U.S. Senate Finance Committee Chairman Mike Crapo (R-Idaho) and Ranking Member Ron Wyden (D-Oregon) have introduced new bipartisan legislation aimed at increasing transparency and accountability among pharmacy benefit managers (PBMs) in federal prescription drug programs.
The PBM Price Transparency and Accountability Act seeks to address market issues that lawmakers say are contributing to higher costs for patients at the pharmacy counter. According to Senator Crapo, “Pharmacy benefit managers should not profit from overcharging patients for their prescriptions. This bipartisan legislation is a decisive step toward making the prescription drug market easier to navigate for both patients and pharmacies. These proposals form a strong foundation for additional efforts to promote pharmacy access, demystify drug pricing and reduce costs for both taxpayers and seniors.”
Senator Wyden added, “It’s long past time to go after middlemen who are making Americans’ prescription drugs more expensive. The Finance Committee has put forward a comprehensive approach to stop the pharmacy benefit manager business practices that are harming seniors and taxpayers who count on Medicare to deliver affordable prescription drugs. It’s time to get this done.”
Key provisions of the bill include removing the link between PBM compensation and negotiated rebates, which aims to discourage PBMs from favoring higher-priced medications. The legislation would also increase reporting requirements for PBMs to Medicare Part D plan sponsors and the U.S. Department of Health and Human Services, as well as empower plan sponsors with greater audit authority over their PBMs.
Additionally, the act reinforces requirements ensuring that plan sponsors contract with any willing pharmacy meeting standard terms—an effort intended to protect independent pharmacies in rural areas from practices that have led to closures. Retail community pharmacies would be required to participate in the National Average Drug Acquisition Cost survey, aiming for more accurate Medicaid payments, while PBMs would be mandated to pass Medicaid payments directly to pharmacies.
A group of senators from both parties—including John Barrasso (R-Wyoming), Michael Bennet (D-Colorado), Marsha Blackburn (R-Tennessee), Catherine Cortez Masto (D-Nevada), Bill Cassidy (R-Louisiana), Maggie Hassan (D-New Hampshire), John Cornyn (R-Texas), Ben Ray Luján (D-New Mexico), Steve Daines (R-Montana), Tina Smith (D-Minnesota), Chuck Grassley (R-Iowa), Mark Warner (D-Virginia), James Lankford (R-Oklahoma), Raphael Warnock (D-Georgia), Roger Marshall (R-Kansas), Peter Welch (D-Vermont), John Thune (R-South Dakota), Sheldon Whitehouse (D-Rhode Island) and Thom Tillis (R-North Carolina)—are co-sponsoring the bill.
The full legislative text is available online.
