Protecting Pharmacies in Medicaid Act
Official title: A bill to amend title XIX of the Social Security Act to ensure accurate payments to pharmacies under Medicaid and to prevent the use of abusive spread pricing practices under Medicaid.
What Do You Think?
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What Happened in Congress?
Not yet voted on the floor.
Where the Bill Stands
- Introduced, done
- Committee, current stage
- Floor Vote, not yet
- Outcome, not yet
What This Bill Does
This bill provides funds beginning in FY2026 for the Centers for Medicare & Medicaid Services to survey retail and non-retail pharmacies (e.g., mail-order pharmacies) to determine average prices of covered outpatient drugs under Medicaid. Pharmacies that fail to participate in the surveys are subject to civil penalties.
The bill additionally provides funds for FY2026 for the Office of the Inspector General of the Department of Health and Human Services to study the results of the survey and report accordingly to Congress.
The bill also requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with pharmacy benefit managers under Medicaid.
Sponsors
Related Documents
Timeline
- Library of CongressIntroduced in Senate
- SenateRead twice and referred to the Committee on Finance.
- Introduced
- Committee
Comments
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