Patients Before Middlemen Act

The Patients Before Middlemen Act (S 882) improves pharmacy access for Medicare beneficiaries by requiring prescription drug plans to allow any pharmacy meeting standard contract terms to join their networks. It establishes "essential retail pharmacies" in medically underserved areas or regions with limited pharmacy access (such as rural areas with no other pharmacies within 10 miles), and creates standards for reasonable and relevant contract terms between drug plans and pharmacies. The bill also increases transparency requirements for pharmacy benefit managers, mandating detailed annual reports on drug costs, rebates, and pricing practices, with many provisions taking effect for plan years beginning January 1, 2028.