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This bill amends the Federal Employees Health Benefits Program to regulate pharmacy benefit managers (PBMs) administering prescription drug benefits. It requires PBMs to reimburse in-network pharmacies based on national average drug acquisition cost plus a capped markup, pay state Medicaid-level dispensing fees, and pass manufacturer rebates to beneficiaries at point of sale. The bill prohibits PBMs from directing patients to affiliated pharmacies, restricting pharmacy networks, or making post-adjudication claim adjustments that reduce pharmacy reimbursement, and establishes civil penalties up to $10,000 per violation for non-compliance.
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