Pharmacists Fight Back in Medicare and Medicaid Act

This bill establishes new requirements for pharmacy benefit managers (PBMs) working with Medicare Part D prescription drug plans and Medicaid programs. It mandates that PBMs pay pharmacies a specific reimbursement amount based on drug acquisition costs plus a fixed fee, pass through manufacturer rebates directly to beneficiaries at the point of sale, and prohibits steering practices that direct patients to specific pharmacies. The bill applies to Medicare Part D plans and Medicaid managed care organizations beginning January 1, 2027, affecting how PBMs interact with pharmacies and handle drug rebates. Violations could result in criminal penalties of up to $1 million or 10 years in prison for willful noncompliance. The bill aims to increase transparency and fairness in pharmacy drug pricing for Medicare and Medicaid beneficiaries.