FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act
Official title: To amend chapter 89 of title 5, United States Code, to ensure program integrity, transparency, and cost savings in the pricing and contracting of prescription … Show full official titleShow less
Official title: To amend chapter 89 of title 5, United States Code, to ensure program integrity, transparency, and cost savings in the pricing and contracting of prescription drug benefits under the Federal Employees Health Benefits Program.
More subjectsShow fewer subjects
Have a question about what this bill does? Ask in plain English; the answer is drawn from the bill's actual text and official record, and it'll tell you when something isn't in the text rather than guess.
Forwarded by Subcommittee to Full Committee (Amended) by Voice Vote .
FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act - Prohibits the Office of Personnel Management (OPM) from entering a contract or approving a health benefits plan with a carrier that is a party to a pharmacy benefit manager (PBM) carrier arrangement to provide or administer prescription drug coverage under the Federal Employees Health Benefits Program (FEHBP) unless the PBM and the carrier comply with requirements of this Act. Directs OPM to terminate a contract or discontinue a plan that fails to comply.
Prohibits: (1) a pharmaceutical drug manufacturer or retail pharmacy from having a controlling interest in the PBM; or (2) the PBM from having a controlling interest in a retail pharmacy. Requires each carrier to certify PBM compliance annually. Prohibits OPM from permitting a carrier that has a controlling interest in a PBM to earn a profit from such interest with respect to an FEHBP contract.
Sets forth requirements of PBM arrangements under the FEHBP, including regarding: (1) drug substitution restrictions; (2) PBM reimbursement of carriers; (3) sale by a PBM of utilization and claims data; (4) drug pricing and the basis for reimbursement; (5) provisions of an explanation of benefits to enrollees; (6) nondiscriminatory contracts regarding required participation; (7) OPM access to PBM contract information; (8) civil monetary penalties for making false statements or claims to the government; and (9) reports from drug manufacturers on average manufacturer prices for drugs each quarter.
- Introduced in House Formatted Text PDF Formatted XML
Cite this page
U.S. Congress. (2026). H.R. 4489: FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act. 111th Congress. Open America. https://openamerica.io/bill/111-HR-4489/
"H.R. 4489: FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act." 111th Congress, 2026, Open America, https://openamerica.io/bill/111-HR-4489/.
H.R. 4489, 111th Cong. (2026), https://openamerica.io/bill/111-HR-4489/.
[H.R. 4489: FEHBP Prescription Drug Integrity, Transparency, and Cost Savings Act](https://openamerica.io/bill/111-HR-4489/)