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

H.R. 6610 Rep. Jake Auchincloss (D-MA-4) In committee
Bill text PDF
  1. Introduced Dec 11
  2. Committee Dec 11
  3. Passed House Next
  4. Passed Senate Not yet
  5. To President Not yet
  6. Law Not yet
Where it stands
In committee, Dec 11, 2025Next: House vote
98d ago Jul 22, 2026: Ordered to be Reported (Amended) by the Yeas and Nays: 40 - 2.
Final votes
No roll callsNo recorded vote on this bill yet
Lobbying
2companies, 6 filings
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Summary

This bill amends federal law to limit the costs and practices of pharmacy benefit managers (PBMs) in health plans for federal employees. It sets new payment rules for pharmacies and creates penalties for PBMs that violate them.

Sec. 2, Pharmacy payment and reimbursement requirements: The Office of Personnel Management (OPM) may only contract with health plans that require PBMs to reimburse in-network pharmacies at least the national average drug acquisition cost plus the lesser of 4% of that cost or $50, plus a state-level dispensing fee. PBMs must pass manufacturer rebates to patients at the point of sale as lower copays or coinsurance, and remit the rest to the plan. PBMs are banned from steering patients to specific pharmacies, excluding pharmacies from networks, or limiting drug distribution. PBMs cannot reduce pharmacy payments after a claim or charge fees unrelated to a claim. Plans must cooperate with OPM inspections.

Sec. 2, Noncompliance penalties: OPM must impose a $10,000 civil penalty per violation on a PBM. If a PBM gets five or more penalties in ten years for the same carrier, the carrier also gets a $10,000 penalty. Maximum penalties per ten-year period are $100,000 for a PBM and $50,000 for a carrier. Carriers with five penalties in ten years must submit a remediation plan to OPM. OPM may inspect carriers for compliance. Penalties are sequential. The Attorney General can sue to collect penalties, which go into the Employees Health Benefits Fund. OPM cannot initiate a penalty action more than six years after a violation. OPM must debar a PBM from federal employee plans if it gets ten or more penalties in ten years. Debarment takes effect 90 days after the tenth penalty. No payments may be made to a debarred PBM. Debarment ends if all underlying penalties are overturned. PBMs and carriers get notice, a hearing, and judicial review before adverse determinations. Matters raised or that could have been raised in a hearing or appeal cannot be used as a defense in a collection action.

Sec. 2, Conforming amendment: Section 8903a(b) is amended to require that health plans comply with the new section 8904(c).

Sec. 2, Effective date: The amendments take effect one year after enactment.

Summary of the bill text as introduced in House (Dec 11, 2025), generated by SecBot from the official bill text; the Library of Congress summary is not yet published.

Official record from Congress.gov, the House Clerk and the Senate; lobbying from Lobbying Disclosure Act filings. Updated Oct 28, 2026.