S 882 119th Congress
Patients Before Middlemen Act
A bill to amend title XVIII of the Social Security Act to assure pharmacy access and choice for beneficiaries under prescription drug plans and MA-PD plans and to establish requirements of pharmacy benefit managers under Medicare part D.
Official Title as Introduced Congress.gov
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Bill journey
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Introduction Congress.gov
Introduced
Introduced in the Senate.
Open bill recordOfficial action Congress.gov
Read twice and referred to the Committee on Finance.
Open bill recordOfficial action Congress.gov
Introduced in Senate
Open bill recordText version Congress.gov
Introduced in Senate
A dated text-version record is available.
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| Date and time | Record | Official detail | Source |
|---|---|---|---|
| IntroductionIntroduced | Introduced in the Senate. | Congress.gov | |
| Official actionRead twice and referred to the Committee on Finance. | No additional detail supplied.IntroReferral · Senate | Congress.gov | |
| Official actionIntroduced in Senate | No additional detail supplied.IntroReferral · Library of Congress · Code 10000 | Congress.gov | |
| Text versionIntroduced in Senate | A dated text-version record is available. | Congress.gov |
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Congressional Research Service
CRS summary
Patients Before Middlemen ActThis 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.
Official documents
Text versions
- Introduced in SenateMar 6, 2025