Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for c…
The bill adds detailed pharmacy benefit manager (PBM) reporting, audit, and contract requirements for Medicare Part D prescription drug plans and MA–PD plans, effective for plan years beginning January 1, 2028. PBMs must provide annual, machine-readable reports with drug-level utilization, pricing, rebate, affiliate, and retained-revenue data, permit audits by plan-selected auditors, and reimburse sponsors for penalties caused by PBM noncompliance.
Liberal emphasizes transparency and potential patient savings
Relative to its intended legislative type, this bill creates substantive new legal obligations and reporting requirements on pharmacy benefit managers and PDP/MA–PD sponsors, with detailed data specifications, audit mechanisms, statutory definitions, and confidentiality controls.
The bill adds detailed pharmacy benefit manager (PBM) reporting, audit, and contract requirements for Medicare Part D prescription drug plans and MA–PD plans, effective for plan years beginning January 1, 2028.
PBMs must provide annual, machine-readable reports with drug-level utilization, pricing, rebate, affiliate, and retained-revenue data, permit audits by plan-selected auditors, and reimburse sponsors for penalties caused by PBM noncompliance.
The Secretary must standardize report formats and protect nonpublic data from public identification; the Comptroller General must study federal and state reporting overlap and submit recommendations within two years.
Moderately scoped regulatory transparency bill with bipartisan appeal potential but significant industry resistance, implementation complexity, and Senate procedural barriers.
Relative to its intended legislative type, this bill creates substantive new legal obligations and reporting requirements on pharmacy benefit managers and PDP/MA–PD sponsors, with detailed data specifications, audit mechanisms, statutory definitions, and confidentiality controls. It also establishes a GAO study requirement (secondary reporting element) and assigns implementation roles to the Secretary and plan sponsors.
Liberal emphasizes transparency and potential patient savings
These are examples from the analysis, not a ranked list of the most-affected groups.
Liberal emphasizes transparency and potential patient savings
Likely supportive because the bill substantially increases PBM transparency and accountability in Medicare Part D.
It is seen as a constructive step to expose rebates, retained revenues, and affiliate steering, though it stops short of requiring rebate pass-through or direct price caps.
Generally favorable to improving transparency while cautious about administrative costs and overlap with state rules.
Sees the GAO study and standardized formats as prudent safeguards, but wants clear cost‑benefit analysis and careful rulemaking.
Likely skeptical or opposed due to expanded federal mandates on private contracts and reporting, raising concerns about regulatory overreach and increased administrative costs.
May accept narrower, targeted transparency but resists broad disclosure and audit rules.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Moderately scoped regulatory transparency bill with bipartisan appeal potential but significant industry resistance, implementation complexity, and Senate procedural barriers.
The bill has not accumulated any surfaced votes yet.
Liberal emphasizes transparency and potential patient savings
Moderately scoped regulatory transparency bill with bipartisan appeal potential but significant industry resistance, implementation complex…
Relative to its intended legislative type, this bill creates substantive new legal obligations and reporting requirements on pharmacy benefit managers and PDP/MA–PD sponsors, with detailed data specifications, audit mec…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.