# 119-hr-5197: Protect Beneficiaries from Middlemen Act

119-hr-5197, Protect Beneficiaries from Middlemen Act, is a 119th Congress bill sponsored by Rep. Malliotakis, Nicole [R-NY-11] (R-NY); status introduced; PRIA reads it as touching household money (as of 2026-04-21).

- Canonical: https://policyrisk.com/legislation/119-hr-5197
- As of: 2026-04-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-5197
- Congress: 119
- Title: Protect Beneficiaries from Middlemen Act
- Status: introduced
- Introduced: 2025-09-08
- Sponsor: Rep. Malliotakis, Nicole [R-NY-11] (R-NY)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

This bill would cap Medicare Part D cost sharing so a beneficiary's copay for a drug between the deductible and the out-of-pocket threshold cannot exceed the drug's **average net price for the plan year or, if lower, the pharmacy's cash price**. Effective for plan years beginning January 1, 2027, it defines both "cash price" and "average net price," aligns the copayment rules in Part D plan language, and requires the Government Accountability Office to report by January 1, 2029 on compliance, enforcement, and disclosure.

## Provisions PRIA read

- Cap Medicare Part D drug copays: benefit, high. For plan years starting on or after January 1, 2027, Medicare Part D plans would cap what you pay for each month’s supply of a covered drug. After the deductible and before your out-of-pocket limit, your copay would be no more than the lower of two amounts. One is the plan’s average net price for t…

## Related bills

- 119-hr-9237: Take Care of America’s Veterans Act
- 119-hr-3151: SHIPS for America Act of 2025
- 119-hr-2725: Affordable Housing Credit Improvement Act of 2025
- 119-hr-2570: Maximum Pressure Act
- 119-hr-4317: PBM Reform Act of 2025
- 119-hr-1229: United States-Israel Defense Partnership Act of 2025

## Sources
- [119-hr-5197 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/5197)

## Related
- [119-hr-9237: Take Care of America’s Veterans Act](https://policyrisk.com/legislation/119-hr-9237)
- [119-hr-3151: SHIPS for America Act of 2025](https://policyrisk.com/legislation/119-hr-3151)
- [119-hr-2725: Affordable Housing Credit Improvement Act of 2025](https://policyrisk.com/legislation/119-hr-2725)
- [119-hr-2570: Maximum Pressure Act](https://policyrisk.com/legislation/119-hr-2570)
- [119-hr-4317: PBM Reform Act of 2025](https://policyrisk.com/legislation/119-hr-4317)
- [119-hr-1229: United States-Israel Defense Partnership Act of 2025](https://policyrisk.com/legislation/119-hr-1229)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-5197 (as of 2026-04-21).