01/31/2026
‼️ The Senate has reached an agreement on the outstanding funding bills for this fiscal year, which includes an NCPA priority PBM reform provision. Under the agreement between Senate Democrats and the White House, the Senate has voted to break up the existing funding package, taking the controversial Department of Homeland Security bill out and passing a short-term continuing resolution to fund DHS while passing the remaining appropriations bills. Due to congressional rules, everything must now go back to the House of Representatives, which is expected to take up the package on Monday.
The Senate passed the remaining funding package, with the bills broken apart, by a vote of 71 to 29. The part of the bill funding the Department of Health and Human Services includes provisions to require the Centers for Medicare & Medicaid Services to define and enforce “reasonable and relevant” Medicare Part D contract terms, and give enforcement authority; promote transparency by allowing CMS to track payment trends to pharmacies and pharmacy inclusion in PBM networks, including a designation of essential retail pharmacies; and prohibit PBM compensation in Medicare Part D from being tied to the manufacturer’s list price of a drug in an effort to reduce drug prices and save money for taxpayers.
‼️ In a vote of 341-88, the House of Representatives passed a spending bill that includes a provision requiring CMS to develop reasonable and relevant contract terms under Medicare Part D and create a mechanism for pharmacies to report contract violations. "The PBM reforms included in this package – the first major PBM reform in Medicare Part D to pass in nearly 20 years – are as welcomed as they are long overdue," said NCPA's Anne Cassity, expressing gratitude to the pharmacy champions in Congress and the many independent pharmacy allies and advocates who have participated in this fight. "We need to get this through the Senate and to the president’s desk as quickly as possible, so independent pharmacies and the patients they treat can have the relief from PBM manipulations they so desperately need."
Our statement is available here: https://bit.ly/3ZrK3Xr
