Bill > HR2214

This bill, known as the DRUG Act (Delinking Revenue from Unfair Gouging Act), aims to fundamentally change how pharmacy benefit managers (PBMs) are compensated and operate. Beginning January 1, 2027, the bill prohibits PBMs from receiving remuneration from entities for services related to prescription drug benefits, with a narrow exception for "bona fide service fees." These fees must be a flat dollar amount and cannot be based on drug prices, rebates, discounts, or other indirect compensation related to prescription drugs. A PBM can only charge a fee that represents the fair market value of a specific, itemized service that the entity would otherwise perform, and the fee cannot be passed on to customers. The bill defines PBMs broadly, including any entity that negotiates drug prices or manages prescription drug benefits for health plans. Violations of these rules can result in significant penalties, including mandatory disgorgement of improper payments and civil monetary penalties of $10,000 per day. The bill applies to group health plans and health insurance coverage, and it amends sections of the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code to implement these changes, with enforcement to be conducted by the Secretaries of Health and Human Services, Labor, and Treasury through interim final regulations.

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https://www.congress.gov/bill/119th-congress/house-bill/2214/all-info