Pharmacy Benefit Manager Transparency Act of 2025
Summary
What This Bill Does
The bill requires prohibition on unfair or deceptive prescription drug pricing practices by pharmacy benefit managers, including spread pricing, arbitrary clawbacks, and offsetting federal reimbursement changes, requires prohibition on reporting false or misleading information about pharmacy benefit management services to federal agencies, and requires annual transparency reporting requirements for PBMs on pricing spreads, fees, clawbacks, formulary changes, and affiliated pharmacy treatment; FTC and GAO reporting to Congress on PBM competition and market. It relies on compliance mandates, reporting requirements, liability protections, and exemptions. The main policy areas are Healthcare, Trade, and Finance.
Who Benefits and How
Independent pharmacies could gain revenue opportunities, Employees and contractors of PBMs, health plans, pharmacies, and manufacturers could face reduced risk, and State governments and regulators could face fewer barriers.
Who Bears the Burden and How
Pharmacy Benefit Managers would take on compliance duties and Federal Trade Commission would take on compliance duties.
Key Provisions
- Requires prohibition on unfair or deceptive prescription drug pricing practices by pharmacy benefit managers, including spread pricing, arbitrary clawbacks, and offsetting federal reimbursement changes.
- Requires prohibition on reporting false or misleading information about pharmacy benefit management services to federal agencies.
- Requires annual transparency reporting requirements for PBMs on pricing spreads, fees, clawbacks, formulary changes, and affiliated pharmacy treatment; FTC and GAO reporting to Congress on PBM competition and market...
- Requires whistleblower protections for employees and contractors who report violations of PBM transparency and pricing rules, including protection from retaliation and right to jury trial.
- Requires FTC enforcement authority over PBM violations as unfair/deceptive acts, with civil penalties up to $1M per violation per day, state attorney general enforcement power, and affirmative defense provisions.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
The bill requires prohibition on unfair or deceptive prescription drug pricing practices by pharmacy benefit managers, including spread pricing, arbitrary clawbacks, and offsetting federal reimbursement changes, requires prohibition on reporting false or misleading information about pharmacy benefit management services to federal agencies, and requires annual transparency reporting requirements for PBMs on pricing spreads, fees, clawbacks, formulary changes, and affiliated pharmacy treatment; FTC and GAO reporting to Congress on PBM competition and market.
Key Policy Areas
Healthcare, Trade, Finance
Primary Purpose
The bill requires prohibition on unfair or deceptive prescription drug pricing practices by pharmacy benefit managers, including spread pricing, arbitrary clawbacks, and offsetting federal reimbursement changes, requires prohibition on reporting false or misleading information about pharmacy benefit management services to federal agencies, and requires annual transparency reporting requirements for PBMs on pricing spreads, fees, clawbacks, formulary changes, and affiliated pharmacy treatment; FTC and GAO reporting to Congress on PBM competition and market.
Policy Domains
Whole bill
Identified Gains
- Independent pharmacies
- Employees and contractors of PBMs, health plans, pharmacies, and manufacturers
- State governments and regulators
- Patients and healthcare consumers
- Health plans and payers
Identified Costs
- Pharmacy Benefit Managers
- Federal Trade Commission
Sponsors
Legislative Progress
In CommitteeMr. Grassley (for himself, Ms. Cantwell, Ms. Ernst, Mr. Welch, …
Read twice and referred to the Committee on Commerce, Science, …
Introduced in Senate
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Pharmacy Benefit Managers
Federal Trade Commission, Federal agencies receiving PBM data, State attorneys general
Federal Trade Commission faces effects in multiple directions
Consumers and patients, Patients and healthcare consumers
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology