HR 4317 United States House · 119th Congress

PBM Reform Act of 2025

The PBM Reform Act of 2025 aims to increase transparency and fairness in pharmacy benefit manager (PBM) operations within Medicare Part D and Medicaid programs. The bill requires Medicare Part D plans to allow any pharmacy meeting standard terms to join their networks, establishes "essential retail pharmacies" in underserved areas (with limited pharmacy access), and mandates detailed reporting on drug pricing, rebates, and reimbursement rates. It creates a process for pharmacies to report PBM violations of reasonable contract terms and prohibits "spread pricing" in Medicaid, where PBMs retain the difference between what they pay pharmacies and what they charge plans. These provisions aim to improve pharmacy access for Medicare beneficiaries and ensure fairer reimbursement practices for pharmacies.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Jul 2025

Committee Review

Floor Vote

President

Introduced Jul 10, 2025 Last action Jul 10, 2025

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Committee

Jul 10, 2025

Committee

Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

lower

Jul 10, 2025

Introduced

Introduced in House

lower

1 primary · 70 co-sponsors