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Rep. Earl Carter has introduced a major, bipartisan pharmacy benefit manager regulation bill, the Pharmacy Benefit Manager Reform Act of 2025 bill.
The bill would require PBMs to provide detailed reports on their activities for small employers and would let large employers opt into receiving the detailed reports, according to a preliminary version of the bill text.
The reporting provision includes a section that's intended to protect the privacy of specific patients.
A PBM could block public disclosure of the reports, but it would have to let an employer show a PBM report to federal regulators.
The secretary of the U.S. Department of Health and Human Services — who is now Robert F. Kennedy Jr. — would be in charge of enforcing the PBM reporting provisions.
The bill also includes drug price transparency provisions for Medicare drug plans. Some of those could end up having an indirect effect on employers, by influencing how drug manufacturers, PBMs and health plans think about all pharmacy benefits arrangements.
Carter introduced the new bill together with six Republican cosponsors and five Democratic cosponsors.
The legislative backdrop: In March, Carter was an original cosponsor of a bipartisan PBM reporting bill that appears to set requirements similar to the employer plan PBM reporting requirements included in the new bill.
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Carter last week announced that he was giving up his post as chairman of the House Energy and Commerce Committee's Health Subcommittee to focus on his efforts to run for a Senate seat in Georgia, but one of the original cosponsors is Rep. Jodey Arrington, R-Texas, the chairman of the House Budget Committee and the lead sponsor of the One Big Beautiful Bill Act.
The administration of President Donald Trump has said that it wants the U.S. Labor Department to look into PBM transparency and other drug supply chain concerns, but it has not given a clear indication of how it stands on the PBM battles in Congress.
But the bill appears to have strong momentum, with many members of Congress in both parties regularly talking about the need for federal PBM legislation.
The pharmacy benefit manager fight: PBMs offer to help employer plan sponsors, insurers and other payers design prescription drug plans, choose the drugs included on the plans' "formularies" and negotiate terms with pharmaceutical manufacturers and distributors.
Traditional pharmacies, some employers and the leaders of some new PBMs and mail-order pharmacy services, such as Mark Cuban, have blasted the big PBMs, arguing that the big PBMs use their huge size and ownership of mail-order pharmacies to set up arrangements that increase their profits while hurting traditional pharmacies and increasing prices for employers and patients.
Health insurers and the big PBMs have argued that the critics are angry about the PBMs' success at holding down drug costs and reducing other players' excess profits.
Some big employer groups, including the ERISA Industry Committee, have suggested that any PBM rule changes that seem necessary should come from Congress, rather than the states, to reduce multistate employers' compliance costs.
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