This bill restricts how pharmacy benefit managers (PBMs)—companies that manage prescription drug benefits—can operate within the Federal Employee Health Benefits Program. The legislation requires PBMs to reimburse pharmacies based on actual drug acquisition costs plus a small markup or fee, match state Medicaid dispensing fees, and pass manufacturer rebates to patients at the point of sale rather than keeping them. The bill prohibits PBMs from directing patients to affiliated pharmacies, restricting which pharmacies can participate in networks, or engaging in practices that limit drug distribution. Federal agencies administering employee health plans cannot contract with PBMs that violate these rules. The bill establishes enforcement mechanisms including civil penalties up to $10,000 per violation (capped at $100,000 per PBM per carrier over 10 years) and debarment from federal contracts after 10 violations within a decade, with hearings and court appeals available. The bill takes effect one year after enactment and affects federal employee health insurance plans and the pharmacy benefit managers serving them.
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