NCPA: New “PBM Reform Act” Must Pass ASAP

ALEXANDRIA, Va. (July 10, 2025) – After PBM reform provisions fell out of the budget reconciliation negotiations in June due to a Senate parliamentarian ruling, a bipartisan group of legislators are continuing to push for action and today introduced a new bill that will serve as the House of Representatives’ comprehensive PBM reform package. After introduction of the new legislation – the PBM Reform Act – the National Community Pharmacists Association issued the following statement on behalf of CEO B. Douglas Hoey, pharmacist, MBA:

“As PBMs continue manipulating drug pricing, extinguishing their competition, and raking in massive profits, patients and pharmacies are suffering. We need help, and we need it quickly. Systemic changes like those in the PBM Reform Act must pass and be enacted as soon as possible. We’re grateful for this bill’s introduction and will do everything we can to push it across the finish line.”

The PBM Reform Act includes all of the PBM reforms that were included in the original Continuing Resolution package from December of last year: the Drug Price Transparency in Medicaid Act, which bans spread pricing in Medicaid and ensures pharmacies are fairly and adequately reimbursed for serving Medicaid beneficiaries; the Protecting Patients Against PBM Abuses Act, which establishes new requirements for PBMs under Medicare Part D, including a policy to delink PBM compensation from the cost of medications and increase transparency; the PBM Accountability Act, which promotes price transparency for prescription drugs purchased by employer health plans by ensuring PBMs provide group health plans and issuers with detailed data on prescription drug spending at least semi-annually; and the NO PBMs Act, which requires the Centers for Medicare & Medicaid Services to define and enforce “reasonable and relevant” Medicare Part D contract terms from PBM/insurer to pharmacy – including reimbursement.

The legislation was introduced by Reps. Buddy Carter (R-Ga.), Debbie Dingell (D-Mich.), Greg Murphy (R-N.C.), Deborah Ross (D-N.C.), Jodey Arrington (R-Texas), Diana Harshbarger (R-Tenn.), Vicente Gonzalez (D-Texas), Rick Allen (R-Ga.), Raja Krishnamoorthi (D-Ill.), John Rose (R-Tenn.), Derek Tran (D-Calif.), and Nicole Malliotakis (R-N.Y.).