PBM Act
- Bill Number
- H.R. 8779
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-05-13: Referred to the House Committee on the Judiciary.
- Last Updated
- 2026-06-18T17:49:15Z
AI-Generated Summary
Purpose The legislation aims to eliminate conflicts of interest in the pharmaceutical supply chain by prohibiting common ownership between pharmacy benefit managers (PBMs), health insurers, and pharmacies. It seeks to restore competition, lower prescription drug costs, protect independent pharmacies, and safeguard patients and taxpayers from practices that may increase prices or reduce access.
Key Provisions
- Ownership Prohibition: It is unlawful for any person to own, operate, or control both a pharmacy and either an insurance company or a PBM.
- Divestment Requirement: Entities violating the prohibition must divest their pharmacy operations within one year of enactment.
- Enforcement Mechanisms: The Federal Trade Commission (FTC) and the Department of Justice (DOJ) Antitrust Division share authority to enforce the rules, including issuing guidance on divestment milestones and imposing monthly profit transfers to escrow for noncompliance.
- Civil Actions: Authorized parties (including the HHS Inspector General, state attorneys general, and private individuals) may sue for violations, with remedies including treble damages, attorney fees, disgorgement of revenues, and orders to cease operations or divest.
- FTC and DOJ Oversight: Divestments must be reported under the Clayton Act; the agencies review effects on competition and may block actions that recreate conflicts of interest.
- Rulemaking and Reporting: The FTC must issue rules to implement the Act, and quarterly compliance reports are required to Congress.
- Definitions: The bill defines key terms such as "pharmacy" (including retail, mail-order, specialty, and hospital pharmacies) and "pharmacy benefit manager" (entities that negotiate drug prices, manage networks, and administer benefits for health plans).
Significant Changes to Existing Law This bill introduces new structural separation requirements not present in current antitrust statutes. It expands enforcement by creating a private right of action with treble damages and allowing state attorneys general to act as parens patriae. It also mandates divestiture timelines and profit escrows, and applies Clayton Act reporting without standard thresholds. The Act explicitly invokes Congress’s authority under the Commerce Clause to regulate interstate activities of national health conglomerates.
Potential Impacts
- Government Agencies: Increases responsibilities for the FTC, DOJ Antitrust Division, and HHS Inspector General in monitoring, reviewing, and enforcing divestitures and compliance.
- Citizens: May lead to greater pharmacy competition and potentially lower drug costs by reducing self-preferencing by integrated entities.
- No direct effects on international relations are addressed in the legislation.
Main Stakeholders Affected
- Vertically integrated health conglomerates that own PBMs, insurers, and pharmacies.
- Independent and unaffiliated pharmacies.
- Health plans and their enrollees.
- Patients and taxpayers.
- State attorneys general and federal enforcement agencies.
Notable Legal, Constitutional, or Political Implications The bill rests on Congress’s constitutional power to regulate interstate commerce. It includes a severability clause to preserve remaining provisions if any part is invalidated. Enhanced private enforcement and disgorgement remedies represent expansions of antitrust tools, with potential for increased litigation. The legislation also requires review of future transactions to prevent re-creation of ownership conflicts.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Harshbarger, Diana [R-TN-1]
Cosponsors (7)
Rep. Auchincloss, Jake [D-MA-4], Rep. Carter, Earl L. "Buddy" [R-GA-1], Rep. Landsman, Greg [D-OH-1], Rep. Nehls, Troy E. [R-TX-22], Rep. Nadler, Jerrold [D-NY-12], Rep. McCormick, Richard [R-GA-7], Rep. Deluzio, Christopher R. [D-PA-17]
Recent Actions
- 2026-05-13: Referred to the House Committee on the Judiciary.
- 2026-05-13: Introduced in House
- 2026-05-13: Introduced in House
Bill Versions
- Patients Before Monopolies Act — issued 2026-05-13 — PDF (14 pages)