Federal Health Plans: New Rules for Pharmacy Middlemen
A house committee must act next: committee consideration.
The bill has strong bipartisan support and high-profile sponsors from both parties, but it faces significant opposition from the powerful pharmacy benefit management industry.
Scores run from -100 (strongly harmful) to +100 (strongly beneficial) for each group, combining impact, certainty, scope, and duration ratings of 1-5. How impact scoring works
Independent, in-network pharmacies would be guaranteed reimbursement based on national average drug acquisition cost plus a set dispensing fee, and PBMs would be barred from clawing back fees after a claim is paid. This targets a common complaint that PBMs pay small pharmacies below their actual drug costs, which has driven many local pharmacies out of business.
“pay an in-network pharmacy a professional dispensing fee that is equal to the professional dispensing fee paid by the State in which the pharmacy is located under title XIX of the Social Security Act”
Referred to the House Committee on Oversight and Government Reform.
Introduced in House
The bill was officially filed and given a number. It now enters the legislative queue.
A bipartisan group of U.S. House leaders introduced the Pharmacists Fight Back Act, calling for pharmacy reimbursements to be based on drug acquisition costs plus dispensing fees for federal plans, including Medicare, Medicaid, and the Federal Employees Health Benefits Program.
The Pharmacists Fight Back Act aims to reform payments in federal health programs by requiring reimbursements based on acquisition costs and fair dispensing fees. It would also ban patient steering and redirect PBM rebates to patients and plan sponsors to decrease premiums.
Congress passed new PBM regulations in February 2026, including laws to prevent middlemen from keeping rebates negotiated on drug prices for federal health plans. The move follows years of complaints from independent pharmacies about predatory reimbursement practices.
No votes or related bills recorded for this bill yet.
Document Type
Congressional Bill
Official Title
Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act]
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