Senate Bill Would Ban PBM "Spread Pricing" in Medicaid, Open Medicare Drug Networks
A senate committee must act next: committee consideration.
No action since December 2025
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
The bill appropriates over $327 million to CMS, the HHS Inspector General, and other agencies to implement and oversee these new PBM transparency and accountability requirements. Federal employees at CMS and the OIG would take on significant new workload related to pharmacy surveys, PBM reporting, enforcement of contract standards, and investigation of complaints. This represents a substantial expansion of their regulatory responsibilities.
Read twice and referred to the Committee on Finance.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in Senate
The bill was officially filed and given a number. It now enters the legislative queue.
The $1.2 trillion spending package passed in February 2026 includes PBM reforms that prohibit price-linked remuneration in Medicare Part D, ban spread pricing in Medicaid, and ensure reasonable pharmacy network contracting. The bill also expands HHS reporting and audit authority.
The bipartisan Senate bill aims to fix market distortions by mandating PBMs pass Medicaid payments directly to pharmacies and requiring participation in the NADAC survey. It also reinforces requirements for Medicare plans to contract with any pharmacy meeting standard terms.
A bipartisan group of House leaders introduced the Pharmacists Fight Back Act, which aligns with the Senate's PBM Price Transparency and Accountability Act. The legislation seeks to create a transparent reimbursement model using market-based pricing benchmarked to the NADAC.
No votes or related bills recorded for this bill yet.
Document Type
Congressional Bill
Official Title
PBM Price Transparency and Accountability Act
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