Legislators
H.R. 6610 affects the Federal Employee Health Benefits Program. Here's why it matters for you and your constituents.
If You're Enrolled in the FEHB Program, H.R. 6610 Will:
Protect Choice of Pharmacy
Restores patient freedom to use a pharmacy of their choice and increases access to care by prohbiting PBM practices that steer patients to PBM-owned pharmacies.
Lowers Plan Premiums and Drug Costs
Returns billions of dollars to patients at the pharmacy counter by requiring PBMs to share drugmaker rebates directly with patients. Remaining rebates will be required to be used to reduce plan premiums.
Increases Drug Price Transparency
Ends PBM exorbitant markups at PBM-owned pharmacies by aligning drug prices across pharmacies, patients, and payors with publicly available market based index pricing.
Holds PBMs Accountable
Ensures the new regulations are implemented effectively with strict penalties to prevent PBMs from circumventing the law.
Why H.R. 6610?
The PBM Problem
"PBMs are at the center of the complex pharmaceutical distribution chain that delivers a wide variety of medicines from manufacturers to patients. PBMs serve as middlemen, negotiating the terms and conditions for access to prescription drugs for hundreds of millions of Americans. Due to decades of mergers and acquisitions, the three largest PBMs now manage nearly 80 percent of all prescriptions filled in the United States. They are also vertically integrated, serving as health plans and pharmacists, and playing other roles in the drug supply chain as well. As a result, they wield enormous power and influence over patients’ access to drugs and the prices they pay. This can have dire consequences for Americans, with nearly three in ten surveyed Americans reporting rationing or even skipping doses of their prescribed medicines due to high costs." FTC Interim Staff Report July 2024
About H.R. 6610: The Pharmacists Fight Back Act
Despite Congressional action in other programs, anticompetitive PBM practices in the FEHBP remain unchecked leaving federal employees, independent pharmacies and taxpayers exposed to predatory “black box” pricing, steering, and rebate schemes. The U.S. OIG recently identified a systemic pattern of overcharges and rebate retention within the FEHBP in addition to PBM rebate shell games to the tune of millions of dollars.
The Pharmacists Fight Back Act (PFBA) restores integrity to the FEHBP through
three core pillars:
1. Fair Reimbursement: Establishes a transparent NADAC + 4% + dispensing
fee model for pharmacies as a floor and a ceiling and ends PBM markups at
affiliated pharmacies.
2. Rebate Transparency: Mandates 100% pass-through of all rebates, including those from offshore GPOs.
3. Patient Choice & Local Access to Care: Prohibits PBMs from steering to their affiliated pharmacies and ensures patients have access to the local pharmacy of their choice.
Please Support H.R. 6610
The health and wellbeing of your constituents are why passing and enforcing H.R. 6610 is so important. Please consider signing on as a co-sponsor.
Ask Your Constituents!
Contact Us to be connected with local pharmacies and patients in your district.