S. 882 · Where this bill is now
In committee
Introduced in the Senate, Mar 6, 2025
What this bill does
In plain words · AI-written from the official summaryNew rules for prescription drug middlemen
This bill sets up standards for how companies that manage prescription drug plans work with pharmacies and each other. It requires the Medicare agency to create fair contract standards between drug plans and pharmacies, and it limits what payment middlemen called pharmacy benefit managers can earn—they'd only get flat service fees, not commissions. The bill also requires these middlemen to report detailed information about prescription costs and drugs they handled, and it sets up penalties if they break the rules.
How it affects you
If you're on Medicare and use prescription drugs, this could affect what you pay and how easily you get your medications. The rules are meant to reduce how much middlemen profit from prescription drug plans, which could eventually lower costs for patients. The changes would start in 2028.
Read the official summary (Introduced in Senate, Mar 6, 2025)
Patients Before Middlemen Act
This bill establishes certain standards and reporting requirements for prescription drug plan (PDP) sponsors, pharmacy benefit managers (PBMs), and pharmacies under the Medicare prescription drug benefit and Medicare Advantage.
Specifically, the Centers for Medicare & Medicaid Services (CMS) must develop reasonable and relevant standards for contracts between PDP sponsors and pharmacies. The CMS must seek input from interested stakeholders when developing these standards. PDP sponsors are subject to civil penalties for violating these standards; PBMs must reimburse PDP sponsors for civil penalties that result from their responsibilities.
The bill also requires the CMS to report periodically on essential retail pharmacies (i.e., pharmacies that serve as the only pharmacy within a certain radius) with respect to costs, contracts, and other specified information, particularly in relation to other types of pharmacies.
Additionally, PBMs may not receive any income other than flat, bona fide service fees. PBMs must turn over any excess amounts they receive to PDP sponsors; PDP sponsors must turn over these amounts to the CMS. In addition, PBMs must report to PDP sponsors and to the CMS an itemized list of prescription drugs that were dispensed during the previous year and related data about costs, claims, affiliated pharmacies, and other specified information. PDP sponsors may audit PBMs to ensure compliance with these requirements and must annually certify their compliance; PBMs are responsible for any associated civil penalties for violations.
The bill's changes generally apply beginning in 2028.
Written by AI (Claude) using only the official summary by the Congressional Research Service, the Library of Congress’s nonpartisan research staff. It can miss nuance, so check the official summary and the bill text for details.
1st SessionS. 882
A BILL
Patients Before Middlemen Act
Sponsor: Sen. Marsha Blackburn (R-TN) · Introduced Mar 6, 2025 · Health · 1 version of the text
Sources: Congress.gov actions and votes · bill text from GovInfo · latest official action Mar 6, 2025: “Read twice and referred to the Committee on Finance.”