Drug middlemen would face new rules to lower costs for Medicare and Medicaid users.
This bill would make big changes to how prescription drugs are paid for in government health programs. It would set new rules for Pharmacy Benefit Managers (PBMs). These rules would make sure pharmacies are paid fairly. For Medicare Part D, drug rebates would go directly to patients, lowering their out-of-pocket costs. For Medicaid, rebates would go to the state. It would also stop PBMs from directing patients to certain pharmacies, with most changes taking effect January 1, 2027.
Today, Pharmacy Benefit Managers (PBMs) have more flexibility in how they pay pharmacies and handle drug rebates. They can also sometimes direct patients to specific pharmacies. If this bill becomes law, starting January 1, 2027, PBMs would have to follow strict rules for pharmacy payments. They would also pass manufacturer rebates directly to Medicare Part D patients at the pharmacy counter. PBMs would be banned from steering patients to certain pharmacies. Medicaid would also see increased drug pricing transparency, requiring pharmacies to report their drug buying prices.
HR 6609 · 119th Congress · December 11, 2025 · AI Summary by gemini-2.5-flash · 10/10
Sign in to see your representatives' phone numbers
15 filings mentioned this bill
Amounts reflect total quarterly lobbying spend reported to the Senate, not bill-specific spending. Source: Senate LDA filings.