Protecting Pharmacies in Medicaid Act

Summary

Protecting Pharmacies in Medicaid Act 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.

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Timeline

1. 11 March 2025

   Introduced

   Read twice and referred to the Committee on Finance.

   Source: IntroReferral

2. 11 March 2025

   Introduced

   Introduced in Senate

   Source: IntroReferral

Votes

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Versions

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Documents

2 official files

• Introduced in Senate

  Introduced in Senate · EN · 11 March 2025

  ViewDownloadOpen at official source

• Introduced in Senate

  summary · EN · 11 March 2025

  Open at official source

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Sponsors

• Sen. Welch, Peter [D-VT] · D · Sponsor
• Sen. Marshall, Roger [R-KS] · R · Sponsor
• Sen. Warner, Mark R. [D-VA] · D · Sponsor
• Sen. Cassidy, Bill [R-LA] · R · Sponsor
• · ssfi00 · Standing

Related records

• related to → Bipartisan Health Care Act
• related to → Lower Costs for Everyday Americans Act