News Briefs: Newly Passed House Budget Bill Includes PBM Reforms
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May 22, 2025
The budget reconciliation package that House Republicans passed on May 22 includes multiple PBM reform measures. In Medicaid, the bill would ban spread pricing and require drug retailers and some non-retail sellers to participate in the National Average Drug Acquisition Cost survey. In Medicare Part D, the legislation would require PBMs to provide detailed information to plan sponsors and HHS about pricing and discounts, and it would force PBMs to “delink” their compensation from the cost or utilization of drug, instead getting paid a set fee. The Congressional Budget Office estimates that the Medicaid PBM restrictions would save about $3 billion over 10 years, but it has not published estimated savings for the Medicare-related PBM provisions.
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