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CIVIC HERALD
HR 6610 · 119th Congress · HouseOther

Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act]

In plain language: This bill establishes new rules for pharmacy benefit managers (PBMs) that administer prescription drug plans for federal employees and retirees. It requires PBMs to pass drugmaker discounts directly to patients at the checkout counter, lowering copays and coinsurance based on the discounted net cost of medicine. The bill also protects patients' choice of pharmacy by banning PBMs from steering patients toward company-owned pharmacies, preventing unfair fees or pay cuts on local drugstores, and establishing $10,000 fines or program bans for companies that break the rules.

Provisional: our plain-language summary, pending review.

Provisionalunreviewed: impact, issue tags, provisions, stakeholders, summary
People affectedThe text applies to enrollees, carriers, PBMs, and pharmacies participating in federal employee health plans under 5 U.S.C. chapter 89, but does not provide a specific count of individuals affected.
Fiscal magnitudeno CBO estimate published
Reach58provisional · pending reviewrigor: heuristic llm
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Issues

What this bill touches.

Market protections+40Pharmaceutical pricing+45Corporate concentration+45

The sign shows the bill's direction on each issue (+ toward, − away); the number is its magnitude. Color never encodes good or bad, and never party.

Who it affects

Who it helps · who it burdens.

Who it helps

  • In-network pharmaciesGuarantees reimbursement based on national or wholesale drug acquisition costs plus up to 4% or $50, ensures professional dispensing fees equal to state Medicaid rates, and prohibits PBMs from imposing clawbacks, retroactive claim fees, or steering enrollees away to affiliated pharmacies (Sec. 2(a)(c)(1)(A)-(C)).provisional
  • Federal employee health plan enrolleesReceive point-of-sale reductions on copayments and coinsurance based on manufacturer rebates, and are protected from mandatory steering to PBM-affiliated pharmacies or being charged additional fees for pharmacy dispensing costs (Sec. 2(a)(c)(1)(A)(iii)(I), Sec. 2(a)(c)(1)(B)(i), (v)).provisional
  • Federal health plan carriersReceive the remaining balance of manufacturer rebates passed through by PBMs after enrollee cost-sharing reductions are applied (Sec. 2(a)(c)(1)(A)(iii)(II)).provisional

Who it burdens

  • Pharmacy benefits managers (PBMs)Subject to strict reimbursement formulas and dispensing fee rules, prohibited from keeping manufacturer rebates or steering enrollees to affiliated pharmacies, prohibited from clawing back fees, and face civil monetary penalties of $10,000 per violation and potential debarment from the federal program for repeated violations (Sec. 2(a)(c)(1), Sec. 2(b)(1)(8902b)(a)-(b)).provisional
  • Federal health plan carriersSubject to civil penalties of up to $50,000 per 10-year period for repeat PBM violations, required to submit compliance plans and undergo OPM oversight inspections, and must provide OPM access to personnel, facilities, and records (Sec. 2(a)(c)(1)(D), Sec. 2(b)(1)(8902b)(a)(1)(B), (a)(3)).provisional

Who backs it

  • Employees Health Benefits FundReceives all civil monetary penalties recovered from noncompliant PBMs and health plan carriers (Sec. 2(b)(1)(8902b)(a)(5)(B)).provisional

Dollar-level funding (FEC sector totals) is coming in a later phase.

What it does

The provisions, in plain language.

  1. Starting one year after enactment, requires pharmacy benefits managers (PBMs) for federal employee health plans to reimburse in-network pharmacies for prescription drug ingredient costs based on the national average drug acquisition cost (or wholesale acquisition cost if unavailable) plus up to 4 percent or $50.

    Sec. 2(a)(c)(1)(A)(i)provisional
  2. Requires PBMs in federal employee health plans to pay in-network pharmacies a professional dispensing fee equal to the state's Medicaid dispensing fee.

    Sec. 2(a)(c)(1)(A)(ii)provisional
  3. Requires PBMs to apply manufacturer rebates directly at the point of sale to lower an enrollee's copayment or coinsurance based on the drug's net cost, and remit the remaining rebate balance to the health plan carrier.

    Sec. 2(a)(c)(1)(A)(iii)provisional
  4. Prohibits PBMs from steering or requiring enrollees to use specific or affiliated pharmacies, or advertising affiliated pharmacies over other in-network pharmacies.

    Sec. 2(a)(c)(1)(B)(i)-(ii)provisional
  5. Prohibits PBMs from clawing back payments, imposing retroactive claim fees, or charging non-claim fees that reduce pharmacy reimbursement amounts.

    Sec. 2(a)(c)(1)(C)provisional
  6. Authorizes OPM to impose civil penalties of $10,000 per violation on noncompliant PBMs (capped at $100,000 per carrier over 10 years) and on repeat-offending carriers (capped at $50,000 over 10 years), with recovered funds deposited into the Employees Health Benefits Fund.

    Sec. 2(b)(1)(8902b)(a)provisional
  7. Directs OPM to debar any PBM that incurs 10 or more finalized civil penalties in a 10-year period from administering federal employee prescription drug benefits.

    Sec. 2(b)(1)(8902b)(b)provisional

How your members of Congress line up

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Timeline

How it moved.

  1. Jul 22, 2026Ordered to be Reported (Amended) by the Yeas and Nays: 40 - 2.
  2. Dec 11, 2025Introduced in House
  3. Dec 11, 2025Introduced in House

The original text

Read it for yourself.

Sources & provenance

Congress.govrefreshed 9 days ago

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