Patients Before Middlemen Act
Official title: 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… Show full official titleShow less
Official title: 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.
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Read twice and referred to the Committee on Finance.
Patients Before Middlemen Act
This 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.
- Introduced in Senate Formatted Text PDF Formatted XML
- NATIONAL COMMUNITY PHARMACISTS ASSOCIATION
- CVS HEALTH (AND SUBSIDIARIES)
- EMD SERONO, INC.
- AMERICA'S HEALTH INSURANCE PLANS, INC. (AHIP)
- ELEVANCE HEALTH, INC.
- NATIONAL ASSOCIATION OF CHAIN DRUG STORES
Bodies those filers lobbied
- HOUSE OF REPRESENTATIVES
- SENATE
- Centers For Medicare and Medicaid Services (CMS)
- Health & Human Services, Dept of (HHS)
- White House Office
- Labor, Dept of (DOL)
- Food & Drug Administration (FDA)
- Office of Management & Budget (OMB)
Cite this page
U.S. Congress. (2026). S. 882: Patients Before Middlemen Act. 119th Congress. Open America. https://openamerica.io/bill/119-S-882/
"S. 882: Patients Before Middlemen Act." 119th Congress, 2026, Open America, https://openamerica.io/bill/119-S-882/.
S. 882, 119th Cong. (2026), https://openamerica.io/bill/119-S-882/.
[S. 882: Patients Before Middlemen Act](https://openamerica.io/bill/119-S-882/)