I 
119TH CONGRESS 
1ST SESSION H. R. 6610 
To amend chapter 89 of title 5, United States Code, to limit the costs 
of pharmacy benefit managers with respect to Federal employee health 
benefit plans, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 11, 2025 
Mr. AUCHINCLOSS (for himself, Mr. COMER, Mrs. HARSHBARGER, Mr. CAR-
TER of Georgia, Mr. CISCOMANI, Mr. MOULTON, Mr. DELUZIO, Ms. 
TLAIB, Ms. BUDZINSKI, Mr. KRISHNAMOORTHI, Mr. KHANNA, Mr. 
COHEN, Ms. PRESSLEY, Mr. VICENTE GONZALEZ of Texas, Mr. MOORE 
of Alabama, Mr. SUBRAMANYAM, Mr. POCAN, Mr. BISHOP, and Ms. 
MCCOLLUM) introduced the following bill; which was referred to the Com-
mittee on Oversight and Government Reform 
A BILL 
To amend chapter 89 of title 5, United States Code, to 
limit the costs of pharmacy benefit managers with re-
spect to Federal employee health benefit plans, 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 ‘‘Pharmacists Fight 
Back [in Federal Employee Health Benefit Plans Act]’’. 
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SEC. 2. PHARMACY PAYMENT AND REIMBURSEMENT RE-
QUIREMENTS. 
(a) IN GENERAL.—Section 8904 of title 5, United 
States Code, is amended by adding at the end the fol-
lowing new subsection: 
‘‘(c)(1) The Office of Personnel Management may not 
contract for or approve a health benefits plan under sec-
tion 8903 of this title unless such plan— 
‘‘(A) requires any pharmacy benefits man-
ager administering prescription drug benefits 
on behalf of such health benefits plan, either di-
rectly or through an affiliate of such pharmacy 
benefits manager, to— 
‘‘(i) reimburse an in-network phar-
macy for the ingredient cost of a prescrip-
tion drug in an amount equal to the sum 
of— 
‘‘(I) the national average drug 
acquisition cost for the drug on the 
day of claim adjudication (or, in the 
case of a drug that does not appear 
on the national average drug acquisi-
tion cost index, the wholesale acquisi-
tion cost for such prescription drug); 
and 
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‘‘(II) the lesser of the amount 
that is equal to 4 percent of the 
amount described in subclause (I) or 
$50; 
‘‘(ii) pay an in-network pharmacy a 
professional dispensing fee that is equal to 
the professional dispensing fee paid by the 
State in which the pharmacy is located 
under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.) for dispensing a 
prescription drug; and 
‘‘(iii) for any manufacturer rebate 
such pharmacy benefits manager or affil-
iate thereof receives in connection with a 
drug obtained at an in-network pharmacy 
by an individual pursuant to such prescrip-
tion drug benefits, such pharmacy benefits 
manager or affiliate shall— 
‘‘(I) apply, at the point of sale of 
such drug, a reduction to the amount 
of any coinsurance or copayment owed 
by such individual with respect to 
such drug, such that the amount of 
coinsurance or copayment so owed is 
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calculated based on the net cost of the 
drug, including such rebate; and 
‘‘(II) remit to the carrier for 
such health benefits plan an amount 
equal to the amount of such rebate, 
less the amount by which the coinsur-
ance or copayment owed by such indi-
vidual with respect to such drug was 
reduced under subclause (I); 
‘‘(B) prohibits such pharmacy benefits 
manager and any affiliate thereof from— 
‘‘(i) directing, ordering, or requiring 
an individual enrolled in such health bene-
fits plan to use a specific pharmacy, in-
cluding a pharmacy that is an affiliate of 
such pharmacy benefits manager, for the 
purpose of filling a prescription for a pre-
scription drug or receiving services; 
‘‘(ii) advertising, marketing, or pro-
moting a specific pharmacy, including a 
pharmacy that is an affiliate of such phar-
macy benefits manager, over another in- 
network pharmacy; 
‘‘(iii) creating any network or engag-
ing in any practice, including accreditation 
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or credentialing standards, day supply lim-
itations, or delivery method limitations, 
that excludes an in-network pharmacy or 
restricts an in-network pharmacy from fill-
ing a prescription for a prescription drug 
for which benefits are available under such 
health benefits plan; 
‘‘(iv) directly or indirectly engaging in 
any practice that attempts to influence or 
induce a pharmaceutical manufacturer to 
limit the distribution of a prescription drug 
to a small number of pharmacies or certain 
types of pharmacies, or to restrict distribu-
tion of such drug to non-affiliate phar-
macies; or 
‘‘(v) requiring an individual enrolled 
in such health benefits plan to reimburse 
the pharmacy benefits manager or affiliate 
for the dispensing fee paid to an in-net-
work pharmacy pursuant to subparagraph 
(A)(ii) with respect to a prescription drug 
obtained at such pharmacy by such indi-
vidual, or otherwise increasing the amount 
owed by such individual with respect to 
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such drug to account for such dispensing 
fee; 
‘‘(C) prohibits any such pharmacy benefits 
manager from lowering, imposing a fee on, or 
otherwise make any adjustment to a prescrip-
tion drug claim at the time the claim for such 
drug is adjudicated or after the claim is adju-
dicated that reduces the amount a pharmacy is 
reimbursed for such drug pursuant to subpara-
graph (A), including by charging any fee to 
such pharmacy that is not associated with a 
prescription drug claim; and 
‘‘(D) requires the carrier providing such 
health benefits plan to cooperate with any in-
spection of such carrier carried out under sec-
tion 8902b(a)(3)(B) of this title, including by 
making available to the Office such documents, 
personnel, and facilities of the carrier as and 
when determined necessary to Office to carry 
out such inspection. 
‘‘(2) In this subsection: 
‘‘(A) The term ‘affiliate’ means an entity, in-
cluding a pharmacy, that directly or indirectly 
through one or more intermediaries— 
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‘‘(i) owns, in whole or in part, or controls 
a pharmacy benefits manager; 
‘‘(ii) is owned, in whole or in part, or con-
trolled by that is a pharmacy benefits manager; 
or 
‘‘(iii) is a subsidiary of or owned, in whole 
or in part, or controlled by an entity that owns 
or controls a pharmacy benefits manager. 
‘‘(B) The term ‘beneficiary’ means a person 
who receives prescription drug benefits under a 
health benefits plan. 
‘‘(C) The term ‘in-network pharmacy’ means a 
pharmacy that is licensed by the State board of 
pharmacy in the State in which such pharmacy is lo-
cated, that fills or seeks to fill a prescription for a 
prescription drug for a beneficiary, and is not barred 
from participating in the program under this chap-
ter under section 8902a. 
‘‘(D) The term ‘pharmacy benefits manager’ 
means a person, business entity, affiliate, or other 
entity that performs pharmacy benefits management 
services. 
‘‘(E) The term ‘pharmacy benefits management 
services’— 
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