I 
118TH CONGRESS 
2D SESSION H. R. 10362 
To prohibit pharmacy benefit managers and pharmacies from being under 
common ownership, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 11, 2024 
Mrs. HARSHBARGER (for herself and Mr. AUCHINCLOSS) introduced the 
following bill; which was referred to the Committee on the Judiciary 
A BILL 
To prohibit pharmacy benefit managers and pharmacies from 
being under common ownership, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Patients Before Mo-
nopolies Act of 2024’’ or the ‘‘PBM Act of 2024’’. 
SEC. 2. PROHIBITIONS RELATING TO ANTICOMPETITIVE 
PHARMACY OWNERSHIP. 
(a) PROHIBITION ON PHARMACY OWNERSHIP BY EN-
TITIES PROVIDING INSURANCE OR PHARMACY BENEFIT 
MANAGEMENT SERVICES.— 
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(1) IN GENERAL.—It shall be unlawful for any 
person to both— 
(A) directly or indirectly own, operate, con-
trol, or direct the operation of the whole or any 
part of a pharmacy; and 
(B) directly or indirectly own, operate, or 
control the whole or any part of— 
(i) an insurance company; or 
(ii) a pharmacy benefit manager. 
(2) DIVESTMENT.—Not later than 3 years after 
the date of enactment of this Act, any person in vio-
lation of subsection (a) shall divest the pharmacy of 
such person. 
(b) CIVIL ACTIONS.— 
(1) IN GENERAL.—When the Inspector General 
of the Department of Health and Human Services, 
the Assistant Attorney General in charge of the 
Antitrust Division of the Department of Justice, the 
Federal Trade Commission, or an attorney general 
of a State has reason to believe that a person is in 
violation of subsection (a), such Inspector General, 
Assistant Attorney General, Federal Trade Commis-
sion or attorney general of a State may bring a civil 
action in an applicable district court of the United 
States for the relief described in paragraph (2). 
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(2) INJUNCTIVE AND EQUITABLE RELIEF.—In 
any action described in paragraph (1), the applicable 
court, on a finding that a person is in violation of 
subsection (a), shall issue an order requiring such 
person— 
(A) to cease and desist from such violation, 
and, if applicable, divest the pharmacy services 
of such person; and 
(B) to disgorge any revenue received from 
the pharmacy from the sale of prescription 
drugs during the period of such violation. 
(3) OTHER RELIEF.—In addition to any relief 
obtained under paragraph (2), the court may grant 
any other equitable relief necessary to redress and 
prevent recurrence of the violation. 
(4) DEPOSIT.—Any revenue received from the 
sale of prescription drugs disgorged pursuant to an 
action under this subsection shall be deposited in a 
fund created by the Federal Trade Commission and 
distributed by the Federal Trade Commission to be 
put to use in the interest of serving the health care 
needs of the harmed community, including con-
sumers overcharged at vertically integrated phar-
macies. 
(c) FTC REVIEW.— 
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(1) REPORTING REQUIRED.—Any divestment of 
a pharmacy or pharmacy benefit manager required 
under subsection (a) shall be reported to the Federal 
Trade Commission and the Assistant Attorney Gen-
eral in charge of the Antitrust Division of the De-
partment of Justice under section 7A of the Clayton 
Act (15 U.S.C. 18a) without respect to the thresh-
olds under subsection (a)(2) of that section. 
(2) TOLLING OF DIVESTMENT PERIOD DURING 
REVIEW.—The divestment period under subsection 
(a) shall be tolled during the pendency of any wait-
ing period required under section 7A of the Clayton 
Act (15 U.S.C. 18a). 
(3) REVIEW
OF
EFFECT
OF
DIVESTITURE.— 
With respect to each divestiture undertaken pursu-
ant to subsection (a), in addition to any applicable 
review under section 7A of the Clayton Act (15 
U.S.C. 18a), the Federal Trade Commission and the 
Assistant Attorney General in charge of the Anti-
trust Division of the Department of Justice shall re-
view the effect on competition, financial viability, 
and the public interest— 
(A) of the divestiture; and 
(B) of the subsequent acquisition of the di-
vested pharmacy by the acquiring person. 
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(d) RULEMAKING AUTHORITY.—The Federal Trade 
Commission shall promulgate rules to carry out this sec-
tion. Such rules shall not diminish any obligation under 
this section. 
(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to limit the authority of the Fed-
eral Trade Commission, the Inspector General of the De-
partment of Justice, the Department of Health and 
Human Services, or the attorney general of a State under 
any other provision of law. 
(f) DEFINITIONS.—In this section: 
(1) HEALTH PLAN.—The term ‘‘health plan’’ 
means any public or private health insurance plan. 
(2) PERSON.—The term ‘‘person’’ has the 
meaning given the term in section 8 of the Sherman 
Act (15 U.S.C. 7). 
(3) PHARMACY.— 
(A) IN GENERAL.—The term ‘‘pharmacy’’ 
means any person, business, or entity licensed, 
registered, or otherwise permitted by a State or 
a territory of the United States to dispense, de-
liver, or distribute a controlled substance, pre-
scription drug, or other medication— 
(i) to the general public; or 
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(ii) to a bed patient for immediate ad-
ministration. 
(B) INCLUSIONS.—The term ‘‘pharmacy’’ 
includes— 
(i) a mail-order pharmacy; 
(ii) a specialty pharmacy; 
(iii) a retail pharmacy; 
(iv) a nursing home pharmacy; 
(v) a long-term care pharmacy; 
(vi) a hospital pharmacy; 
(vii) an infusion or other outpatient 
treatment pharmacy; 
(viii) any organization the National 
Provider Identifier (NPI) registration of 
which has 1 or more taxonomy codes under 
the pharmacy section of the National Uni-
form Claim Committee (or a subsequent 
organization); and 
(ix) any other type of pharmacy. 
(4) PHARMACY BENEFIT MANAGER.—The term 
‘‘pharmacy benefit manager’’ means any person, 
business, or other entity, such as a third-party ad-
ministrator, regardless of whether such person, busi-
ness, or entity identifies itself as a pharmacy benefit 
manager, that, either directly or indirectly through 
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an intermediary (including an affiliate, subsidiary, 
or agent) or an arrangement with a third party— 
(A) acts as a negotiator of prices, rebates, 
fees, or discounts for prescription drugs on be-
half of a health plan or health plan sponsor; 
(B) contracts with pharmacies to create 
pharmacy networks and designs and manages 
such networks; or 
(C) manages or administers the prescrip-
tion drug benefits provided by a health plan, in-
cluding the processing and payment of claims 
for prescription drugs, arranging alternative ac-
cess to or funding for prescription drugs, the 
performance of utilization management services, 
including drug utilization review, the processing 
of drug prior authorization requests, the adju-
dication of appeals or grievances related to the 
prescription drug benefit, contracting with net-
work pharmacies, controlling the cost of covered 
prescription drugs, or the provision of related 
services. 
Æ 
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