# 119-hr-6609: Pharmacists Fight Back in Medicare and Medicaid Act

119-hr-6609, Pharmacists Fight Back in Medicare and Medicaid Act, is a 119th Congress bill sponsored by Rep. Auchincloss, Jake [D-MA-4] (D-MA); status introduced; PRIA reads it as touching household money (as of 2026-09-21).

- Canonical: https://policyrisk.com/legislation/119-hr-6609
- As of: 2026-09-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-6609
- Congress: 119
- Title: Pharmacists Fight Back in Medicare and Medicaid Act
- Status: introduced
- Introduced: 2025-12-11
- Sponsor: Rep. Auchincloss, Jake [D-MA-4] (D-MA)
- Cosponsors: 41
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-09-21

## Summary

**Would standardize PBM payment, rebate pass-through, and transparency rules across Medicare Part D and Medicaid.** It would set a clear pharmacy payment formula, require point-of-sale rebate reductions to lower patient cost sharing, and create civil and criminal penalties for noncompliance. - Medicare and Medicaid enrollees would have rebates applied at the point of sale to reduce coinsurance or copays for covered Part D drugs, so out-of-pocket shares reflect those rebates. - Pharmacies and dispensing sites would get ingredient payments equal to NADAC or, if unavailable, WAC plus 4 percent of that price capped at $50, plus the State-reported dispensing fee. Contracts may not let PBMs or sponsors impose fees that reduce the pharmacy's receipts and would expand acquisition-price survey reporting across many pharmacy types. - PBMs, plan sponsors, and States would face new written-agreement, anti-steering, rebate remittance, and reporting rules, annual PBM certification to sponsors and the Secretary by July 1, 2028, and felony penalties up to $1,000,000 and 10 years imprisonment with matching civil fines.

## Cosponsors (41)

- Rep. Harshbarger, Diana [R-TN-1] (R-TN), 2025-12-11T00:00:00.000Z
- Rep. Comer, James [R-KY-1] (R-KY), 2025-12-11T00:00:00.000Z
- Rep. Carter, Earl L. "Buddy" [R-GA-1] (R-GA), 2025-12-11T00:00:00.000Z
- Rep. Ciscomani, Juan [R-AZ-6] (R-AZ), 2025-12-11T00:00:00.000Z
- Rep. Moulton, Seth [D-MA-6] (D-MA), 2025-12-11T00:00:00.000Z
- Rep. Deluzio, Christopher R. [D-PA-17] (D-PA), 2025-12-11T00:00:00.000Z
- Rep. Peters, Scott H. [D-CA-50] (D-CA), 2025-12-11T00:00:00.000Z
- Rep. Tlaib, Rashida [D-MI-12] (D-MI), 2025-12-11T00:00:00.000Z
- Rep. Budzinski, Nikki [D-IL-13] (D-IL), 2025-12-11T00:00:00.000Z
- Rep. Krishnamoorthi, Raja [D-IL-8] (D-IL), 2025-12-11T00:00:00.000Z
- Rep. Khanna, Ro [D-CA-17] (D-CA), 2025-12-11T00:00:00.000Z
- Rep. Lynch, Stephen F. [D-MA-8] (D-MA), 2025-12-11T00:00:00.000Z
- Rep. Goldman, Craig A. [R-TX-12] (R-TX), 2025-12-11T00:00:00.000Z
- Rep. Cohen, Steve [D-TN-9] (D-TN), 2025-12-11T00:00:00.000Z
- Rep. Pressley, Ayanna [D-MA-7] (D-MA), 2025-12-11T00:00:00.000Z
- Rep. Gonzalez, Vicente [D-TX-34] (D-TX), 2025-12-11T00:00:00.000Z
- Rep. Moore, Barry [R-AL-1] (R-AL), 2025-12-11T00:00:00.000Z
- Rep. Subramanyam, Suhas [D-VA-10] (D-VA), 2025-12-11T00:00:00.000Z
- Rep. Pocan, Mark [D-WI-2] (D-WI), 2025-12-11T00:00:00.000Z
- Rep. Bishop, Sanford D. [D-GA-2] (D-GA), 2025-12-11T00:00:00.000Z
- Rep. McCollum, Betty [D-MN-4] (D-MN), 2025-12-11T00:00:00.000Z
- Rep. Westerman, Bruce [R-AR-4] (R-AR), 2025-12-23T00:00:00.000Z
- Rep. Scott, Austin [R-GA-8] (R-GA), 2026-01-07T00:00:00.000Z
- Rep. Fleischmann, Charles J. "Chuck" [R-TN-3] (R-TN), 2026-01-07T00:00:00.000Z
- Rep. Rogers, Harold [R-KY-5] (R-KY), 2026-01-07T00:00:00.000Z
- Rep. Fulcher, Russ [R-ID-1] (R-ID), 2026-01-07T00:00:00.000Z
- Rep. Maloy, Celeste [R-UT-2] (R-UT), 2026-01-07T00:00:00.000Z
- Rep. McGarvey, Morgan [D-KY-3] (D-KY), 2026-01-07T00:00:00.000Z
- Rep. Bergman, Jack [R-MI-1] (R-MI), 2026-01-09T00:00:00.000Z
- Rep. Sessions, Pete [R-TX-17] (R-TX), 2026-01-09T00:00:00.000Z
- Rep. Clyde, Andrew S. [R-GA-9] (R-GA), 2026-01-30T00:00:00.000Z
- Rep. Rogers, Mike D. [R-AL-3] (R-AL), 2026-02-04T00:00:00.000Z
- Rep. Aderholt, Robert B. [R-AL-4] (R-AL), 2026-02-09T00:00:00.000Z
- Rep. Williams, Roger [R-TX-25] (R-TX), 2026-02-23T00:00:00.000Z
- Rep. Strong, Dale W. [R-AL-5] (R-AL), 2026-04-14T00:00:00.000Z
- Rep. Mann, Tracey [R-KS-1] (R-KS), 2026-04-21T00:00:00.000Z
- Rep. James, John [R-MI-10] (R-MI), 2026-04-30T00:00:00.000Z
- Rep. Langworthy, Nicholas A. [R-NY-23] (R-NY), 2026-05-04T00:00:00.000Z
- Rep. Palmer, Gary J. [R-AL-6] (R-AL), 2026-05-14T00:00:00.000Z
- Rep. Tenney, Claudia [R-NY-24] (R-NY), 2026-05-14T00:00:00.000Z
- Rep. Allen, Rick W. [R-GA-12] (R-GA), 2026-08-31T00:00:00.000Z

## Provisions PRIA read

- Medicaid PBM and pharmacy payments: benefit, medium. If enacted, contracts that start January 1, 2027 or later would require PBMs and similar entities to pay pharmacies NADAC on the claim date (or WAC if no NADAC) plus 4% of that amount, with the 4% part capped so it cannot exceed $50 per claim, plus the State plan dispensing fee. PBMs and entities w…
- New Medicare Part D drug rules: mixed, medium. If enacted, for plan years beginning January 1, 2027, in-network pharmacies would be paid NADAC on the claim date (or WAC if no NADAC) plus 4% of that amount, with the 4% portion capped so it cannot exceed $50 per claim. Plans and PBMs would also have to pay the State Medicaid dispensing fee to in-…

## Related bills

- 119-hr-8800: National Defense Authorization Act for Fiscal Year 2027
- 119-hr-6610: Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act]
- 119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act
- 119-hr-909: Crime Victims Fund Stabilization Act of 2025
- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act
- 119-hr-2102: Major Richard Star Act

## Sources
- [119-hr-6609 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/6609)

## Related
- [119-hr-8800: National Defense Authorization Act for Fiscal Year 2027](https://policyrisk.com/legislation/119-hr-8800)
- [119-hr-6610: Pharmacists Fight Back in Federal Employee Health Benefit Plans Act](https://policyrisk.com/legislation/119-hr-6610)
- [119-hr-842: Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage A…](https://policyrisk.com/legislation/119-hr-842)
- [119-hr-909: Crime Victims Fund Stabilization Act of 2025](https://policyrisk.com/legislation/119-hr-909)
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [119-hr-2102: Major Richard Star Act](https://policyrisk.com/legislation/119-hr-2102)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-6609 (as of 2026-09-21).