owe $10,000 per day.

More companies counted as PBMs

This bill would define a "pharmacy benefit manager" broadly. It would cover any company that negotiates drug prices or runs drug benefits for a plan, even through middlemen. Covered work includes formularies, claims, prior authorization, appeals, and pharmacy contracts. More firms would need to follow the PBM pay rules starting January 1, 2027.

Interim rules to implement PBM changes

Agencies would issue interim final rules to put these PBM changes into effect. They would consult Health and Human Services, Labor, and Treasury as required. This step shapes timing and enforcement but would not change your benefits by itself.

Sponsors & CoSponsors

Sponsor

Miller-Meeks, Mariannette [R-IA-1]

IA • R

Cosponsors

  • Rep. Barragán, Nanette Diaz [D-CA-44]

    CA • D

    Sponsored 3/18/2025

  • Rep. Malliotakis, Nicole [R-NY-11]

    NY • R

    Sponsored 3/18/2025

  • Rep. Schneider, Bradley Scott [D-IL-10]

    IL • D

    Sponsored 3/18/2025

  • Rep. Allen, Rick W. [R-GA-12]

    GA • R

    Sponsored 3/18/2025

  • Rep. Norcross, Donald [D-NJ-1]

    NJ • D

    Sponsored 3/18/2025

  • Rep. Thanedar, Shri [D-MI-13]

    MI • D

    Sponsored 11/4/2025

Roll Call Votes

No roll call votes available for this bill.

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