The DRUG Act would regulate how pharmacy benefit managers (PBMs) are paid for managing prescription drug benefits, starting January 1, 2026. Beginning that date, PBMs would be prohibited from earning money based on drug prices, rebates, or discounts—instead they could only charge flat-fee amounts for actual services provided. The bill would also prevent PBMs from steering patients toward their own affiliated pharmacies through higher out-of-pocket costs, requiring different reimbursement rates, or retaliating against patients who use independent pharmacies. Violations would result in civil penalties of $10,000 per day, and PBMs would be required to return any illegal payments to insurance plans. The legislation applies to private health insurance, employer-sponsored plans, federal employee health plans, and Medicare Part D plans.
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